Student Dissertation

Agency : ASHA; IYCF; Young Child Feeding; NHM

Objective : Primary Objective: To study the knowledge and selected practices of ASHAs in Gir Somnath district regarding IYCF practices. Secondary Objective: To study the association between knowledge and selected variables.

Background : The optimal infant and young child feeding practices during the first 2 years of life is of paramount importance as this period is the “critical window” for the promotion of health, good growth, behavioural and cognitive development. Optimal infant and young child feeding practices include initiation of breast-feeding within 1 hour of birth, exclusive breast-feeding for the first 6 months, and continuation of breast-feeding for 2 years or more, along with nutritionally adequate, safe, age appropriate, responsive complementary feeding starting at 6 months.

Methodology : Study Design: - Descriptive study with Cross-sectional design Study Area: - District Gir Somnath, Gujarat. Study Duration: - Three months (6th February 2016 to 6th May 2016). Study population: - Accredited Social Health Activist (ASHAs) of Gir Somnath district of Gujarat. Sampling technique: Convenience Sampling. The ASHAs from two blocks, namely Veraval and Talala who had come for ASHA meeting purpose in the district headquarters were included. Sample size: The sample size taken for the study is 130 Data collection Technique: The investigator met with ASHA workers those who attended the ASHA meeting at the district headquarters. Data collection Tool: A semi-structured interview schedule was used as a tool for data collection. It had two parts: Basic information and Knowledge and selected practices of ASHAs regarding Infant and Young Child Feeding practices. Data Analysis: After the collection, the data was entered in SPSS. Most of the data analysis was done on SPSS. However, Microsoft excel was also used for analysis. Frequencies were calculated, and graphs were prepared. Chi square test was used to find out the association between knowledge and selected variables.

Findings : All ASHAs know about meaning of exclusive breastfeeding, period of exclusive breastfeeding-six months, initiation of breastfeeding-within an hour after normal delivery, Colostrum and its importance, should be given to the baby and not discarded away, the pre-lacteal feeds like honey, jaggery or sugar should not be given, and Water also should not be given. The introduction of the complementary feeding should be done at the age of 6 months was known to all the ASHAs. All the ASHAs were aware of the consistency of food to be semi solid. All the ASHAs knew that the complementary feeding should be given through bowls and spoons as containers and bottles should not be used for the same. There is a significant relationship between training and advantages of breastfeeding in children and mother. ASHAs have knowledge about practices and promote the IYCF practices in the community.

Recommendations : Rationale: ASHAs represent the cornerstone of the strategy of NRHM and are expected to spread awareness on health and its determinants and also sensitize the community towards better health practices. Gir Somnath district has high number of home deliveries. Gir Somnath district has high number of malnourished children which is a major outcome of improper feeding practices. This district also shows high number of infant deaths, the reasons majorly being low birth weight and malnourishment. It is necessary to know whether the health activists, the ones which are directly in contact with the population are well aware of the feeding practices and promoting the same to reduce the malnourishment amongst the children. An assessment of their knowledge regarding IYCF, which has been attempted in the present study, would help us identify the gaps in their knowledge as well as the gaps in the translation of knowledge to practice. Because in order to improve on the above indicators it is necessary for the IYCF practices to improve and thus it is necessary first to gauge the knowledge of ASHAs. Research Question: What is the status of knowledge in ASHAs of Gir Somnath district of Gujarat with regards to the Infant and Young Child Feeding practices?

The overall basic knowledge of ASHAs regarding IYCF practices is very good in the Gir Somnath district of Gujarat. Majority of the ASHAs do not have complete knowledge of advantages of breastfeeding to mothers and children. Only two percent of the ASHAs included in the study are aware of more than three advantages and have full knowledge of IYCF practices. ASHAs practice level of promotion of IYCF practices is satisfactory. Training is an important variable and shows increase in the knowledge level with completion of training. Training is associated with the knowledge level in ASHAs