JIWAJI UNIVERSITY, GWALIOR, M.P.

PROFORMA FOR REGISTRATION OF SUBJECT FOR

DESERTATION

1. NAME OF THE Candidate : SHRADDHA GANDHI

AND ADDRESS M.SC. NURSING PREVIOUS
RSC COLLEGE OF NURSING,

2. COURSE OF STUDY SUBJECT : M.Sc. Nursing

(Obstetrics and Gyn. Nursing).

3. DATE OF ADMISSION : 25/09/2008

4. TITLE OF THE TOPIC : “A DESCRIPTIVE STUDY TO ASSESS

THE VARIOUS INFLUENCING FACTORS
ATTITUDE AND HEALTH SEEKING
BEHAVIOR IN UTILIZATION OF HEALTH
SERVICES RENDERED IN RURAL PHC
ANTRI AMONG WOMEN OF GWALIOR
(M.P.) 2008-10
5. INTRODUCTION:

India has a good heritage of heath care practice, health tradition and health
care technology. In India, we are practicing various indigenous system of
medicine. We believe that these system of medicine. All human life on the planet
is born of women. A woman is an important person for her children and her family.
A woman has been changed with the responsibility of maintenance and health.
Women and health care system addresses the importance of the most prevalent
health problem-affecting women. The women’s health and her participation in the
delivery of services have a direct bearing in achieving the economic target set by
the various countries.

For the majority of women around the world pregnancy and child birth are normal
healthy and often happy experience.

IN INDIA:

• 65% of deliveries occur at home

• Only 41% of women have a skilled birth attendant at the time of delivery
• 60% of all maternal deaths occur after delivery but only in six women
receive postnatal care (white Ribbon Alliance).

Over 1, 50,000 maternal deaths take place every year in India.

Maternal morbidity has damaging effect on women, their children and their
families.

Both antenatal care and delivery services in India are inadequate According to the
National Family Health survey (NFHS, 1992-1993), in the last 4 years, 37% of
mothers did not receive any ANC, either at home or elsewhere. Only 54% received
two doses of T.T. and 51% received iron and folic acid tablets. 74% of deliveries
took place at home. A doctor/nurse or midwife attended only 34% of deliveries.
Data from other sources indicate that about 50% of the women who died from
maternal causes were transported to a PHC or hospital. Many women who had
developed complications could not take to hospital because transportation was
either not available or unaffordable. These findings highlight the importance of
prompt and appropriate referral and efficient transportation in reducing maternal
deaths.

NEED FOR STUDY:

In India, through the birth rate has come down and immunization coverage
has improved, yet the persistent high maternal morbidity and mortality shows that
the maternal health component of the RCH programme hasn’t succeeded. The
government of India should not jump to the second phase of the programme
without understanding what has gone wrong in the first phase.

The women’s health scenario is even worse in the State of Madhya Pradesh.
Madhya Pradesh has the second largest state in area and sustains seventh largest
population of India. This state’s health status is amongst the poorest in the country,
with women and children being the most affected. Rural, urban and regional
imbalances are significant.

The antenatal health services provided in Gwalior is about 34.7% and postnatal
services 27.6% and at home visit 3.8% and T.T.8.4%which is inadequate as per
requirement of ministry of health and family welfare service.
So, the researcher felt the need to assess MCH services rendered in rural PHC
Gwalior

REVIEW OF LITERATURE:

 Mr. ERLINDAWATI, J.CCHOMPIKUL, Conducted a study to assess factor

related to the utilization of antenatal services among pregnant women. At
health center, Indonesia, A study was conducted in 2008; cluster sampling
was used to select 160 pregnant women in third trimester. The researchers
and for trained interviewers were interested for data collection by using
structured questionnaire. Their were 63.13 % of pregnant women who had
adequate utilization and 36.82% who had inadequate utilization of antenatal
care services.

 Mr. C.K. Joshi, A.BHARDWAJ at Bikaner. A study was conducted at

Bikaner 2006 a study to assess the evaluation of MCH services .there was
scantly utilization of MCH services. In rural area 12.15% the expectant
mother revised antenatal care, 95.81 of estimated child birth did not receive
assistance from trained personnel only, 3.27% of the delivers were
conducted at home by trained health staff. Immunization services provided
to Expected mother and children were deficient only 24.46% expectant
mother attending antenatal clinic were given two doses of tetanus toxied and
10.97%of the children were protected by polio vaccine and triple antigen.
There services were not fully utilized due to various resources including
maldistribution of facilities and lack of felt need in the country. Thus there is
a need of much more implementation of MCH services to the antenatal
Mother.

 Alam A Yetal conducted comparative study in 2005 of knowledge attitude

and practices among antenatal care facilities utilizing and non utilizing
women. The finding indicates paller was significant by lower among women
utilizing antenatal care (57%) as compared to those who were not (77.6%)
(Odds ratio 0.38-95%) confidence intervals (0.18 -0.81) p value 0.02)
 Tetanus toxoid coverage was higher among women utilizing antenatal care
92% compared to those who were not important 59.2% having knowledge
about danger signals in Pregnancy and realization of the importance of
eating a healthy diet during Pregnancy was significantly higher among
women utilizing antenatal care. Lesser prevalence of anemia better tetanus
toxied coverage was seen among women attending antenatal care.
Identification of danger signals in pregnancy and recognition of nutritional
demands of pregnancy are better understood by women utilizing antenatal
care facilities.

 Dr. Than Thun Sein at myarmal in 2005 a study conducted for performance
in midwives in a rural area. The study was a cross sectional survey in plain
and hilly area. A total of 490 pregnant women and 29 midwives were
included in the study population. The method of data collection for each
included knowledge of midwives obtained through administration of written
questionair resources availability through observation using a check list
through interview conducted face to face approximately 30 days were spent.
Result and conclusion obtain knowledge scares of 70% and above indicating
the knowledge of antenatal mother. So investigator thing that antenatal care
require for hilly and plain areas.

PROBLEM STATEMENT:
“A DESCRIPTIVE STUDY TO ASSESS THE VARIOUS
INFLUENCING FACTORS ATTITUDEAND HEALTH SEEKING
BEHAVIOR IN UTILIZATION OF HEALTH SERVICES
RENDERED IN RURAL PHC ANTRI AMONG WOMEN OF
GWALIOR (M.P.) 2008-10

OBJECTIVES:
1. To assess the various influencing factors among women in utilization of
PHC health services.
2. To assess the attitude of women in utilization of PHC health services.
3. To assess the Health seeking behavior of women in utilization of PHC health
services.
4. To correlate the various influencing factors and Health seeking behaviour
Of women in utilization of PHC health services
5. To correlate the attitude and Health seeking behaviour of women in
utilization of PHC health services
6 To associate Health seeking behavior of women with selected demographic
variables

OPERATIONAL DEFINITION OF TERMS:

1) FACTORS:- It refers to major elements in the study such as

A) Social factor which including
i) Belief and superstitions
ii) Customs and tradition
iii) Women’s autonomy

B) Economic factors

C) Physical factors

D) Quality of services provided by health

care personnel

2) HEALTH SEEKING BEHAVIOR: - The way women try to find out the
means in taking Care of their
health.

3) Attitude ref er’s to ability to state the opinion or

feeling regarding the utilization of health
services as elicited by a two point scale
desigened by investigater.

4) PHC: - Reefer’s to first level of primary health care given to the women
mother by health worker.
5) WOMEN;-refers to the women in reproductive group of 15-45 year and
residing in and around the villages in the six km radius from
primary health center
6) health services;-refers to a set of searvices rendered to preserve and promote the
reproductive health by preventing and treating health hazareds.

HYPOTHESIS:

H1 there will be a significant relationship between various influencing factors and

health seeking behavior of women
H2 there will be significant relationship between the attitude and health seeking
behavior of women
H3 there would be a significant association of health seeking behaviour of women
with selected demographical variable

RESEARCH VARIABLE:

INDEPENDENT VARIABLE: In this study demographic variable are like age, sex,
family background, beliefs.

DEPENDENT VARIABLE: This study will be dependant on factors affecting and,

attitude health seeking behavior in women

ASSUMPTION: This study assumes that: The researcher believes-

1. The various factors like physical factor, social factor, and economical factor

may influence the health seeking behaviour of antenatal mother.

2. Positive attitude promotes the utilization of health services

DELIMITATION:
The study is delimited to a period of 4weeks

LIMITATION:
The study will be limited to selected rural PHC of Gwalior.

MATERIALS & METHODS:

Sources of Data:
Women in selected PHC Gwalior

Method of Collection Data:

The investigator personally will collect data using interview techniques.

Population:
Population refers woman reproductive age between 15 - 45 years.

Sample
Women in the age group of 15-45 year residingin antri form the sampel of this
study
Sample size:
The sample of the study consists of 100 women.
Sample Technique:
Non- probable convenient sampling technique will be used.

Research Approach:
Non – experimental descriptive correlation design.

Research Design:
Non – experimental descriptive correlation design

Research Setting
The Research setting will be selected at rural PHC Gwalior M.P.

Sample Criteria:

a) Inclusive Criteria
1. Women who are willing to participate in this study.

2. Women whose age is 15 to 45 years will be participate in this study.

3. Who are able to communicate in Hindi, English and local language.

b) Exclusive Criteria
- Who are not willing to participate in this study and not available during the
collection of data.
- Women who are utilized services other than PHC services.

Data Collection Tool: The tool consists of structured questionnaire.

Section A:
Part-1 deal with the demographic variables.

Section B
Structuered questionnaire to assess the influencing factoer,health seeking
behaviouer and attitude by two point rating scale.

Plan of Analysis Data: The Data will be analyzed by descriptive statistics like
mean, mode, median, percentage, standard deviation will be used.

Inferential Statistics: - Correlation, Chi-Squire methods will be used.

Does the study require any investigation or intervention to be conducted on patient

or other human or animals?
 No, not required any investigation or intervention to be conducted on patient
or other human or animals.

Has Ethical clearance being obtained from your institution in case of Methods
and materials.

Yes- the ethical clearance will be sought from the research committee of
⇒ Written permission will be obtained from PHC authorities.

⇒ Written consent will be obtained from antenatal mothers.

⇒ The identity of the antenatal Mothers will be kept confidential.

⇒ Scientific objectivity of the study will be maintained with honesty and

impartiality

BIBLIOGRAPHY

1. Basavanthappa, “Community health nursing”, Banglore, Japyee

publication. 1st Ed., 1998, pg175.

2. Alam A.Y., et.al. “Comparative study of knowledge, attitude and practices

among antenatal care facilities utilizing women.” journal of Pakistan
medical association, Feb-2005., vol-55., no-2., pg-53-56.

3. Joshi, E.K., et.al. “A Evaluation of MCH Sevices in Bikaner”., Indian

Medical Association. Mar-2006., vol-57., no-3., pg-65-66.

4. Mahajan, B.K., Text Book of Preventive and Social Medicine. 3rd Ed.,
Jaypee publication, pg-524-30.

5. Polit & Hungler, Text Book of Nursing Research and Principles, 5th Ed.,
Lippincott Publication.

Web SITE:-
www. medline.com
www. indian medical association.com
www. who.com.
www. indian journal of community medicine.com