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ORIGINAL ARTICLE
Year : 2015  |  Volume : 4  |  Issue : 4  |  Page : 230-233

Impact of educational intervention on knowledge regarding infant feeding practices among medical students at Mysore


Department of Community Medicine, JSS Medical College, Mysore, Karnataka, India

Date of Web Publication20-Oct-2015

Correspondence Address:
GS Vidya
Department of Community Medicine, JSS Medical College, Mysore - 570 015, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.167657

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  Abstract 

Background: Appropriate infant feeding practices is the cost-effective intervention to improve the growth among infants, and it directly contributes to a reduction in the infant morbidity and mortality. Objective: To assess the impact of the educational intervention on knowledge regarding infant feeding practices among medical students. Materials and Methods: This educational interventional study was conducted among 3rd year medical students of a medical college for a period of 3 months. The baseline survey was conducted using a pretested, structured, self-administered questionnaire to assess the knowledge regarding infant feeding practices after obtaining informed consent. This was followed by an educational session regarding correct infant feeding practices. Endline survey was conducted after 1 month using the same questionnaire to assess the impact of educational intervention. Results: The present study revealed that the educational intervention to be the most effective mode for improving the knowledge of medical students regarding infant feeding practices (baseline score vs. endline score: Median [interquartile range] was 21 [19–23] and 28 [24–30], respectively, Z = 7.80, P = 0.001). Conclusion: Educational intervention is an effective tool to influence the knowledge regarding infant feeding practices.

Keywords: Breast feeding, educational intervention, medical students


How to cite this article:
Vidya G, Renuka M, Praveen K, Shrinivasa B. Impact of educational intervention on knowledge regarding infant feeding practices among medical students at Mysore. Int J Health Allied Sci 2015;4:230-3

How to cite this URL:
Vidya G, Renuka M, Praveen K, Shrinivasa B. Impact of educational intervention on knowledge regarding infant feeding practices among medical students at Mysore. Int J Health Allied Sci [serial online] 2015 [cited 2020 Jan 20];4:230-3. Available from: http://www.ijhas.in/text.asp?2015/4/4/230/167657


  Introduction Top


Breast feeding has been important since the beginning of humanity. It is considered as the most economical and easily accessible complete nutrition for every newborn child. Although exclusive breast feeding is the best way to feed infants, it is not commonly practiced.[1]

Infant and young child nutrition is of utmost importance for the very simple reason that growth rate in life of human beings is maximum during the 1st year of life and infant feeding practices comprising both the breast feeding as well as complementary feeding have major role in determining the nutritional status of the child in future.

Scientific evidence reveals that malnutrition has been responsible directly or indirectly for 60% of all deaths among children under 5 years annually. Over two-third of these deaths are often associated with inappropriate feeding practices and occur during the 1st year of life.[2]

Medical professionals hold the responsibility of spreading evidence-based scientific practices for promoting correct infant feeding. The need to assess and improve the knowledge by educational intervention among the medical students pertaining to infant feeding practices is crucial as they are the future health care providers. In this context, the present study was carried out to meet this objective.


  Materials and Methods Top


An interventional study was conducted among 3rd year medical students in a medical college situated in Mysore for a period of 3 months. Third year students were selected for the study because this is a phase where they would have already been exposed to the various aspects of basic and clinical subjects which address the needs, advantages, and status of infant feeding practices. Thus, exploring their current knowledge on infant feeding practices and giving them adequate training on the same would help them in better interaction with expectant and lactating mothers once they enter into their full-time clinical postings.

A pretested, structured, self-administered questionnaire was developed to assess the knowledge regarding correct infant feeding practices. The questionnaire included 36 questions related to the initiation of breast feeding, prelacteal feeds, exclusive breast feeding, supplementary feeding, and practices pertaining to infant feeding. Each item in the questionnaire was assigned one mark.

After obtaining informed consent, a questionnaire was administered to assess the knowledge regarding correct infant feeding practices. Students present on the day of the study were included.

Intervention

Baseline evaluation was followed by an intervention i.e., educational session which included video presentations, power point presentations, and lectures on initiation and techniques of breast feeding, importance of exclusive breast feeding, weaning, complementary feeding, and interactive sessions by the faculties of the Department of Community Medicine. The educational sessions were carried out for the duration of 30 min/day over a period of 1 week. This was followed by an endline survey allowing a gap of a month's duration using the same questionnaire.

Variables and questionnaire

For the assessment of knowledge of respondents regarding infant feeding practices, a grading system was obtained based on the scores obtained. Each of the 36 questions was assigned a score. The maximum score obtained was 36 and minimum was 0. The score grading was as follows,

  • 0–9 = 1 poor
  • 10–18 = 2 good
  • 19–27 = 3 satisfactory
  • 28–36 = 4 excellent.
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    The data entry and analysis were done using SPSS version 16.0. Statistical methods employed included Chi-square test and Wilcoxon sign rank test. P value of <0.05 was considered as significant.


      Results Top


    A total of 110 medical students participated in the study. It was observed that the mean age of the students was 21.6 (±1.015) years, and 56% of them were females.

    [Table 1] shows the distribution of respondents, who gave correct responses in baseline and endline survey. There was a significant improvement in the knowledge pertaining to infant feeding practices from baseline to endline survey for 17 out of 36 questions.
    Table 1: Distribution of study subjects who gave correct responses in baseline and endline survey

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    During baseline survey, 84.5% perceived that exclusive breast feeding should be given until 6 months, and the correct response rate significantly increased to 97% following an educational intervention. In baseline survey, 70% of the respondents felt that breast feeding should be on demand (frequency of breast feeding) and there was significant improvement rate in the correct response rate in endline survey to 86%. Before the educational intervention, 21.8% correctly felt that bottle feeding and pacifiers should not be recommended when the breast milk is inadequate and it increased to 50.5% following intervention.

    As per baseline survey, the median knowledge score regarding infant feeding practices among medical students was 21.0. Following educational intervention, the median score was found to be 28.0. This difference between baseline and endline scores were found to be statistically significant (Z = 7.80, P < 0.001) [Table 2].
    Table 2: Comparison between maximum scores of respondent's knowledge on infant feeding practices in baseline and endline survey

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    It was observed in the present study that respondents among excellent knowledge category (28–36 correct responses) increased from 1.9% to 98.1% following educational intervention, and the improvement was statistically significant (χ²: 74.13, df: 2, P = 0.001) [Table 3].
    Table 3: Association between scores attained in baseline and endline survey on infant feeding practices following educational interventional program

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      Discussion Top


    Breast feeding is an age old art and science in child rearing which holds its significance even today. It is an unequaled way of providing ideal food for the healthy growth and development of infants; also an integral part of the reproductive process with important implications for the health of mothers.[3] Despite the marked advantages of breast feeding, its popularity has declined significantly in many parts of the world.

    Art and science of breast feeding depend on the quality of education of the mother. Medical professionals play an important role in providing behavior change communication to mothers.

    The present study has clearly shown that baseline knowledge with respect to many parameters was poor to good, and educational intervention definitely made a surge in their knowledge.

    Review of evidence has shown that, on a population basis, exclusive breast feeding for 6 months is the optimal way of feeding infant.[3] The present study showed that correct response rate significantly improved by 13% following intervention.

    Similarly, knowledge regarding the duration of breast feeding and correct positioning improved by 50% and 40%, respectively.

    A study conducted by Hillenbrand and Larsen [4] among pediatric and medicine-pediatric residents in training with the University Health Systems of Eastern Carolina to assess the effect of educational intervention about breast feeding on the knowledge, confidence, and behaviors of pediatric resident physicians showed that, mean knowledge scores increased from 69% before the intervention to 80% after the intervention. Before the intervention, residents performed an acceptable number of behaviors 22% of the time, while after the intervention their performance was acceptable 65% of the time. Particular behaviors that showed significant improvement after the intervention included discussing signs of breast feeding adequacy with the mother and correct management of lactation problems.

    A cross-sectional survey of medical students from 1st year to final year at a private medical college conducted at Ziauddin by Anjum et al.[5] to assess knowledge regarding breast feeding practices revealed that only 54% from clinical group and 33% from preclinical group were aware that nothing is required except breast feeding for initial few months of life (P < 0.001). Approximately, half (51%) from preclinical group and 70% from clinical group knew that breast feeding should be continued up to 2 years of age. One-third (33%) from preclinical group and 69% from the clinical group stated that breast feeding reduces the chances of a subsequent pregnancy (P < 0.001). The overall knowledge of medical students was low while the clinical year students had better knowledge as compared to the preclinical students. A cross-sectional study was conducted in Manipur, India, by Devi et al.[6] to assess the knowledge regarding breast feeding among medical students (n = 468) by administering a questionnaire which contained 22 knowledge-based questions. Each of the questions was assigned a score. The score obtained out of 30 was calculated for each respondent and were then graded as having below average (0–15), 16–20 (average), and 21–30 (above average). Average and above average score was considered as adequate and below average score was considered as inadequate knowledge. The results showed that knowledge level of the students were below average in 253 (54.0%), average in 108 (23.1%), and above average in 107 (22.9%) of them.


      Conclusion Top


    Educational intervention is an effective tool to improve the knowledge regarding infant feeding practices. Regular sessions should be held in medical colleges to remove the misconceptions among medical students regarding the same as they are the future health care providers and can be the immediate infant feeding counselors.

    Acknowledgments

    Authors thank Dr. Kavitha Yadav, Dr. Gojula Gouthami, and Dr. Vidyalaxmi (Lecturer in Statistics) for their support and help. We also thank all the study participants for their cooperation in the conduct of this study.

    Financial support and sponsorship

    Nil.

    Conflicts of interest

    There are no conflicts of interest.

     
      References Top

    1.
    Innocenti Declaration. On the Protection, Promotion and Support of Breastfeeding; 1990. Available from: . [Last accessed on 2007 Jul 26; Last cited on 2007 Apr 04].  Back to cited text no. 1
        
    2.
    National Guidelines on Infant and Young Child Feeding. Ministry of Human Resource Development. Department of Women and Child development. Govt. of India; 2004. Available from: Last accessed on 2014 Feb 05; Last cited on 2014 Jan 15].  Back to cited text no. 2
        
    3.
    Exclusive Breastfeeding; 2011. Available from: . [Last accessed on 2014 Feb 05; Last cited on 2014 Jan 15].  Back to cited text no. 3
        
    4.
    Hillenbrand KM, Larsen PG. Effect of an educational intervention about breastfeeding on the knowledge, confidence, and behaviors of pediatric resident physicians. Pediatrics 2002;110:e59.  Back to cited text no. 4
        
    5.
    Anjum Q, Ashfaq T, Siddiqui H. Knowledge regarding breastfeeding practices among medical students of Ziauddin University Karachi. J Pak Med Assoc 2007;57:480-3.  Back to cited text no. 5
        
    6.
    Devi HS, Avinash K, Vijaya E, Sourab P, Singh TA. Knowledge of breastfeeding among medical students in Manipur, India. 2013;2.  Back to cited text no. 6
        



     
     
        Tables

      [Table 1], [Table 2], [Table 3]


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