A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge and Attitude Regarding the Importance of Institutional Delivery Among Women in a Selected Community Area of Bareilly, U.P.

Institutional delivery refers to childbirth that takes place in a health facility where skilled health personnel can provide care during labour, delivery and the immediate postnatal period. Skilled attendance and timely access to appropriate care are important components of strategies to prevent avoidable maternal and newborn illness and death. The World Health Organization has emphasized the need for quality maternal health services and action to end preventable maternal mortality [1].

Pregnancy and childbirth are normal life events, but complications such as haemorrhage, hypertensive disorders, infection and obstructed labour may develop unexpectedly. Facility-based delivery can improve the opportunity for early recognition, referral and management of such complications. Preventive and social medicine literature also emphasizes the importance of maternal health services, antenatal care and skilled attendance during childbirth [2].

Birth preparedness and complication readiness involve planning the place of delivery, arranging transport and support, recognizing danger signs and knowing where to seek skilled care. Studies from India and other settings have examined birth preparedness, complication readiness and factors related to the use of institutional delivery services [3,4]. Access to services may also be influenced by distance, socioeconomic circumstances, education and availability of transport [5].

In India, public programmes such as Janani Suraksha Yojana were introduced to promote institutional delivery, particularly among eligible pregnant women, and to improve access to maternity services [6]. National survey data are commonly used to monitor maternal and child health indicators and patterns of facility-based childbirth [7]. However, the availability of programmes alone may not ensure that all women understand the benefits of institutional delivery or feel prepared to use these services.

Community health education is one way to explain the benefits of skilled delivery care, the possible risks of unassisted home delivery, the importance of planning for emergencies and the services available at health facilities. The present study therefore assessed women’s knowledge and attitude regarding the importance of institutional delivery and examined changes following a structured teaching programme in a selected community area of Bareilly, Uttar Pradesh.

Objective:

1. To assess the level of knowledge and attitude regarding the importance of institutional delivery among women.

2. To evaluate the effectiveness of a structured teaching programme on knowledge and attitude regarding the importance of institutional delivery among women.

3. To determine the association between pre-test knowledge and attitude scores and selected socio-demographic variables.

Hypotheses

H1: There will be a significant difference between pre-test and post-test knowledge scores and attitude regarding the importance of institutional delivery among women.

H2: There will be a significant association between pre-test knowledge scores and attitude regarding the importance of institutional delivery among women and their selected socio-demographic variables.

The paired t-test results demonstrated statistically significant pre-test/post-test differences in knowledge and attitude (p<0.001). The associations with socio-demographic variables are described in the thesis; the chi-square tables should be checked against the original data before definitive conclusions are drawn.

MATERIALS & METHODS:

Research design and setting

A quantitative approach and pre-experimental one-group pre-test–post-test design were used. The study was conducted in Abdullahpur Mafi, Bareilly, Uttar Pradesh, India.

Sample and sampling technique

The sample comprised 50 women of reproductive age. A non-probability sampling technique was used. The thesis states that participants were available during data collection, willing to participate and able to understand the questionnaire language.

Research tools and reliability

The tools comprised a demographic proforma, a structured knowledge questionnaire and an attitude checklist. Knowledge scores were categorized as inadequate (0–10), moderate (11–20) and adequate (21–30). The thesis reports content review by five Community Health Nursing experts and test–retest reliability of r=0.89.

Data collection and analysis

The thesis reports that formal permission was obtained from the Gram Pradhan and that informed consent, anonymity and confidentiality were maintained. The main data collection was reported as beginning on 12 August 2026. Frequencies, percentages, means and standard deviations were used for descriptive analysis; paired t-tests and chi-square tests were reported for inferential analysis.

Ethical considerations

The thesis describes informed consent and maintenance of confidentiality. An institutional ethics committee approval number was not identified in the source text available for this article.

Analysis and Interpretation:

A total of 50 women participated. The main outcome findings reported in the thesis are summarized below.

Table 1: Frequency and Percentage Distribution of Socio-Demographic Variables Among Women (N = 50)

Interpretation: The socio-demographic table presents the participants by age, religion, educational qualification, occupation, monthly family income, type of family, number of children, gravida, place of previous delivery and source of information. The largest age group was 26–30 years (34%). The frequencies and percentages are reported as recorded in the thesis.

Table 2: Frequency and Percentage Distribution of Pre-Test and Post-Test Knowledge Levels Among Women (N = 50)

Interpretation: Before the teaching programme, 30 women (60%) had inadequate knowledge, 15 (30%) had moderate knowledge and 5 (10%) had adequate knowledge. After the programme, 35 women (70%) had adequate knowledge, 13 (26%) had moderate knowledge and 2 (4%) had inadequate knowledge. The distribution indicates an improvement in knowledge category after the structured teaching programme.

Table 3: Frequency and Percentage Distribution of Pre-Test and Post-Test Attitude Levels Among Women (N = 50)

Interpretation: At pre-test, 25 women (50%) were in the inadequate attitude category, 10 (20%) in the moderate category and 15 (30%) in the adequate category. At post-test, 40 women (80%) were in the adequate category, 7 (14%) in the moderate category and 3 (6%) in the inadequate category. The distribution indicates a shift towards a more adequate attitude after the programme.

Table 4: Comparison of Mean and Standard Deviation Between Pre-Test and Post-Test Knowledge and Attitude Scores

Interpretation: The mean knowledge score increased from 12.0 (SD 4.40) before the programme to 22.3 (SD 2.37) after the programme, a reported increase of 10.3 points (paired t = 20.13, p < 0.001). The mean attitude score increased from 10.0 (SD 4.28) to 20.1 (SD 2.20), an arithmetic difference of 10.1 points (paired t = 20.00, p < 0.001). Both reported paired t-tests indicate statistically significant pre-test/post-test differences. The thesis narrative gives a different attitude mean difference in one place; the table values are retained as printed.

Table 5: Association Between Pre-Test Knowledge Level and Selected Socio-Demographic Variables (as Reported in the Thesis)

Interpretation: The thesis identifies age (χ² = 9.16), educational qualification (χ² = 12.47), occupation (χ² = 8.16) and monthly family income (χ² = 4.62) as significantly associated with pre-test knowledge. Religion (χ² = 10.25), type of family (χ² = 5.25), number of children (χ² = 7.63), gravida (χ² = 4.62), place of previous delivery (χ² = 5.53) and source of information (χ² = 8.09) are reported as not significant. These are reproduced from the thesis; some reported chi-square values, degrees of freedom and significance labels appear internally inconsistent and should be checked against the original analysis before publication.

DISCUSSION

The study findings indicate that knowledge regarding institutional delivery improved after the structured teaching programme. Adequate knowledge increased from 10% in the pre-test to 70% in the post-test, while inadequate knowledge declined from 60% to 4%. The mean knowledge score increased by 10.3 points, and the reported paired t-test was statistically significant. These findings suggest that the educational session was associated with improved knowledge among the women who participated.

Attitude showed a similar pattern. The proportion categorized as having an adequate attitude increased from 30% to 80%, while the inadequate category decreased from 50% to 6%. The mean attitude score increased from 10.0 to 20.1. The reported paired t-test was statistically significant, which is consistent with improvement between the two measurements. The discrepancy in the thesis narrative for the attitude mean difference should nevertheless be corrected against the raw data.

The topic is consistent with wider maternal health work that emphasizes skilled attendance, birth preparedness and the importance of reducing practical barriers to facility-based childbirth [1,3–6]. Research on institutional delivery has also identified socioeconomic and access-related factors, including distance and transportation, as relevant to delivery choices [5,8]. A structured teaching programme can provide information, but education alone cannot remove barriers such as transport, cost, distance or service availability.

The thesis reports that age, education, occupation and monthly family income were associated with baseline knowledge. This may suggest that health education should be understandable and accessible to women with varied educational and socioeconomic backgrounds. However, the association findings should not be treated as conclusive until the chi-square calculations and significance labels have been checked against the original data.

Because this was a one-group pre-test–post-test study, the results show change over time in the participating sample but cannot establish with certainty that the teaching programme alone caused the improvement. Repeated exposure to the questionnaire, other sources of information and events during the study period could also have influenced scores.

CONCLUSION:

Among the 50 women studied in Abdullahpur Mafi, Bareilly, the proportion with adequate knowledge regarding institutional delivery increased from 10% to 70% after the structured teaching programme. Adequate attitude increased from 30% to 80%. The thesis reports statistically significant pre-test/post-test differences for both knowledge and attitude (p<0.001). The findings support the usefulness of focused community education as one component of efforts to promote informed decisions about institutional delivery. Results should be interpreted in light of the small non-probability sample, the lack of a control group and the statistical inconsistencies noted in the source thesis.

Limitations:

• The sample size was limited to 50 women from one selected community area, so generalization should be cautious.

• The non-probability sampling technique may limit representativeness.

• The one-group pre-test–post-test design did not include a control group.

• Long-term retention of knowledge and attitude was not assessed in the reported results.

• Some thesis values and labels require verification, including the post-test knowledge wording, attitude mean difference and chi-square interpretations.

REFERENCES

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