• Users Online: 561
  • Print this page
  • Email this page


 
 
Table of Contents
ORIGINAL ARTICLE
Year : 2019  |  Volume : 5  |  Issue : 2  |  Page : 123-128

Evaluation of knowledge and awareness regarding usage of mcp card amongst health functionaries and beneficiaries


Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh, India

Date of Submission21-Feb-2019
Date of Decision24-Apr-2019
Date of Acceptance09-Jul-2019
Date of Web Publication19-Dec-2019

Correspondence Address:
Amreen Khan
Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJCFM.IJCFM_13_19

Rights and Permissions
  Abstract 

Introduction: Mother and child protection (MCP) card has been developed as a tool to help families to know about various types of services which they need to access for the health and well-being of women and children. The auxiliary nurse-midwife (ANM)/anganwadi worker (AWW) record the desired information in place provided in the card and the beneficiaries are pregnant women and mother/families of children up to 3 years of age. The present study was therefore undertaken with the objectives to assess the knowledge of health functionaries on appropriate usage of MCP card; to study the knowledge of beneficiaries about the MCP card and its importance in maternal and childcare.
Material and Methods: This was a cross-sectional study, conducted from February 1, 2018 to April 30, 2018 on health functionaries at anganwadi center and beneficiaries of MCP card. One hundred and five anganwadis and 3 beneficiaries per anganwadi were selected using convenience sample consisting of one pregnant female, one mother/family member of child <6 months and one mother/family member of child between 6 months and 3 years. Data regarding sociodemographic details of health functionaries and beneficiaries along with data regarding usage of MCP card were assessed.
Results: Overall knowledge regarding immunization was maximum (87.6%) among health functionaries, whereas knowledge regarding five cleans was minimum (10.5%). Only 56.3% and 76.5% AWW and ANM received orientation training regarding MCP card. Out of 315 beneficiaries, only 50.8% beneficiaries knew about correct validity of MCP card, i.e., 0–3 years and 190 (60.3%) beneficiaries found MCP card helpful during referral. Majority of beneficiaries wanted custody of MCP card to be with the mother or beneficiary themselves. Only 8.6% and 4.4% beneficiaries wanted custody of card to be with AWW and ANM, respectively.
Conclusion: The MCP cards are being used adequately for keeping the background information, antenatal care provided to the mother, and immunization among both health functionaries and beneficiaries.

Keywords: Beneficiaries, evaluation, health functionaries, Mother and Child Protection, usage


How to cite this article:
Melwani V, Toppo M, Khan A. Evaluation of knowledge and awareness regarding usage of mcp card amongst health functionaries and beneficiaries. Indian J Community Fam Med 2019;5:123-8

How to cite this URL:
Melwani V, Toppo M, Khan A. Evaluation of knowledge and awareness regarding usage of mcp card amongst health functionaries and beneficiaries. Indian J Community Fam Med [serial online] 2019 [cited 2020 Jul 2];5:123-8. Available from: http://www.ijcfm.org/text.asp?2019/5/2/123/273517


  Introduction Top


The Mother and Child Protection (MCP) card was introduced in National rural health mission and Integrated child development scheme with effect from April 1, 2010.[1] It endorses an integrated, holistic approach to ensure proper childcare leading to survival, growth, development, and protection of the young child through child-centered, family-focused, and community-based intervention.[2]

The MCP card has been developed as a tool for families to learn, understand, and follow healthy practices for achieving good health of pregnant women, young mothers, and children. This card helps families to know about various types of services which they need to access for the health and well-being of women and children. It empowers families to make decisions to improve health and nutritional status and supports development of young children on a continual basis.[3]

The Auxiliary Nurse-Midwife (ANM)/Angan Wadi Worker (AWW) record the desired information in the place provided in the card and the beneficiaries are pregnant women and mother/families of children up to 3 years of age. MCP card is an important document to track maternal and childcare thus, its proper handling is necessary. Since the education level of ANM/AWW is usually up to 8th class and their level of understanding is poor. The present study was therefore undertaken to evaluate the usage of the MCP card by Integrated Child Development Services (ICDS) and health functionaries and the beneficiaries.

Objectives

The main objectives were as follows:

  1. To assess the knowledge of health functionaries on appropriate usage of MCP card
  2. To study the knowledge of beneficiaries (pregnant and lactating mothers or family members with children below 3 years) about the MCP card and its importance in maternal and childcare.



  Material and Methods Top


The present study was a community-based cross-sectional study, conducted for a period of 3 months from February 1, 2018 to April 30, 2018. The study population consisted of health functionaries available at anganwadi center filling the MCP card and beneficiaries such as pregnant female, mother, or family of child up to 3 years. A list of all the anganwadi centers of Bhopal city was downloaded from the ICDS portal. One hundred and five anganwadis were selected using systematic random sampling. At least 3 beneficiaries per anganwadi were selected using convenience sample consisting of one pregnant female, one mother/family member of child <6 months, and one mother/family member of child between 6 months and 3 years. Three different category of beneficiaries have been chosen so as to have representation of all these in the study sample as MCP card covers all of them. A total of 105 anganwadi and 315 beneficiaries were selected in the study. Two sets of questionnaires were developed, one for health functionaries and other for the beneficiaries.

The ethical clearance was obtained from the Ethics Committee of Gandhi Medical College. The purpose of study was explained to study participants, and their informed verbal consent was obtained. Data regarding sociodemographic details of health functionaries, their knowledge regarding all the sections of MCP card [Table 1], its importance were enquired and entered in first set of questionnaires. Knowledge regarding importance, uses, and benefits of MCP card was enquired from beneficiaries and entered in second set of questionnaires. Data were compiled using MS Excel and analyzed using EpiInfoTM version 7.2.2.6 software (CDC). Epi InfoTM is a trademark of the Centres for Disease control and Prevention (CDC). The software is in the public domain and freely available for use, copying translation and distribution.
Table 1: Sections of Mother and Child Protection card

Click here to view



  Results Top


Section I-Responses of health functionaries

The present study included 105 health functionaries, of them 87 (82.8) were AWWs, 17 (16.2%) were ANM and only 1 (1%) were Acredited Social Health Activist (ASHA).

Majority of health functionaries (53.4%) belonged to 31–40 years of age, followed by 41–50 years (18.1%). Moreover, 29.6% health functionaries were educated up to high school, 13.3% were educated up to primary school, whereas 1.9% health functionaries were illiterate [Table 2].
Table 2: Sociodemographic variables of health functionaries

Click here to view


There are 12 sections in the MCP card [Table 1]. It is important to have good knowledge and awareness about each section of MCP card for proper entry into MCP card and providing relevant information to beneficiaries. Among AWW, there was good knowledge regarding immunization schedule (90.8%), pregnancy record (75.9%), and growth monitoring (70.1%), whereas 11.5% knew about five cleans. Knowledge regarding newborn care was poor in ANM and none of the ANM knew about five cleans section [Table 3].{Table 1}
Table 3: Distribution according to knowledge regarding various sections of mother and child protection card among health functionaries

Click here to view


Overall knowledge regarding immunization was maximum (87.6%) among health functionaries, whereas knowledge regarding five cleans was minimum (10.5%) [Table 3].

About 56.3% and 76.5% AWW and ANM, respectively, received orientation training regarding MCP card and the place of training for 45.7% health functionaries was District Hospital, Bhopal.

About 92%, 82.4%, and 100% AWW, ANM, and ASHA, respectively, were currently using MCP card. The reasons for not using MCP card by AWW were lack of training (4.6%) and nonavailability of MCP cards (3.4%), whereas the reason by ANM was nonavailability of MCP cards (17.6%) [Table 4].
Table 4: Distribution according to the usage of mother and child protection card

Click here to view


When enquired about the custody of MCP card, 96.2% health functionaries answered it should be mother. Usage of MCP card as answered by AWW was being done for immunization (100%), growth monitoring (98.9%), antenatal care (ANC) visit (81.6%), and home visits (19.5%). Majority of ANM and ASHA were using MCP cards for ANC visits [Table 4].

About 98.9% AWW, 100% ANM, and 100% ASHA advised the beneficiaries to take MCP card during referral as answered by health functionaries themselves.

Majority of health functionaries (76.2%) stated treatment start on time if the beneficiaries use MCP card during referrals. As per 12.4%, 7.6%, and 1.9% health functionaries, MCP card is helpful for record maintenance, easy identification and easy availing of health services. Whereas 16.2% did not respond at all as they did not know the advantage of it.

Majority of health functionaries (45.7%) did not encountered any problem during usage of MCP card, whereas 22.9% health functionaries answered beneficiaries forget to bring MCP card and again 22.9% mentioned that the supply of MCP card is low [Table 5].
Table 5: Distribution according to problems faced and suggestions given by health beneficiaries

Click here to view


Majority of health functionaries (44.8%) suggested that growth charts must be color coded and 9.5% suggested supply of MCP card must be improved, while 34.5% did not provided any suggestions [Table 5].

Section II-Responses of beneficiaries

Out of 315 beneficiaries, equal number of pregnant females (105), mother or family member of child <6 months (105), and mother or family member of child between 6 months and 3 years (105) were included.

Majority of beneficiaries (87.3%) were 21–30 years of age and 27.6% and 24.5% were educated up to middle and high school, respectively. Maximum beneficiaries (51.4%) belonged to middle socioeconomic status as per the modified BG Prasad classification [Table 6].
Table 6: Distribution according to sociodemographic variables of beneficiaries

Click here to view


Maximum beneficiaries, i.e., 94.3% knew MCP card is used for immunization followed by growth monitoring (34.9%), ANC (29.8%), and postnatal care (12.1%), whereas 6% beneficiaries did not respond at all.

About 286 (90.8%) beneficiaries were explained about usage of MCP card. Of them, 71.3% were explained by AWW followed by ANM (24.1%) and ASHA (4.6%).

Only 50.8% beneficiaries knew about correct validity of MCP card, i.e., 0–3 years.

About 42.2% beneficiaries mentioned that health functionaries provide treatment without MCP card, whereas 8.6% of them mentioned that they are not provided with any treatment or immunization [Table 7].
Table 7: Distribution according to treatment/immunization without mother and child protection card

Click here to view


Out of 315, 190 (60.3%) beneficiaries found MCP card helpful during referral. Of them, 95.8% got timely treatment during referral and in 3.1% it was useful in saving life of mother and child.

Out of total beneficiaries enquired, 20.1 (63.8%) participants ever read MCP card. Reasons for reading MCP card in majority of beneficiaries (48.2%) was growth monitoring followed by to see date of next checkup or immunization (43.8%) [Table 8].
Table 8: Distribution according to reasons for reading mother and child protection card

Click here to view


Majority of beneficiaries wanted custody of MCP card to be with the mother or beneficiary themselves. Only 8.6% and 4.4% beneficiaries wanted custody of card to be with AWW and ANM, respectively.


  Discussion Top


The present study involved 105 health functionaries, of them 87 (82.8%) were AWWs, 17 (16.2%) were ANM and only 1 (1%) were ASHA.

The AWW had good knowledge regarding immunization schedule (90.8%), pregnancy record (75.9%), and growth monitoring (70.1%), whereas 11.5% knew about five cleans. However, the ANM had poor knowledge regarding newborn care was and none of them were aware about five cleans section. Whereas in a report by the National Institute of Public Cooperation and Child Development which focused on the role, perception, and job performed by ANMs with regard to the various sections in the MCP card, and they reported the job and responsibilities as very lucid. The role perceived, and job performed by ANMs, herself focus mainly on “recording of information” in the MCP card related to regular checkups during pregnancy (77.2%); danger signs during pregnancy (77.2%); postnatal record of mother (81.8%); record of newborn baby (81.8%); and immunization and Vitamin A supplementation (68.1%). Furthermore, they observed role perception and job performed by ASHAs with regard to the various sections in the MCP card was moderate. The ASHAs mainly perceived their role, as a recorder of information with respect to only “family identification.”[1]

About 56.3% AWW and 76.5% ANM received orientation training regarding MCP card. Around 45.7% health functionaries were trained at District Hospital, Bhopal. In our study, 92%, 82.4%, and 100% AWW, ANM, and ASHA, respectively, were currently using MCP card. Reasons given by AWW for not using MCP card was lack of training (4.6%) and nonavailability of MCP cards (3.4%), whereas nonavailability of MCP cards was the reason given by 17.6% ANM. In a study by Kumar et al., all the AWW were aware and had used the MCP card to record information, whereas, not all, but 15 out of 17 (88.2%) of Sahiyya were aware and 12 out of 17 (70.59%) had used it. Majority of the Sahiyyas were trained in Primary health centre (PHC), whereas, among trained AWW's, 50% of them received training as job training and rest 50% in PHC. The reason for deficiency of training could be due to lack of interest by AWWs and Sahiyyas or may be due to the excessive burden of their own household work.[4] In another study by Paul et al., almost all the ASHAs, ANMs, and AWWs were aware of the MCP card and also reported using it. They observed that the MCP card has been mainly used by ASHAs and ANMs for explaining about ANC services and explaining about how to prepare for delivery; and by AWWs for explaining about childhood illnesses; and advising about nutrition, immunization, etc.[5] Whereas in a study conducted by Thakur et al., they found that all the AWWs were trained before joining.[6]

In the present study, 76.2% health functionaries stated treatment start on time as advantage of MCP card during referrals. As per 12.4%, 7.6%, and 1.9% health functionaries, MCP card is helpful for record maintenance, easy identification, and easy availing of health services. Thus, further study is needed to identify advantages of MCP card for both functionaries and beneficiaries.

Out of 315 beneficiaries involved in the present study, equal number of pregnant females (105), mother or family member of child <6 months (105) and mother or family member of child between 6 months and 3 years (105) were included. Majority of beneficiaries (87.3%) belonged to 21–30 years of age and 27.6% and 24.5% were educated up to middle and high school. Maximum beneficiaries (51.4%) belonged to middle socioeconomic status as per the modified BG Prasad classification. In a study by Jena et al. on 200 beneficiaries, 36% were aged between 25 and 29 years and 14% mothers were illiterate. Most of the mothers belonged to type 2 and type 3 socioeconomic status, i.e., 33.5% and 38%, respectively.[7]

In the present study, maximum beneficiaries, i.e., 94.3% knew MCP card is used for immunization followed by growth monitoring (34.9%), ANC (29.8%), and postnatal care (12.1%). Only 50.8% beneficiaries knew about correct validity of MCP card, i.e., 0–3 years. Rama et al. in their study observed 95% of the participants were aware of the need for immunization of their infant; 58% of the participants were not aware of this shape and only 42% of the participants had adequate knowledge regarding correct interpretation of the normal growth curve.[8]

Out of total beneficiaries enquired, 201 (63.8%) participants have read MCP card. Reasons for reading MCP card in majority of beneficiaries (48.2%) were growth monitoring followed by tracking of next checkup or immunization (43.8%).

Majority of beneficiaries wanted custody of MCP card to be with the mother or beneficiary themselves. Only 8.6% and 4.4% beneficiaries wanted custody of card to be with AWW and ANM, respectively. Thus, further study is needed to explore the reasons why beneficiaries do not want to handle their card to health functionaries.


  Conclusion Top


MCP cards have been developed to support families to understand and follow positive practices for achieving good health of pregnant women, young mothers, and children. This study demonstrated that both the health beneficiaries and health functionaries had good knowledge about usage of MCP cards. They were mainly using card for keeping the background information, to provide adequate antenatal care provided to the mother, to deliver effective immunization, and to track the treatment schedule. However, provision of proper training and proper guidelines to health functionaries regarding the use of MCP cards can further improve the effectiveness of services provided though MCP cards. Moreover, advanced training can also support to created further awareness about MCP cards among health beneficiaries, to motivate them to take MCP card during hospital visits and Anganwadi visit, and to teach them about importance of various sections of MCP card and to its proper storage.



Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
National Institute of Public Cooperation and Child Development. Evaluation of Usage of Mother and Child Protection Card by ICDS and Health Functionaries, Report of Pre-Test Study; MCPC. New Delhi: National Institute of Public Cooperation and Child Development; 2005.  Back to cited text no. 1
    
2.
Bag S, Datta M. Evaluation of mother and child protection card entries in a rural area of West Bengal. Int J Community Med Public Health 2017;4:2604-7.  Back to cited text no. 2
    
3.
A Guide for Use of Mother-Child Protection Card for the Community and the Family, AWW, ANM and Sector Supervisors, 2014. Available from: https://http://hetv.org/pdf/protection-card/mcp-english.pdf. [Last accessed on 2018 Oct 08].  Back to cited text no. 3
    
4.
Kumar M, Shikha S, Kashyap V. Assessment of knowledge and skill of Sahiyya (ASHA) and Anganwadi worker on appropriate usage of mother and child protection card in Ranchi, Jharkhand: A cross sectional study. Int J Community Med Public Health 2018;5:5316-20.  Back to cited text no. 4
    
5.
Paul D, Srivastav SK, Bhatiya N. Evaluation of Functioning of Accredited Social Health Activists (ASHAs) in ICDS Related Activities, A Report. National Institute of Public Cooperation and Child Development; 2011. Available from: https://www.nipccd.nic.in/file/ reports/asha.pdf. [Last accessed on 2019 Apr 10].  Back to cited text no. 5
    
6.
Thakur K, Chauhan HS, Gupta NL, Thakur P, Malla D. A study to assess the knowledge and practices of anganwadi workers and availability of infrastructure in ICDS program, at district Mandi of Himachal Pradesh. Int Multidiscip Res J 2015;2:1-6.  Back to cited text no. 6
    
7.
Jena D, Sabat S, Tripathy RM, Mahapatra DK. Utilization of MCP card for enrichment of knowledge on antenatal care by mothers attending immunization clinic: A hospital based cross-sectional study. Int J Adv Med 2017;4:1466.  Back to cited text no. 7
    
8.
Rama R, Gopalakrishnan S, Udayshankar PM. Assessment of knowledge regarding new-born care among mothers in Kancheepuram district, Tamil Nadu. Int J Community Med Public Health 2017;1:58-63.  Back to cited text no. 8
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Introduction
Material and Methods
Results
Discussion
Conclusion
References
Article Tables

 Article Access Statistics
    Viewed840    
    Printed32    
    Emailed0    
    PDF Downloaded60    
    Comments [Add]    

Recommend this journal