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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 15  |  Issue : 1  |  Page : 58-60

Effect of live demonstration on practices of ANM regarding identification and management of mothers for puerperal infection during postnatal period


1 Department of Community Health Nursing, Bharati Vidyapeeth College of Nursing, Symbiosis College of Nursing, Symbiosis International (Deemed University), Pune, India
2 Department of community health nursing Bharati Vidyapeeth College of Nursing, Pune, India

Date of Submission04-Feb-2020
Date of Acceptance01-Apr-2020
Date of Web Publication13-Oct-2020

Correspondence Address:
Prof. Jasneet Kaur
Plot No. A 206, Sunwind Society, Near Toyota Showroom, Bavdhan, Pune - 411 021, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_36_20

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  Abstract 


Introduction: Puerperal sepsis is an infective condition in the mother following childbirth. It is the third most common cause of maternal death worldwide as a result of childbirth after hemorrhage and abortion. According to the World Health Organization estimates, puerperal sepsis accounts for 15% of the 500,000 maternal deaths annually. In low- and middle-income countries, puerperal infections are the sixth leading cause of disease burden in women during their reproductive years. Puerperal sepsis can cause long-term health problems such as chronic pelvic inflammatory disease and infertility in females. Objective: The main objective of the study was to determine the effect of demonstration on practices of Auxillary Nurse Midwives (ANMs) regarding identification and management of mothers for puerperal infection during postnatal period. Materials and Methods: A quasi-experimental design was adopted to implement live demonstration on 60 ANMs. The samples were selected by convenience sampling technique. A checklist was used to assess the practices of ANM identification and management of high-risk mothers for secondary postpartum hemorrhage during postnatal period. Results: The average pretest knowledge mean in the experimental group was 68.7, which increased to 134.1 in posttest. T-value for this test was 80 with 103 degrees of freedom. Corresponding P value was small (<0.05); null hypothesis is rejected. It is evident that the live demonstration is significantly effective in improving the knowledge of ANMs regarding identification and management of mothers for puerperal infection during postnatal period.

Keywords: High-risk mothers, live demonstration, postnatal period, puerperal infection


How to cite this article:
Kaur J, Ray S. Effect of live demonstration on practices of ANM regarding identification and management of mothers for puerperal infection during postnatal period. J Datta Meghe Inst Med Sci Univ 2020;15:58-60

How to cite this URL:
Kaur J, Ray S. Effect of live demonstration on practices of ANM regarding identification and management of mothers for puerperal infection during postnatal period. J Datta Meghe Inst Med Sci Univ [serial online] 2020 [cited 2020 Oct 28];15:58-60. Available from: http://www.journaldmims.com/text.asp?2020/15/1/58/297986




  Introduction Top


Puerperal sepsis is an infective condition in the mother following childbirth. It is the third most common cause of maternal death worldwide as a result of childbirth after hemorrhage and abortion. According to the World Health Organization estimates, puerperal sepsis accounts for 15% of the 500,000 maternal deaths annually. In low- and middle-income countries, puerperal infections are the sixth leading cause of disease burden in women during their reproductive years. Puerperal sepsis can cause long-term health problems such as chronic pelvic inflammatory disease and infertility in females.[1]

Maternal mortality ratio of nation has decreased from 167 to 130 that showed there is overall 22% reduction.[3] Web tracking system, compulsory antenatal visits, name based tracking of pregnant women and children has been initiated by government of India as a policy decision to track every pregnant woman and infant by name for provision of timely antenatal care. Also the institutional deliveries are available at all health centres and made compulsory.[2] The active measures are definitely support the reduction in maternal mortality rate, but no special measures are available for postnatal period except the postnatal visits by nursing health task force.

The identification and initial management of high risk mother during the postnatal period totally depends on the knowledge and the skillful practices to apply that knowledge.

Purpose of the study

In India, the hypertensive disorders of pregnancy and postpartum hemorrhage (PPH) are responsible for nearly 40% of all maternal deaths. Most of these deaths occur in primary health settings which frequently lack essential equipment and medication, are understaffed, and have limited or no access to specialist care.[4] Community health-care workers are regarded as essential providers of basic maternity care; the quality of care they provide is dependent on the level of knowledge and skills they possess. Maternal mortality is a huge public health issue where the causes range from excessive blood loss (PPH) to puerperal infections. NFHS-4 (2016-17) reported a small (9%) reduction in anemia among pregnant women, but a rare reduction in postnatal complications. Almost 50% of maternal deaths go unreported; as much as 61% of maternal death is due to PPH and puerperal infections.[5] Hence, ground-level workers should possess knowledge and adequate skills to how to identify and manage the postnatal complications, especially puerperal infections.

Objectives

  1. To assess the pretest practices of ANMs on identification and management of mothers during postnatal period for puerperal infection in both experimental and control groups before live demonstration
  2. To assess the posttest practices of ANMs on identification and management of mothers during postnatal period for puerperal infection in both experimental and control groups after live demonstration
  3. To determine the effectiveness of live demonstration on practices of ANMs on identification and management of mothers during postnatal period for puerperal infection in the experimental group
  4. To determine the association between practices of ANMs with selected demographic variable.



  Materials and Methods Top


Design

The research design selected for the study was a quasi–experimental, nonequivalent control group design.

Setting

Setting of the research study was selected areas of Pune district.

Target population

Target population for the present research was ANMs working in rural area under Zila Parishad, Pune.

Tool

A checklist was developed to observe practices of ANMs on identification and management of high-risk mothers during postnatal period for puerperal infection.

Procedure for data collection

  • Approval from the ethics committee was obtained
  • Organizational permission from the district health office of Pune district was accorded
  • The administration approval was taken to club the ANMs, at one center for feasibility of the training
  • Informed consent was taken from the participants
  • The data were collected in the form of checklist developed to assess the practices
  • There were two groups: experimental and control groups. The live demonstration was given to the experimental group
  • The posttest was taken after the gap of 2 weeks.



  Results Top


Section 1: Demographic characteristics were calculated by percentage where maximum ANMs were in the age group of more than 41 years. Maximum of them (82%) were working in subcenters and were residential nurses. Maximum (73%) were having experience of more than 10 years [Figure 1].
Figure 1:Pretest practices of ANMs on identification and management of mothers during postnatal period for puerperal infection in both experimental and control groups

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Section 2: Analysis of data related to the pretest practices of ANMs on identification and management of mothers during postnatal period for puerperal infection in both experimental and control groups – In pretest, in the experimental group, 82.7% of the ANMs had poor practices and 17.3% [Figure 2] of them had average practices regarding identification and management of mothers during postnatal period for puerperal infection. In the control group, 84.4% of the ANMs had poor practices and 15.6% of them had average practices regarding identification and management of mothers during postnatal period for puerperal infection.
Figure 2:Posttest practices of ANMs on identification and management of mothers during postnatal period for puerperal infection in both experimental and control groups

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Section 3: Posttest practices of ANMs on identification and management of mothers during postnatal period for puerperal infection in both experimental and control groups – In posttest, in the experimental group, 80% of the ANMs have average practices and 20% have good practices regarding identification and management of mothers with puerperal infection during postnatal period. In the control group, 74% of the ANM force had poor practices and 26.% of them had average practices regarding identification and management of mothers with puerperal infection during postnatal period.

Section 4: Effectiveness of live demonstration on practices of ANMs on identification and management of high-risk mothers during postnatal period for PPH in the experimental group [Table 1] – Average practice score in pretest was 68.7, which increased to 134.1 in posttest. T-value for this test was 80 with 103 degrees of freedom. Corresponding P value was small (<0.05); null hypothesis is rejected. It is evident that the live demonstration is significantly effective in improving the practices of ANMs regarding identification and management of high-risk mothers during postnatal period for puerperal infection in the experimental group.
Table 1: Effectiveness of live demonstration on practices of auxiliary nurse midwives

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Section 5: Association of practices of ANMs with selected demographic variable – None of the demographic variables was found to have significant association with the practices of ANMs regarding identification and management of high-risk mothers during postnatal period for PPH.


  Conclusion Top


The present study emphasized on the live demonstration on identification and management of high-risk mothers during postnatal period for puerperal infection. Specifically, it has been examined whether this technique really effective in improving the practices or not. The findings indicated that live demonstration is having a positive effect in improving the practices regarding identification and management of high-risk mothers during postnatal period for puerperal infection.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. World Health Statistics. Geneva, Switzerland: World Health Organization; 2014. Available from: http://www.who.int/gho/publications/world_health_statistics/2014/en/. [Last retrieved on 2015 Apr 10].  Back to cited text no. 1
    
2.
World Health Organization. Maternal Death Surveillance and Response: Technical Guidance. Information for Action to Prevent Maternal Death. Geneva, Switzerland: World Health Organization; 2013b. Available from: http://www.who.int/maternal_child_adolescent/documents/maternal_deathsurveillance/en/. [Last accessed on 06 Jan 2020].  Back to cited text no. 2
    
3.
Registrar General of India. Sample registration system. SRS Bull 2000;33:1-8.  Back to cited text no. 3
    
4.
Ministry of Health and Family Welfare- Government of India. National Rural Health Mission (2005–12): Mission Document. New Delhi: Ministry of Health and Family Welfare- Government of India; 2005.  Back to cited text no. 4
    
5.
Registrar General of India. Annual Health Survey Bulletin 2014–15. Maharashtra, New Delhi: Office of the Registrar General and Census Commissioner, India; 2011.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1]



 

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