For many years accidents in children have posed as the most significant health problem. It is also one of the major causes of death that is preventable. Under-five accidents may lead to serious injury and disability across the world. Currently, injuries among under-fives are very common and they can happen at any time during day-to-day life (Kafle et al, 2018). First Aid involves simple techniques with a scientific background used for life preservation. Mostly it doesn’t require any advanced equipment or much medical knowledge. It is often as important as what should be done and what should not be done. First Aid offers immediate assistance to anyone who is injured before health professionals arrive (Wadhwani, 2022).

Worldwide incidence of under-five accidents varies from country to country. Many studies have revealed that the mortality rate globally is 83.7 per 1 lakh per annum. Children 2 to 6 years of age have the greatest number of accidental injuries as compared to other age groups. Totally, as high as 2,83,000 deaths occurred by falls alone, secondly, 22,000 children died by drowning. Karnataka is one of the states of India where at least 30,000 children die annually due to accidents, poisoning, and drowning. In developing countries, under-five accidents are shown higher than in developed countries (Gaikwad, et al, 2022). The study showed that 80 percent of 1-6 years children attending Anganwadi spent a minimum of 3 to 4 hours per day in the Anganwadi centre.

Objectives
This study aimed:
1. To assess the knowledge regarding first aid management for selected accidents among under-five children among Anganwadi workers, and;
2. To find out the association between knowledge regarding first aid management for selected accidents of under-five children among Anganwadi workers with their selected sociodemographic variables.

Methodology
A descriptive quantitative research design was used for this study. Participants were selected from selected areas of Maharashtra. This study was set in 18 Primary Health Centres (PHCs) in the Ratnagiri district; these PHCs cover 118 Vadis (villages) with 100 Anganwadi workers. Considering the scope of study, using sample size calculation formula) the Anganwadis were selected with a purposive random sampling method.

Sample size estimation was based on the power of the study.
Confidence level (Z)-1.96; the margin of error (E)- 0.10; Sample proportion (P) - 30%
q=(1-p) = 1- 0.40 = 0.6
N = Z2 p q /e2
N= (1.96)2 x 0.40 x 0.6/ (0.10)2
N= 3.84 x 0.40 x 0.6/0.01
N= 0.9216/0.01
N = 92.16
N= 100

Tools used:
The tool was divided into two parts. Part I consisted of demographic data - age in years, education, years of experience, and source of information. Part II was a structured knowledge questionnaire consisted of 30 questions. For data collection purpose, it was further distributed on foreign body aspiration 4 questions, drowning 4 questions, choking 4 questions, burns 4 questions, minor cuts 3 questions, sprain 3 questions, bruises 3 questions, falls 3 questions, scratches 2 questions. The tool validation was done by 11 nursing experts from all over Maharashtra. The reliability of the tool was calculated by the split-half method and the reliability coefficient of the whole test was then estimated by Spearman’s brown prophecy formula; it was found to be 0.78. The knowledge level was arbitrarily divided into three categories based on the Anganwadi worker’s scores i.e., Poor knowledge 1-15 (75%). Administrative permission was obtained first from the Ratnagiri district health office, Maharashtra, and from selected primary health centres and Gram Panchayat to collect data from participants before conducting the study. Informed consent was taken from the sample, and confidentiality of data was maintained. The pilot study was carried out among 20 participants, which found the tool feasible and reliable. The institutional ethical committee issued the ethical clearance certificate for the project.

Results
Description of participant’s characteristics: In this study, the majority of the participants, 46 (46%) were 23-27 years old, 39 (39%) of them had completed secondary education, 45 (45%) had 3-4 years of experience and 44 (44%) of them got information from In-service education.

Table 1 shows that the mean knowledge score for foreign body aspiration was 2.73, SD=1.13. Similarly, in Drowning, mean score was 2.87, SD=0.93; for Choking it was 3.04, SD=0.83; Burns 3.34, SD=0.80; Minor cuts, 2.38, SD=0.73, Sprain 2.33, SD=0.75; Bruises 2.48, SD=0.78; Falls 2.32, SD=0.77; Scratches 1.71, SD=0.55, and overall knowledge score of 23.2 with SD=3.58.

Table 1: Knowledge scores regarding first aid management for selected accidents of under-five children among Anganwadi workers (N=100)

Table 2 shows that 7 (7%) of them had poor knowledge, 32 (32%) had average knowledge, and 61 (61%) had good knowledge of First Aid management.

Table 2: Distribution of participants according to the level of knowledge regarding first aid management for selected accidents of under-five children among Anganwadi workers (N=100)

Table 3 shows that there is an association between educational qualification, years of experience, and source of information demographic variables of Anganwadi workers and knowledge regarding first aid management for selected accidents of under-five children at p<0.05 level.

Table 3: Chi-square value showing the association between the knowledge scores and demographic variables (N=100)

Discussion
Current study results are consistent with those from prior studies. The results of the current research indicate that of Anganwadi workers, 7 (7%) of them had poor knowledge, 32 (32%) of them had average knowledge and 61 (61%) of them had good knowledge. A similar study shows that 15 (16.6%) of Anganwadi teachers had poor knowledge whereas 75 (83.3%) of nurses had average (above 33% to 66%) knowledge regarding selected first aid (Baskaran, 2016). A study found that overall knowledge among Anganwadi workers regarding first aid management for selected accidents of under-five children is a mean of 23.2, median and mode is 24, standard deviation of 3.58, and range is between 10-29. Another study says that knowledge among Anganwadi workers has a mean of 8.85, a median and mode is 9, and a standard deviation of 1.71 (Damor et al, 2022). The current study found that there is an association between educational qualification, years of experience, source of information of Anganwadi workers, and knowledge regarding first aid management for selected accidents of under-five children. Hence hypothesis H1 is accepted. Baskaran (2016) also found that there was a significant association between knowledge and age at p < 0.05.

Nursing Implications
In a community, as part of health professionals in a primary health centre, Anganwadi workers have ample opportunities to educate the community people regarding first aid management for selected accidents of under-five children, especially mothers. In nursing education, nursing students should be equipped with adequate knowledge, skills, and attitudes to fulfill their duties and responsibilities in the nursing field. The findings of the study can be used by nurse educators to educate mothers, and nursing students regarding first-aid management for selected accidents of under-five children. Nursing administrators should make the public aware of first aid management for selected accidents of under-five children among mothers. Inservice education and continuing nursing education programmes need to be initiated for nurses to update their knowledge on first aid management for selected accidents of under-five children. The investigator found scarcity in research works by Indian nurses on first aid management for selected accidents of under-five children among Anganwadi workers. Considering scarce studies in this area. The findings in this study can be utilised by nursing researchers for future studies.

Recommendations
Based on the findings of the present study, it is recommended that this type of study may be done in other aspects of health to explore Anganwadi worker’s knowledge. We can do this study on multipurpose health workers because they also play a vital role in the maintenance of community health.

Conclusion
The study emphasises the need for continuous education and training programmes specifically designed for Anganwadi workers. By addressing knowledge deficiencies and utilising their expertise, it is feasible to enhance first aid management procedures for young children, hence improving health outcomes in this vulnerable demographic. Future research should concentrate on creating and executing structured training programmes that can augment the knowledge and skills of these personnel in first aid management for childhood accidents to be enabled to respond to emergencies successfully. These findings corroborate prior research that underscores the essential importance of education in enhancing healthrelated knowledge and practices among caregivers and health professionals.

 

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