Abstract of Dissertation

Keyword : Infant Child Feeding; Young Child Feeding; Water and Sanitation Hygiene Practices; Breastfeedings

Objective : Objective: 1. To measure the level of knowledge regarding IYCF and WASH among rural lactating mothers having a child aged between 6 months to 24 months. 2. To measure the level of practice followed by the rural lactating mothers. 3. To assess the level of malnutrition with the help of MUAC Tape.

Background : Breastfeeding is defined as the practice through which adequate nutrition and other nutritional supplements or requirements of the newborn are taken care of (Verma and Dixit, J Neonatal Biology2016). Adequate nutrition is essential for ‘infants’ health and their overall development. Mother`s milk provides all essential micronutrients that are required for physical and cognitive development of an infant up to six months of age. Breastfeeding practices in rural areas governed by their beliefs which are influenced by their social, cultural and economic conditions. Feeding practices constitute major components of childcaring apart from socio-cultural, economic and demographic factors. Early initiation of breastfeeding is a smart investment in saving young lives for both, the poor and the rich by reducing hospital cost. Additionally, complementary feeding improves the ability to fight illness and reduces the risk of infection. In growing children, essential nutrients need to be supplemented as breastmilk alone cannot meet the additional demand. With a better understanding of engagement in handwashing and sanitation practices before cooking, serving and eating food, a comprehensive social and behaviour change initiative can be developed to mobilize key participant to improve overall health.

Methodology : Study Design: Cross-sectional study. Study Setting: The study is included lactating mothers having a child aged between 6 months to 24monthsresiding in various community blocks of Araria District in Bihar. Sample size and sampling design: The study is being carried out on 140lactating mothers from 9 different community blocks. Randomly selected and voluntary subjects are being taken as a sample from the 40 randomly selected Anganwadi Centres. Inclusion Criteria: All lactating mothers with a child aged between 06-24 months and are consenting. Exclusion Criteria: Women who do not have a child aged between 06-24 months, and those who are otherwise eligible, but refuse to consent to the study Study period: February` 2018- April 2018 Study Instruments: Structured interview schedule is being used for collecting data. Analysis plan: Data entry and analysis has been done using SPSS 21 package.

Findings : Results: The assessment was conducted to get the information regarding knowledge and practice level about IYCF and WASH, of the lactating mothers in Araria. Whereas 57.8 percent of the respondents were having knowledge colostrum feeding; 55 percent of them practiced the same. Most of the respondents were housewives and agricultural labours. With the literacy rate fell below the national average most of the respondents were having primary education. It was a matter of concern that none were graduated or having higher education. The study predicts that more than half of the respondents were having knowledge of early initiation of breastfeeding but all of them could not initiate the early breastfeeding. Almost 72 percent of the respondent was having knowledge of exclusive breastfeeding but only 41 percent of them practiced that. Apart from this knowledge and practice level were almost the same for complementary feeding and continuous feeding. The practice of giving pre-lacteals was followed more than the knowledge level, as it was followed by other caretakers rather than a mother. Knowledge regarding iron and zinc supplementation were very less among respondents. Knowledge and practice related to washing practices were more than 70 percent but none of the respondents know the 7 steps of handwashing with soap. The entire household who were having a toilet, they were using it.

Recommendations : Before the administration of questionnaire interviewer explained to the respondents, the objective of the study and the importance of participation in the study. Informed consent was taken before filling up the questionnaire. I have taken the consideration from District Resource Unit-Care India and District Health Society-Araria.

Rationale: Bihar is amongst the most populous state of the country and contributes a large share to national infant mortality, under-5 mortality and neonatal mortality. One of the main reasons cited is poor breastfeeding practices and low level of breastfeeding. Many myths and misconceptions about breastfeeding prevail in the rural areas of Araria District in Bihar. Specifically, the tendency of administering prolateral substance after delivery. New mothers are unsure regarding breastfeeding initiation and the duration of exclusive breastfeeding. Furthermore, it has been observed that very few mothers follow a breastfeeding schedule. It is a common practice to feed a child on demand (baby`s crying) and to start the complementary feeding when the child starts to crawl and walk. Thus, the current study is aimed at understanding the knowledge level of the mothers or caretaker in Araria District of Bihar regarding breastfeeding and WASH, and to understand the actual practices followed by them. Research question: What is the level of knowledge and practice of Infant Young Child Feeding and water and sanitation hygiene practices among rural lactating mothers having a child aged between 6 months to 24 months.?