Assessment of Modification in Knowledge, Attitude and Practices for Child Abuse Prevention among Anganwadi Workers and Auxiliary Nurse Midwives in Bangalore: A Cohort Study at Ground Level

Background: A follow up of cohort study among Anganwadi workers (AWW) and auxiliary nurse midwives (ANM) working at the grassroot and ground level in Indian villages and town. They are closely connected to families living in the community they work. Child abuse of various forms are encountered but are frequently either not detected or stay unreported, this has a serious effect on a child psychologically, emotionally, mentally as well as physically. Objective: To assess the level of modification in knowledge, and attitude towards prevention of child abuse among AWW and ANM in Bangalore, India. Materials and Methods: This cohort study was undertaken with the help of a pretested self- administered questionnaire in both the groups. A total of 69 AWW and 53 ANM who were previously randomly selected and assessed for their knowledge attitude and practice during their scheduled monthly meetings were targeted in this study as well. With an attrition of 4 AWW and 1 ANM a total of 65 AWW and 52 ANM took part in this cohort study. They were formally educated with the help of printed materials lectures and color plates for 7 days; and a crash course of 3 days after 1 month was done for recapitulation of knowledge. These cohorts were the followed up after 3 months and after reiterating the need for the study and confidentiality assurance for the responses to the questions in the study, the respondents were assessed using a questionnaire. Completed copies of a questionnaire were subjected to data analysis. Results: Change in Knowledge: Increase in percentage of participants with better knowledge: 60.6% AWW; and 20.8% ANM. A significant increase in mean knowledge score was seen after formal education was given: with a p value of 0.03 which was statistically significant. Change in Attitude: Increase in percentage of participants with better attitude towards preventing child abuse increased by: 20.3% among AWW and 7.6% among ANM. A statistically non - significant increase in mean knowledge score was seen post intervention with a p value of 0.08. Change in Practice: increase in percentage of participants with better command on procedures to prevent, detect and report child abuse increased by: 84% among AWW and 69.9% among ANM. A statistically significant increase in mean knowledge score was seen post intervention: with a p value of 0.02. Conclusion: The educational intervention significantly improved the knowledge, attitudes, and practices of the participants regarding child Abuse. The changes observed were statistically significant, indicating the effectiveness of the targeted educational program in enhancing understanding and promoting positive behaviours. After formal education AWW and ANM were sufficiently prepared to know what to look for when they suspect child abuse and what to actually do when they encounter this problem in a rural setting which signifies the importance of including and imparting Child Abuse knowledge during their training period.