DEVELOPMENT OF MULTIMEDIA MODULE FOR EFFECTIVE DOMESTIC WATER SANITATION- AN EXPERIMENTAL STUDY IN TRIBAL AREA

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1 DEVELOPMENT OF MULTIMEDIA MODULE FOR EFFECTIVE DOMESTIC WATER SANITATION- AN EXPERIMENTAL STUDY IN TRIBAL AREA A. LALITHA B.Sc. (Home Science) MASTER OF SCIENCE IN HOME SCIENCE (DEPARTMENT OF HOME SCIENCE EXTENSION AND COMMUNICATION MANAGEMENT) 2015

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3 DEVELOPMENT OF MULTIMEDIA MODULE FOR EFFECTIVE DOMESTIC WATER SANITATION AN EXPERIMENTAL STUDY IN TRIBAL AREA BY A.LALITHA B.Sc. (Home Science) THESIS SUBMITTED TO THE PROFESSOR JAYASHANKAR TELANGANA STATE AGRICULTURAL UNIVERSITY IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTER OF SCIENCE IN HOME SCIENCE (DEPARTMENT OF HOME SCIENCE EXTENSION AND COMMUNICATION MANAGEMENT) CHAIRPERSON: Dr. A. MARY SWARNALATHA DEPARTMENT OF HOME SCIENCE EXTENSION AND COMMUNICATION MANAGEMENT COLLEGE OF HOME SCIENCE SAIFABAD HYDERABAD PROFESSOR JAYASHANKAR TELANGANA STATE AGRICULTURAL UNIVERSITY HYDERABAD i

4 DECLARATION I, A. LALITHA, hereby declare that the thesis entitled DEVELOPMENT OF MULTIMEDIA MODULE FOR EFFECTIVE DOMESTIC WATER SANITATION - AN EXPERIMENTAL STUDY IN TRIBAL AREA submitted to the Professor Jayashankar Telangana State Agricultural University for the degree of Master of Science in Home Science is the result of original research work done by me. I also declare that no material contained in the thesis has been published earlier in any manner. Place: HYDERABAD Date: (A. LALITHA) I.D. NO. HHM/2013/019 ii

5 CERTIFICATE. Ms. A. LALITHA has satisfactorily prosecuted the course of research and that thesis entitled DEVELOPMENT OF MULTIMEDIA MODULE FOR EFFECTIVE DOMESTIC WATER SANITATION - AN EXPERIMENTAL STUDY IN TRIBAL AREA submitted is the result of original research work and is of sufficiently high standard to warrant its presentation to the examination. I also certify that neither the thesis nor its part thereof has been previously submitted by her for a degree of any university Date: (Dr. A. MARY SWARNALATHA) Chairperson iii

6 CERTIFICATE This is to certify that the thesis entitled DEVELOPMENT OF MULTIMEDIA MODULE FOR EFFECTIVE DOMESTIC WATER SANITATION - AN EXPERIMENTAL STUDY IN TRIBAL AREA submitted in partial fulfillment of the requirements for the degree of Master Of Science In Home Science of the Professor Jayashankar Telangana State Agricultural University, Hyderabad is a record of the bonafide original research work carried out by Ms. A. LALITHA under our guidance and supervision. No part of the thesis has been submitted by the student for any other degree or diploma. The published part and all assistance received during the course of the investigations have been duly acknowledged by the author of the thesis. iv Dr. A. MARY SWARNALATHA (Chairman of the Advisory Committee) Thesis approved by the Student s Advisory Committee Chairperson Member Member Dr.A.MARYSWARNALATHA Professor & HEAD, Department of Home Science, Extension & Communication Management, College of Home Science, Saifabad, Hyderabad 04. Dr.R.NEELA RANI Associate Professor Department of Home Science, Extension & Communication Management, College of Home Science, Saifabad, Hyderabad 04. Dr. S. SUCHIRITHA DEVI Assistant Professor Department of Foods & Nutrition PJTSAU, Rajendranagar Hyderabad 30. Date of final viva-voce:

7 ACKNOWLEDGEMENTS First and foremost I am indebted to Almighty God for having bestowed upon me His grace and blessings always which have helped me to present this piece of work. I take immense pleasure to express my sincere and deep sense of gratitude to my major advisor, Dr. A. Mary Swarnalatha, Professor & Head, Department of Home Science Extension & Communication Management. College of Home Science, Hyderabad. It is my bound responsibility to Dr.M.S.Chaitanya Kumari, former Associate Professor, Department of Home Science Extension & Communication Management. College of Home Science, Hyderabad, PJTSAU, and presently in ANGRAU for her concrete suggestions, careful and constructive criticism, constant encouragement and meticulous attention at all stages of the research work. My profound thanks are extended to Dr.R.Neela Rani, Associate Professor, Department of Home Science Extension & Communication Management. College of Home Science, Hyderabad, for her untiring interest and encouragement, useful suggestions and timely help extended in the preparation of this thesis. My heartfelt thanks are to Dr.S.Suchiritha Devi, Assistant Professor, Department of Foods and Nutrition, Rajendranagar, Hyderabad for the advice and help given during my research work. I extend my heartfelt thanks to the Head and staff of the Department of Home Science Extension & Communication Management, for their concrete suggestions and timely help rendered throughout the study. It gives me great pleasure to humbly express my profound gratitude and heartfelt thanks to my super senior V. Sindu Rani, ICDS, Extension officer(grade I), for extending support in selection of sample and carrying out research activities. I would like to express my heartfelt thanks to Dr. Nageswara Rao, Retired Statistician, for his suggestions and support in completing statistical analysis. I am proud to have well supported family in all aspects and I allocate my highest respect and regard to my parents Shri A.Bodiya Naik & Smt. A.Suguna, and my siblings A. Nagaraju & A.Anitha for being always beside me. I also like to express my deep sense of gratitude to my friends Divya, Anusha, Sreelatha, Swathi Nagaraj and Maheswari all the support, companionship, entertainment and caring they provided. My sincerest gratitude to all my batch mates, seniors and juniors who in some or other way helped in the completion of my thesis. I am thankful to the authorities of PJTSAU for providing the opportunity to study in the university. Date: (A.LALITHA) v

8 LIST OF CONTENTS CHAPTER TITLE PAGE NO. I INTRODUCTION 1-6 II REVIEW OF LITERATURE 7-21 III MATERIALS AND METHODS IV RESULTS AND DISCUSSION V SUMMARY AND CONCLUSIONS LITERATURE CITED APPENDICES vi

9 LIST OF TABLES S.NO TABLE TITLE PAGE NO NO Variables and their Empirical measurement Distribution of the tribal women based on their age Distribution of the tribal women based on their education Distribution of the tribal women based on their size of family Distribution of the tribal women based on their type of house Distribution of the tribal women based on their occupation Distribution of respondents based on the water sources Distribution of respondents based on the water fetching practices Distribution of respondents based on the gender role in water fetching Distribution of the respondents based on their water 48 storage practices Distribution of the respondents based on their water 50 handling practices Distribution of the respondents based on their water 52 and hygiene practices Distribution of the respondents based on their water 55 purification methods Content analysis with indicators contribution towards 60 vii

10 content effectiveness Module analysis with indicators contribution towards module effectiveness Significant difference in knowledge between pre and post tests of the respondents Distribution of tribal women based on their perception on domestic water sanitation Distribution of Anganwadi workers based on their perception on domestic water sanitation Significant difference in perception level of tribal women and Anganwadi workers on domestic water sanitation viii

11 LIST OF ILLUSTRATIONS S.NO FIGURE NO TITLE Selection of sample and sample size PAGE NO Conceptual frame work of the study Age categorization of the respondents Educational levels of the respondents Size of family of the respondents Type of house of the respondents Occupation of the respondents Drinking purpose of the respondents Household purposes of the respondents Frequency of fetching water of the respondents Frequency of waiting of the respondents Frequency of waiting time of the respondents Gender role of the respondents Storage vessels cleaning of the respondents Handling water of the respondents Washing hand before handling water of the 51 respondents Material used for hand washing of the respondents Washing hands before eating food of the 53 respondents Washing hands after defecation of the respondents Disposal of waste water of the respondents 54 ix

12 Distribution of the respondents based on their 56 water purification methods Process of development of multimedia module on 58 tribal domestic water sanitation Story board for development of multimedia 59 module Quartile deviation in perception of tribal women Quartile deviation in perception of Anganwadi workers 71 x

13 LIST OF PLATES S.No. Plate No. Title Page No Researcher interviewing tribal women Screening of module on tribal domestic water sanitation in tribal women Conducting pre test to Anganwadi workers Screening of video on construction of soakage pit 74 xi

14 LIST OF ABBREVIATIONS WHO MDG UNICEF ITDA PSP HP MIH MAC IEC AM CD CAL NIN TV : World Health Organization : Millennium Development Goal : United Nations International Children s Emergency Fund : Integrated Tribal Development Agency : Public Stand Post : Hand Pump : Make It Healthy : Make a Change : Information Education and Communication : Animated Module : Compact Disc : Computer Aided Learning : National Institute of Nutrition : Television xii

15 Name : A. LALITHA I D NO : HHM/ 2013/019 Title of the Thesis : DEVELOPMENT OF MULTIMEDIA MODULE FOR EFFECTIVE DOMESTIC WATER SANITATION AN EXPERIMENTAL STUDY IN TRIBAL AREA Degree to which it is submitted : MASTER OF SCIENCE IN HOME SCIENCE Major Field : HOME SCIENCE EXTENSION AND COMMUNICATION MANAGEMENT Faculty : HOME SCIENCE Major advisor : DR. A. MARY SWARNALATHA University : PROFESSOR JAYASHANKAR TELANGANA STATE AGRICULTURAL UNIVERSITY Year of submission : 2015 ABSTRACT Water has direct impact on health and economic status of an individual as well as nation. Effective water sanitation is crucial in view of the depletion of world s safe water and increased health burden of unsafe water. In view of the above problem the research was proposed to develop a multimedia module for effective domestic water sanitation following the experimental research design in Adilabad district. A total of 90 respondents comprising 60 tribal women and 30 Anganwadi workers of Adilabad district were randomly selected. Content effectiveness of the developed module was analyzed by 30 experts from the faculty of Home Science. After execution, perception of the respondents were collected towards the key messages disseminated through the developed module. Results revealed that majority (46.6%) of the tribal women were middle aged followed by young age (35%). 48.3% of the selected tribal women were illiterates, followed by high school education (23.3%) and primary schooling (18.3%). More than half (51.6%) of the selected tribal women were belonged to medium size family followed by small size family (43.3%). About 66.6 per cent of the tribal women had pucca houses and agriculture was the main occupation of majority (71.6%) of the tribal women. xiii

16 The primary water source was hand pump for drinking and household purposes, while pond and tap were secondary water sources which were available within a distance of a kilometer. Forty six and seven percent of the tribal women expressed that they fetched water more than 5 times a day for drinking and household use from water source, whereas in the case of Anganwadi workers, more than half of them fetched water less than 3 times a day. For fetching water a great majority of the tribal women and Anganwadi workers waited for less than 15 minutes at the community water source. Seventy per cent of the tribal women were responsible for fetching water (70%) in the household and in very negligible (1.7%) percent households it was the responsibility of men. 43.3% of the Anganwadi workers stated that women were mainly responsible for water fetching but only 10% of the Anganwadi workers households it was the responsibility of men. All the respondents collect water from the source several times every day and never stored the water for more than a day. A great majority of the tribal women (90%) and Anganwadi workers (86.6%) took out water by dipping glass held in hand. Only 15% of the tribal women and 40% of the Anganwadi workers had the practice of hand washing before handling water. Among those who practiced hand washing, only 2 tribal women and 7 Anganwadi workers had the practice of hand washing with soap. A great majority (96.6%) of the tribal women and 83.3% of the Anganwadi workers had hand washing practice before eating. Fifty percent of the tribal women are practicing the indigenous practices like washing hands with ash/soil after defecation. While an equal percentage of the tribal women washed their hands with soap and normal water after defecation. But after defecation all the Anganwadi workers had the practice of hand washing with soap and water. Filtering with cloth /sieve was the common water purification practice observed in the tribal area irrespective of the source of collection. Majority of the tribal women (83. 3%) and Anganwadi workers (66.6%)stated that they filtered drinking water using cloth or sieve at collection point in order to filter the solid dust particles. Along with cloth filtration about 44.0% of the tribal women and 35% of the Anganwadi workerspractice boiling of drinking water. For development of the multimedia module, content was collected and identified the issues and given to the selected experts along with checklist for selection of key issues. Content for identified tribal domestic water sanitation management was translated into a vernacular language i.e. Telugu. Outlines, flow charts and story boards were prepared for the development of the multimedia module. Using a page based authoring tool i.e., PowerPoint multimedia module was developed. Beta testing was done for quality assurance by the experts. The content analysis indicator Practical utility (22%) had high percentage of contribution towards content effectiveness followed by informative (21.7%) and adequacy (21.0%). Module analysis revealed that the major indicator use of illustrations contribute 22.6 percentage towards module effectiveness among the other indicators of the module followed by animation (20.8%), audio and video (20.4%). The obtained Z-test values revealed that there is a significant difference between the perception of the tribal women and Anganwadi workers. Paired t-test values showed that xiv

17 there is a significant difference between the mean score values of pre and post tests of the respondents, and t- values were highly significant at 1% level. Rank order of the perception statements showed that tribal women expressed their highly favorable attitude towards the statements Washing hands with soap before handling water and food, Boiling of drinking water for 10 minutes and Washing hands with soap after defecation were perceived highly favorable and were ranked as 1, 2 and 3 by the tribal women. The statements Boiling of water for 10 minutes, Diverting waste water to backyard garden were rated 1, 2, and 3 by the Anganwadi workers. xv

18 Chapter I INTRODUCTION My suggestion is that we should first work to ensure the third world has drinking clean water and sanitation --- Bjorn Lomborg The issues of development, environment and health are closely entwined. This reflects the complex links between the social, economic, ecological and political factors that determine standard of living and other aspects of social well-being that influence human health. A healthy population and safe environment are important pre-conditions for a sustainable future. India cannot achieve real development if majority of its people particularly live in an unhealthy and unclean surroundings due to lack of access to safe water and sanitation. Poor water and sanitation facilities have many other serious repercussions. A direct link exists between water, sanitation and, health and nutrition and human well being. Consumption of contaminated drinking water, improper disposal of human excreta, lack of personal and food hygiene and improper disposal of solid and liquid waste have been major causes of many diseases in India and it is estimated that around 30 million people suffer from water related illnesses. Children particularly girls and women are the most affected. Tribal scenario in India There are twenty countries in the world with substantial tribal population. India has the largest tribal population in the world. The 1991 census of India had recorded the tribal population to be 67.8 million and they constitute 8 percent of the national population. Tribal groups are very heterogeneous. Article 366 (25) refers to Scheduled Tribes as those communities who are scheduled in accordance with Article 342 of the Constitution. According to Article 342 of the Constitution, the Scheduled Tribes are the tribes or tribal communities or part of or groups within these tribes and tribal communities which have been declared as such by the President through a public notification. According to the 2011 Census there are 24, 94, 54, 252 households of which 2, 14, 67,179 households belongs to ST population. Total population of the country is 1

19 1,21,05,69,573, out of this 10, 42, 81,034 are classified as ST with 5, 24, 09,823 males and 5, 18, 71,211 females. The decadal growth rate of the tribal population during is 23.7% which is higher than India s total decadal growth (17.6%). The tribal population of India constitutes 8.6% of total population of the country and majority of them. Adilabad district is situated on the northern boundary of Telangana, forming a border with Maharashtra on the north, east and western borders and Nizamabad and Karimnagar districts of Telangana on the southern border. It is the second largest district in the Telangana region and occupies an area of 16,128 square kilometers, surrounded with 44.8 percent of the thick forest area. According to district data base in Adilabad 85.3% had access to electricity, 88% had drinking water, 25.3% toilet facilities and 10.4% lived in a pucca houses. The total population of the district is 2,741,239, out of which the tribal population is % as per 2011 census. The Gond sare predominant among the tribes and constitute about 50% of the tribal population. Adilabad has a sex ratio of 1003 females for every 1000 males, and a literacy rate of 61.55%. Tribals are the most deprived marginalized group living in deplorable conditions. The health problems need special attention in the context of tribal communities of India. Available research studies point out that the tribal population has distinctive health problems which are mainly governed by their habitat, difficult terrains and ecologically variable niches. The widespread poverty, illiteracy, malnutrition, absence of safe drinking water and sanitary living conditions, poor maternal and child health services and ineffective coverage of national health and nutritional services have been traced out in several studies as possible contributing factors to dismal health conditions prevailing among the tribal population in India. Significance of safe drinking water The World Health Organization (WHO) defines safe drinking water as, water that does not represent any significant risk to health over a lifetime of consumption, including different sensitivities that may occur between life stages (World Health Organization, 2008). However for billions of people across the globe, access to safe drinking water is limited. Lack of safe water creates an enormous burden in the form of 2

20 waterborne illnesses such as diarrheal disease, cholera, typhoid etc. Diarrhea and waterborne diseases are leading causes of mortality and morbidity in developing countries. Safe water is one of the most important felt needs in public health in developing countries in the twenty first century. The year 2005 marked the beginning of the International Decade for Action: Water for Life and renewed effort to achieve the Millennium Development Goal (MDG) to reduce by half the proportion of the world s population without sustainable access to safe drinking water and sanitation by It is estimated by World Health Organization (WHO) and United Nations International Children s Emergency Fund (UNICEF) that 1.1 billion people lack access to improved water supplies and 2.6 billion people lack adequate sanitation Poor sanitation, water and hygiene have many other serious repercussions. Inadequate access to safe water and sanitation services, coupled with poor hygiene practices, kills and sickens thousands of children every day, and leads to impoverishment and diminished opportunities for thousands more. Poor farmers and wage earners are less productive due to illness, health systems are overwhelmed and national economies suffer. Water has direct impact on health and economic status and effective water sanitation is crucial in view of the depletion of world s safe water and increased health burden of unsafe water. In India, over a billion people lack safe water, 80 per cent of the infection diseases are water borne, killing 1.5 millions of children each year. Approximately 88 per cent of diarrheal diseases are attributed to unsafe water supply, inadequate sanitation and hygiene (WHO, 2004). The proportion of population in rural areas with access to safe drinking water has a direct impact on the health of the masses. Water sources and sanitation facilities have an important influence on the health of household members, especially children. The intensity of the water related health problems is very high in tribal habitations compared to rural and urban. Education through multimedia modules To make the illiterate tribal communities water sanitation literates, effective educational strategies with purposively designed instructional materials are vital. Today electronic communication tools combined with massive coverage, even in remote areas allows a poor man get to be connected with knowledge sharing systems. Missing of tribal context and dialect is the limitation of the electronic media to reach the tribal 3

21 community. If educational content is developed blending tribal dialect and relevant cultural context of the community the accelerated diffusion and adoption is possible. Multimedia instruction using computer technology is one method that can be used to supplement or replace the traditional off-line and standardized education for educating illiterates. The Multimedia communications program blends creativity and technology in dynamic and rewarding work. One can create and design educational material with moving and still images, text and sound in order to reach and engage varied audiences. The advent of multimedia and multimedia technologies has changed the way educators teach and learners learn. With multimedia, the communication of the information can be done in a more effective manner and it can be an effective instructional medium for delivering information (Neo and Neo, 2000). Modern educational technology envisages multimedia technology to develop an effective presentation of contents. The development of these multimedia technologies offers new ways for learning which can take place in formal and informal education. It creates teaching situation, through the multi-directional sensory system to stimulate the learners interest in learning, there by strengthens the memory, it is capable of enhancing learning and teaching at the same time. Multimedia provides integrated service of seeing, hearing and involving. Multimedia is a means to communicate information in both an effective and cognitive manner. Need and importance of the study Safe drinking water is human health. Water for drinking must be pure. Water quality, howsoever good at source, deteriorates during transfer in domestic containers. Various diseases like diarrhea, dysentery, cholera and jaundice are transmitted through contaminated water and poor sanitation. Two third of all illness in India is related to water borne diseases such as typhoid, diarrhea and dysentery. As usual, children and women were the worst sufferers, due to lack of safe drinking water regarding hygienic practices. Therefore, there is an urgent need to educate the tribal women regarding hygienic practices and provide safe drinking water in tribal areas. Few methods are being used at household level to make water safe for drinking in rural areas, namely, boiling and filtering through muslin cloth. Chlorine tablet is rarely used at home. The water filters available in the market are not used, as they are expensive. 4

22 In view of the above circumstances the present study was proposed for the development of multimedia module for effective tribal domestic water sanitation using computer technology. In this study, the multimedia module was designed for illiterate tribal population in order to create awareness and improve knowledge on water sanitation issues like importance of safe drinking water, water sanitation practices, water purification methods, signs & symptoms and prevention & control of water borne diseases, waste water management methods etc. The developed module may provide a model for tailored program offering specific health information. Several studies also reported that multimedia interventions and animated modules are successful in improving knowledge, and changing the attitude of the learners. So the present study is formulated to know how developed multimedia modules on tribal domestic water sanitation incorporating with different media formats such as text, images, animation and video are effective with the following objectives. Objectives of investigation 1. To study the existing domestic water sanitation practices in Adilabad district. 2. To develop multimedia module on domestic water sanitation management. 3. To analyze the content effectiveness of the developed multimedia module. 4. To assess the perception of the respondents on domestic water sanitation practices Scope of the study Educating the illiterate Indian population on domestic water sanitation requires effective communication strategies to bring socio cultural acceptance and change in people s behavior i. knowledge, practices and attitudes. The present study focused on an effective communication approach called interpersonal communication using contemporary educational methodology like multimedia module. Design and development of multimedia module on domestic water sanitation for tribal women are planned in more generic way, therefore, the special informational needs of tribal women are addressed. The present attempt in a humble way aims to present authentic and scientifically proven information on domestic water sanitation, which would help the extension functionaries working in the fields of water sanitation, health education, tribal welfare and family welfare in imparting water sanitation education and creating awareness in tribal areas. 5

23 The present investigation studies the personal profile, existing water sanitation practices of tribal households, content effectiveness of the module and perception of the respondents on water sanitation practices after execution of the intervention. The study also provides well designed and developed quantitative outcome called multimedia module. Limitations of the study The study was conducted with some unavoidable limitations such as regard time, study area, sample size etc. which are usually encountered by a single investigator. Conducting the investigation in tribal areas is comparatively difficult because of the distinct socio-culture and situational factors of the tribes who are not easily approachable. This problem was overcome by building rapport and getting the required support from the personnel of ITDA (integrated tribal development agency) and local tribal leaders in establishing rapport with the respondents and execution of the study. It is also a fact that the investigator was confined to one tribal district for the study obviously; the findings emanating from the study would be applicable only in similar geographical contours. Presentation of the study This is presented in six chapters. The first chapter deals with Introduction where in the scenario, need, objectives, the scope and limitation of the study are discussed. The second chapter Review of Literature deals with review of available and related studies in the light of the present investigation. The third chapter focuses on Methodology used for collection of data, statistical tools employed etc. The fourth chapter covers the Results & Discussion of the study. The fifth chapter is Summary& Conclusion with the implications of the study. At the end Literature cited and Appendices are presented. 6

24 Chapter II REVIEW OF LITERATURE Review of literature includes the systematic identification and analysis of information related to research problem. It helps in interpretation of the findings and to draw implications of research and its main aim is to fill the gaps of the already existing research literature. A comprehensive review of literature is essential for any research. The chapter deals with the review of literature for the present study and is presented under the following headings 2.1 Profile characteristics of tribal women 2.2 The existing domestic water sanitation practices 2.3 Development of multimedia module 2.4 Effectiveness of multimedia module 2.5 Perception of the respondents on domestic water sanitation practices 2.1 Profile characteristics of tribal women Lalitha (2014) conducted a study to find out the Tribal Diversity in Andhra Pradesh and Telangana: A Comparative Analysis of the educated lot. The results brought out an alarming fact that 69% of the tribal population is illiterate, 13% have completed primary education and 8% have completed up to secondary education. Only 6% of the population has intermediate level education and only a small percentage of 4% are graduate degree holders. Agriculture is the main source of income and livelihood for a majority of the tribals. The highest component of the tribals owns a tiled house (51%) as compared to owning a hut (18%). In terms of housing, more than 90% of houses in Vishakhapatnam are tiled. Majority (56%) of the families in Warangal live in slabbed houses. About one-third of the Lambadi tribe still lives in huts. Dhanasree et al. (2014) in their Socio-Economic Empowerment of Tribal Women in High Altitude and Tribal Zone of Andhra Pradesh revealed that 48.3 per cent of the respondents were illiterates followed by functionally literate (32.7%), 7

25 primary school (18.8%). Most (49.4 %) of the tribal respondents were having medium family size followed by large family size (31.1 %) and small (19.4 %). Had medium level of annual income followed with low (22.2 %) and high (10.5 %) levels of annual income and agriculture was the main occupation for majority of the tribal families. Kumar et al. (2014) stated that Literacy rate among the male and female tribes at the state level in Andhra Pradesh was respectively 47.6 % and 26.1%. Over 70% of the tribal literates fall in the category of and primary level of education. While 8 % each covered under middle and secondary level of education. Bharti et al. (2013) conducted a study in rural block of Haryana on knowledge attitude and practices regarding water handling and water quality assessment. Informants were mostly adult females (96.4%). The most common occupation of head of household was farming (54.7%) followed by labour (30.8%). The literacy level of head of majority of households was till matriculation (50.8%) and around 9.6% of them were illiterate. Ministry of tribal affairs (2013) stated that 40.6% of STs live in good conditioned houses and 6.2% live in dilapidated houses and 22.6% of STs have latrine facility within the premises. 19.7% of STs have drinking water source inside their premises whereas 33.5% have it away from their premises. The data shown that at the All India level only 46.9% of all households out of which 22.6% of ST households have latrine facility within the premises. Bhattacharya et al. (2011) studied water handling and sanitation practices in rural community of Madhya Pradesh and the profile of the rural respondents showed that in ichhawar block literacy rate was 33% as against 40% in Astha block. No much difference was observed in middle and secondary level of education in both the blocks. With regard to type of house, in Astha 45% households were kutcha, 28.8% semi pucca and 30% pucca. In Ichhwar block 54.2% households were kutcha, 21.3% pucca and 24.5% were semi pucca. Most of the people in rural areas own livestock and their main occupation was agriculture. Ministry of tribal affairs (2010) in their census data illustrated that, in India only 24.4% ST households possess permanent houses and 51.4% have semi permanent houses while the rest 24.2% are in temporary structures. The source of drinking water was Taps for 20% of households, Hand pumps (35.8%), Tube wells (5.9%), Wells 8

26 (28.4%), Tanks, Ponds, Lakes (1.4%) and for Rivers, Canals, Springs, etc. (7.1%). Also, the sources of drinking water were Within premises for 15.2% of households, Near premises for 56.6% of households and Away for 28.2% of households. Kumari (2004) in her study on tribal women entrepreneurs in High Altitude Tribal zone of Andhra Pradesh stated that majority of the tribal women were middle aged, illiterates, married and trained with medium category of entrepreneurial experience, socio-economic status, family support, marketing facilities, management orientation and value orientation. Most of them availed financial support rarely. 2.1 The existing domestic water sanitation practices Water collection, storage and handling Joshi et al. (2014) in their study Water and sanitation hygiene practices in urban slum settings revealed that piped water (45%) and bore well/tube well water (30%), were the main sources of water in urban slums. While 18% availed water from both the sources. More than half of the water sources were through public supply (53%) % had access to water source within the household. The study also revealed that a gender disparity in fetching water, as females (93%) were largely responsible for fetching water. Majority of the participants had to walk a distance of more than 30 minutes to fetch water. The study also showed that the most common problems faced during the water supply included unclean water (28%), irregular water supply (12%) and bad odor (7% ). Only 33% of the study participants cleaned water containers daily. Bharti et al. (2013) in their study revealed that all informants perceived about importance of covered drinking water in prevention of diseases but covered drinking water was found in 96.8% of households and stored in earthen pots (92.5%). Around two third of informants (64.4%) did not know about importance of ladle to draw water while ladle was actually being used in less than one third (30.5%) of households only. Busenna and Snehalatha(2013) conducted a study in Kurnool district to assess water, sanitation and hygienic practices in rural India and results indicated that nearly 98% of the women were washing hands after defecation and before and after eating of food while only 2% of the households did not washing hands with soap after defecation. With reference to caste, 63.8% of SCs are washing hands without using any material, followed by STs (57.1%), BCs (48.9%) and OCs (27.3%). 50% of STs and their 9

27 children are not washing hands before and after food, followed by BCs (30.7%), OCs (29.4%) and SCs (20.5%). Nearly, 43% children are using soap for washing hands before and after food. Majority of the households are far away for tap connection and toilet access in general and particularly in SCs and STs. Mishra and Nandeshwar (2013) in their study to assess water source sanitation, Water quality and water related practices at household levelin Madhya Pradesh. The results showed that out of 312 households, 236 (75.6%) did not have access to safe drinking water with in the household premises. Majority of the families (76.4%) used both earthen and metal pots for storage of drinking water. A good practice of covering stored water was found in the study area. About 97.4% families were engaged in this practice and also collect drinking water every day. It also evidenced that more than half (56.09%) of the households, females were responsible to collect water. 15.7%, of the households have water facility within their premises. Percentage of households who spends up to 30 minutes in collecting water was 23.7%, 39.5% households takes up to 1 hour and 36.8% household spent more than 1 hour. Busenna and Snehalatha (2013) conducted a study in Kurnool district to assess water, sanitation and hygienic practices in rural India and results showed that 14% of households have their own tap connections. For 45% of households, the main water source is PSP (Public Stand Post). Nearly 32% are fetching water from HP (Hand Pump) being second highest water source irrespective of the community. Bhattacharya et al. (2011) in their study found only 38% of household used handled jug to take out drinking water from vessel and most of the respondents interviewed took out water by dipping glass held in hand. This practice of drawing water increases the risk of microbial contamination of drinking water by contact with potentially contaminated hands. Chawla et al. (2006) conducted a study in Haryana on sanitation practices and safe drinking water technology in rural homes. It revealed that for kitchen activities, all respondents stored water in earthenware followed by metal containers (89%) whereas 71% stored water in plastic containers. Less than fifty per cent respondent s stored water in plastic buckets, metal buckets and drum. Water for personal and household activities was stored in plastic buckets (100%) followed by plastic containers (84%) and metal buckets (78%). In addition to this, more than fifty per cent (55%) also used water 10

28 from hand pump, 33% from tube well and 11 % from public well for drinking purpose and other household activities Water and hygiene practices Greenland et al. (2013) in their study on the context and practice of hand washing among new mothers in Serang, Indonesia reveled that hand washing with soap was found to be infrequent, typically occurring after eating, cooking and household chores or after cleaning a child s bottom. Hand washing before preparing food or eating was rare. Pre-pregnancy routines were reported to have been disrupted. Advice on child care comes from many sources, particularly the midwife and new child s grandmother. Mishra and Nandeshwar (2013) in their study revealed that the only water purification method known and practiced in the selected village was filtration by cloth or plastic sieve. Only 99 (31.7%) families reported of washing hands always, 175 (56%) sometimes and 38 (12.2%) families never wash their hands before drawing water from the vessels Water purification methods Francis et al. (2015) reported that majority of the participants considered public water supply safe for drinking and other household use. Among those who considered public water to be unsafe for drinking, boiling drinking water prior to consumption was the most popular water purification method practiced. A few parents spoke about warming water before giving it to children, especially during winters. Other less popular methods employed were filtering with a cloth or sieve and filtration with ceramic filters. Participants across all categories reported filtering of water more frequently for children than for adults. This is illustrated well by the following responses: Bharti et al. (2013) revealed that around two third (64.3%) of informants were aware that boiling or filtering water can prevent water borne diseases but it was being practiced in only 10 % of households. Diarrheal episodes in any family member in past 6 months were noticed only 26.7% households. Gopal et al. (2009) in their study of water supply & sanitation practices in India using geographic information systems found that water in the village was microbiologically unfit for consumption and direct observations supplemented by GIS 11

29 maps revealed poor planning, poor engineering design and lack of policing of the water distribution system causing possible contamination of drinking water from sewage at multiple sites. Gopal et al. (2009) conducted a research to study the water supply & sanitation practices in India using geographic information systems. Their study evidenced that the commonest form of disinfection in rural India is single-point chlorination, using bleaching powder. However, this may not be effective because of the possibility of multiple sites of contamination. In this study village, the amount of chlorine added was inadequate by the WHO (world health organization) standards. Vigneswaran and Sundaravadivel (2007) stated that all over the world, rural communities have adopted simple and rudimentary treatment techniques that mainly aim at filtering out the visible impurities from the water collected from the local sources. These methods are expedient and can remove certain types of particles in water, they do not provide water necessarily of what could be considered, under present day situation, as drinking quality. However, it can be considered that these methods provide water of quality that is acceptable to these rural communities. Filtration through cloth, sieve and boiling were the main water purification methods fallowed by the rural India. 2.2 Multimedia module in water and health education The Project WET write shop (2014) was part of the Water Education Project launched "DiscoverWater.org where teachers and students can learn all about water through fun, interactive games and lessons. Young visitors can play games, read stories, watch videos, print coloring pages and commit to taking action to improve water resources, while educators and parents can use the site to teach engaging, science-based lessons around water. Susan et al. (2008) in their study used two modules Make It Healthy (MIH) interactive multimedia module and Make a Change (MAC) computer text module to teach healthy diet for school children. The results indicated that significant knowledge gains were observed with both modules. The MIH module had significantly more gains than those who used MAC. The changes like choosing of low fat foods were observed in school children after teaching with MIH. 12

30 Raghavan et al. (1997) carried out a study in 20 villages on home gardening for combating vitamin A deficiency. Village assistants and district level supervisors provided multimedia nutrition education. An evaluation at the end of 3years revealed that there was more than 6 fold increase in the percentage of house hold with home gardens. Kolasa et al. (1997) suggested using multimedia technology helps to provide appropriate physician role models, teaching nutrition assessment and counseling in medical schools. Pressley (1997) stated that the separate presentation of visual and textual elements of hyperlinked related pictures may contribute to children decoding the text more accurately and thus enhances children s recall ability. Szabo and Phookey (1996) acknowledged that video and animated images form a substantial part of a Hypermedia presentation and they can provide a much more communicative and convincing display under particular circumstances. For example, they may prove very powerful in representing highly abstract words and concepts that do not have a readily apparent physical referent or counterpart (e.g. atom, blood flow). Additionally, moving images may provide a more direct and accessible means of communicating concepts like time, motion, trajectory and space. Murray (1994) claims that animation, especially cartoon techniques, can be very motivating, have charisma and glamour they are more economical for the computer s memory and are therefore displayed more rapidly, a fact that contributes to the general excitement. Furthermore, animated and interactive images, in comparison to static ones, can radically increase the viewer s sense of reality and hence increase motivation. It seems that moving pictures have some kind of inherent characteristics like playful motion and interactivity that attract the attention of the eye, characteristics that are missing in static pictures. 2.3 Multimedia module on domestic water sanitation Sriram and Maheswari (2013) conducted study on Integrated Communication Strategy for Creating Awareness on Sanitation and Hygiene Behavior Change. It was analyzed the awareness level on sanitation and the effectiveness of the prevailing Information, Education and Communication (IEC) approach among rural Indians. Focus Group Discussion and Survey methods were used to analyze the awareness level and 13

31 effectiveness of IEC among the rural people and also a new Integrated Communication Strategy (ICS) to improve the situation. UN-Habitat ( ) Nepal in conducted study on behavior change communication strategies on sanitation and hygiene and the communication strategie. were used to change the behavior of the people to promote the hygiene situation in the Nepal are demonstrations, documentation, use of printed and audio-visual aids, draft script/text, select images/storyboard, pre test storyboard/layouts/prototypes. Biran et al. (2009) conducted a study on effect of a soap promotion and hygiene education campaign on hand washing behavior in rural India: a cluster randomized trial. Revealed that the intervention reached 40% of the target population. Germ awareness increased hand washing (a possible indicator of perceived social norms) was observed hand washing with soap on key occasions was rare (6%), especially after faecal contact (2%). Observed hand washing with soap on key occasions did not change 4 weeks after the intervention in either the intervention arm (1%, 95% CI) 2% +0.3%), or the control arm (+0.4%, 95% CI) 1% +2%). Data from motion detectors indicated a significant but small increase in overall soap use in the intervention arm. They cannot con- fidently identify the nature of this increase except to say that there was no change in a key measure of hand washing after defecation. WHO (World health organization) (2008) in their study Guidance on communication with respect to safe drinking water and household hygiene reported that as part of the communication strategy, they developed the national hygiene map, a three-page leaflet on cardboard with pictures, graphics and limited text. It was predominantly on safe water systems, with photographs of chlorinating water, how to store it and other methods of making sure drinking water was safe, boiling, but it was predominantly focused on safe water supply. And also they used local radio to get some music or a drama in between the message to break it all up every fifteen minutes. Mafuya and Shukla (2006) in their study of a safe hygiene practices in Eastern Cape rural communities of South Africa revealed that indigenous and conventional hygiene promotion techniques were identified included media, bill boards, word of mouth, radio talk shows, awareness campaigns, competitions, dramas, school programmes, home-produced posters and pamphlets and making use of celebrities and those implications for policy-makers, programme planners, academics and practitioners in the field. 14

32 Mafuya and Shukla (2006) reported that in South Africa motivate people to adopt safe hygienic practices in the Eastern Cape Province shown that Regular water supply, provision of sanitation facilities, stakeholder participation and improvement of consumer sanitation knowledge are factors which can motivate people to adopt safe hygienic practices. There are cultural, educational, economic, institutional, environmental and psycho-social factors that could motivate people to adopt safe hygienic practices. 2.3 Content effectiveness of multimedia module Vishnu (2011) studied effectiveness of animated modules of nutrition messages on high school children. Three modules were developed based on the selected nutrition messages in each category. Animated Module 1 (AM 1) is titled Food groups and functions, Animated Module 2 (AM 2) titled Be well red aware of anemia and Animated Module 3 (AM 3) is titled Bye bye to junk foods. In AM1 the indicator presentation contributed to the maximum, AM 2 indicator colour had attained high percentage indicator score and in AM 3 the indicators colour (18.7%), illustration (18.6%) and design (18.3) ranged almost equally in contributing to the effectiveness of the module. Girija and Vijayalakshmi (2010) developed a self learning material on social sciences with the help of computer multimedia package. The experimental group was treated with the self learning material and control group was treated with the traditional teaching. The findings indicated that self learning material with multimedia techniques brought improvement in Social sciences on the achievement of students from experimental group and superior performance over traditional group. Singaravelu (2010) conducted a study using multimedia module on pedagogical technique for the scholars of Master of Philosophy. The research study findings showed that experimental group Knowledge level was increased in post test after exposing multimedia module andit proved the effectiveness of multimedia assisted teaching in the pedagogical technique. Carolyn (2009) developed a project for assessing the effectiveness of an interactive multimedia product namely Syber Shop, to increase knowledge and influence on behaviour in nutrition and physical activity among adolescents. Syber 15

33 Shop was found to be effective in increasing knowledge and an effective way to educate young people about healthy eating and physical activity. Benjamin et al. (2008) in their study used interactive learning modules for preclinical medical education. Results showed that higher scores in the experimental group relative to the control group after exposing to these modules and 83 % rated them as very helpful and extremely helpful. Their data suggested that medical students may learn more effectively and feel less intimidated by difficult concepts when interactive modules supplemented traditional instruction and they are significantly different in terms of effectiveness in teaching. Antony et al. (2007) conducted a study to assess nutrition knowledge levels of the adolescent girls with two different interventions. One is traditional method using print media and other is audio-visual CD. The control group is exposed to traditional method and experimental group is exposed to audio visual CD (Compact Disc). A significant improvement in the nutrition related knowledge was observed among the experimental group. However, no significant difference in the improvement of nutrition knowledge levels was observed with the second intervention over the first intervention as already the children in the experimental group gained knowledge through print media. Patricia et al. (2007) developed a computer- based compact disc instructional module covering the nutrition topics of oral rehydration therapy, calcium, and vitamins were used. This module was tested on pediatric residents. The results indicated that experimental group demonstrated significantly better than the control group in post test. This computer based compact disc instructional module positively impacted both residents knowledge and attitude. Vickie and Abraham (2006) suggested that with computer animation technology dynamic and three-dimensional presentations are possible. The difficult chemical models and chemical phenomena can be easily explained through computer animations for chemistry students. Lim et al. (2004) in his study on animated anatomical model on anatomy and regional block technique was presented to the delegates and surveyed whether the presentation enhanced their understanding of anatomy and regional block technique on technical principals, surface land markings. It was found that 87.5 percent reported that 16

34 presentation enhanced their understanding of the anatomical and technical principles. Results showed that 24.1 percent improved in surface land marking skills after the teaching presentation. Finally the study concluded that three- dimensional animation is a promising new tool to accelerate the learning of regional anesthetic techniques. Timothy (2004) studied the impact of multimedia animation on learning Boolean algebra for adult students. Findings indicated that animation appear as a foster and greater degree of learning Boolean algebra for adult students in a junior college setting. Tutorial on Boolean algebra enhanced with animations produced a significant improvement in knowledge of adult students. Katrin (2003)conducted a study with two interventions one is traditional nutrition education materials used in control schools and other is computer based educational tool used in intervention schools. In intervention schools, younger pupils (8-9 years) had better nutritional knowledge than older pupils (10-11 years) as they exposed to the computer based nutritional educational tool. This tool increased the possibilities of school-based nutrition education. It has the potential to make learning about nutrition more enjoyable, exciting and effective. Radharani (2003) conducted study on Consumer education through multimedia. The research finding reveled that consumer education through multimedia package brought an effective change in the consumer behaviour of women. Warren et al. (2003) in their research paper described the development, implementation and evaluation of a school and family based intervention to prevent obesity in children aged 5-7 years. Children s growth, nutrition knowledge, diet and physical activity were assessed at baseline and at the end of the intervention. Significant improvements in nutritional knowledge were seen in all children between baseline and post intervention, highly significant results were observed in the nutrition group. Fruit and vegetable intake was increased in control group significantly with changes seen in fruit consumption of nutrition group. Kim (2002) used interactive nutrition and medicine physician modules were used. These Modules was used to provide a consistent nutrition education to medical school students that combined the biochemical, path physiological, and clinical aspects of diet-disease relationships and lifecycle conditions. Each module focuses on a 17

35 specific disease state or lifecycle phase. These modules were effective in providing nutrition education to medical school students. Maciej et al. (2002) studied the effectiveness of seven interactive modules on anemia and diabetes for teaching nutrition to first year medical students and enhance nutrition course for first-year medical students. Students answered the multiple-choice questions to test their nutrition knowledge on anemia and diabetes. The percentage of correct responses to 12 knowledge questions from each module increased from 25% before use of the module to 74% immediately after its use. On their midterm examination, 72% of the students correctly answered questions related to nutritional anemia and nutrition aspects of diabetes. There was 15% increase in knowledge of these 2 areas when compared with the results obtained from first-year medical students earlier who had not used the modules. The results showed that these modules are the effective tools for teaching nutritional and health issues of anemia and diabetes to firstyear medical students and they found the modules are significantly different in design, illustration, and text presentation. Jyothi and Annamma (2001) studied the effectiveness of animated video film entitled Raktabha-kahani anemia ki covering the important aspects of iron deficiency and used for imparting nutrition education to experimental group of adolescent girls. Results showed that there is high increase in knowledge because post test scores are higher than pre test scores as they were exposed to the video film. This results show that the video film is highly effective in imparting nutrition education to adolescent girls. Natessan and Girija (2001) in their study prepared multimedia animated modules for selected 24 topics of VIII standard General Science text book. The research study findings indicated that experimental group student s achievements are higher than the control group. The multimedia based modular approach was rated high on presentation. Emma et al. (2000) developed a computer aided learning (CAL) module which is for educating patients and practitioners concerning diabetes and its care. They found that interactive module is very effective, colourful and useful in teaching practical skills and promoting consolidates theoretical understanding. It is hoped that this module will improve patient self care, and in the long-term reduce the incidence of diabetic complications. 18

36 Campbell et al. (1999) conducted a pilot study on evaluation of a tailored multimedia program to improve dietary behavior among 378 low-income women, the findings suggested that computerized tailored self-help health promotion programs may be effective educational interventions for lower income and minority populations. Nagaraj and Byra (1985) conducted a study on the relative effectiveness of video tape recorded presentation against traditional method and also their combination with other visuals was carried out to compare the effectiveness in terms of gain in knowledge in nutritional concepts, retention of knowledge and symbolic adoption Carol et al. (1985) found that video tapes and lecture method produced similar results with respect to the attitudes, behavior and audience participation. But the participants instructed via video tapes learned and retained more nutrition information. National Institute of Nutrition (NIN) (1985) conducted nutrition education through TV and found that among the different formats used the most popular was animations / cartoons (74%), skits (68%), interviews (64%), dance/ drama (63%), demonstration (41%) and talks (32%). About 74% of viewers stated that nutrition and health messages with animations/ cartoons were useful and effective due to dual effect of audio and video moreover strengthened and enriched the understanding of messages. 2.5 Perception of the respondents on water sanitation practices Francis et al. (2015) reported that faulty perception on water treatment, lack of knowledge about health hazards associated with drinking unsafe water, false sense of perception from locally available water, resistance to change in taste or odor of water and a lack of support from male members of the household were important factors impending acceptance and long term use of the intervention. Joshi et al. (2014) in their study Water and sanitation hygiene practices in urban slum settings reported that all participants perceived that hands should be washed prior to handling of food. Other perceived critical times of hand washing were after defecation (88%) and after eating (75%) among other reasons. Almost all participants washed their hands before eating food (98%). 78% of the participants washed their hands because they perceived it was hygienic, and because it could prevent infection (75%). Almost all participants (98%) disposed their solid wastes in the community dustbins. 19

37 Bharti et al. (2013) in their study revealed that all informants perceived about importance of covered drinking water in prevention of diseases but covered drinking water was found in 96.8% of households and stored in earthen pots (92.5%). Around two third of informants (64.4%) did not know about importance of ladle to draw water while ladle was actually being used in less than one third (30.5%) of households only. Ashish and Amadi (2013) (web) conducted a study and assessed the school children s knowledge, attitudes, and practices included perceptions the study revealed that use of soap/sanitizer (46%, ), latrine coverage in household and community (60%,), hand washing frequency (80%,), sanitation practice (latrine use, 53%,), household water treatment, water storage practices (20%,), and prior knowledge of hygiene practices (20%,) were the major findings. Water Aid (2011) People s perception on sanitation: Findings from Nepal reported that Regardless of gender, caste/ethnicity and where they live (urban or rural area), all community leaders have been found to be acquainted with the importance of sanitation and hygiene. They know what practices comprise personal and public hygiene. It also revealed that basic hygiene, as they perceive it, helps enhance selfesteem. Those who are tidy, clean and healthy are respected in society. They have further said that those who do not have toilets at home feel inferior to those who have toilets at home. Nath et al. (2010) in their Study on Perception and Practice of Hygiene and impact on health in India the level of hygiene perception and practice were divided into two categories low and high. Taking into consideration the seven issues, the perception level and practice pattern were plotted in the four quadrants based on the minimum, maximum and the mean values of perception and practice. The overall perceptions ranged from a minimum of 65% to a maximum of 93% yielding a mean awareness/perception level of 79%. The range for personal hygienic practice was 29% (minimum) through 83% (maximum), with a mean level of reported practice of 52%. Berg (2009) in their study on Perception of health risk and averting behavioran analysis of household water consumption in Southwest Sri Lanka reported that a higher perceived risk induces households with and without a house connection to treat water more before drinking it, which indicates that households in our sample are aware that the action of boiling/filtering water is one type of preventing behavior against the risk of illness. 20

38 Scott et al. (2007) conducted a study on Marketing hygiene behaviors: the impact of different communication channels revealed that hand washing behavior of women in Ghana as part of the communication strategy, were developed TV and radio had greater reach and impact on reported hand washing than community events, while exposure to both a mass media channel and an event yielded the greatest effect, resulting in a 30% increase in reported hand washing with soap after visiting the toilet or cleaning a child s bottom. Yeshwant et al. (2006) developed a multimedia CD (Compact Disc) on Drainage System and studied comprehension for seven messages of drainage system conveyed through developed multimedia CD on rural women. Out of seven messages, four messages were comprehended by all the rural women as having covered drainage line, cleaning drainage lines daily protects environment and use of waste water in kitchen garden. The messages of various water uses and environment pollution and diseases due to improper drainage system were comprehended by 91.4% and 80% of rural women respectively. The only message of taking waste water to soak pit was comprehended by 71.4% respondents. These findings reflect that majority of the rural women were able to understand the messages related to drainage system because the programme designed was having rural background shots with synchronized audio recording following simple language, using easy words. 21

39 Chapter III MATERIALS AND METHODS This chapter describes the methodology followed to conduct a study on the Development of multimedia module for effective domestic water sanitation - An experimental study in tribal area. It is presented under following heads. 3.1 Research design 3.2 Location of the study 3.3 Sampling procedure 3.4 Variables and their empirical measurement 3.5 Development of multimedia module 3.6 Methods used for data collection 3.7 Statistical procedure 3.8 Conceptual frame work 3.9 Operational definitions 3.1 Research design Research design is the plan, structure and strategy of investigations so as to obtain answers to research questions and to control variance. It is the entire process of planning to carry out the investigation. There are different types of research designs like descriptive research design, experimental research design, semi- experimental research design, exploratory research design etc,. Based upon the nature of the research problem and objectives of the present study, experimental research design was selected. 3.2 Location of the study The district of Adilabad was selected purposively as the tribes are densely populated when compared to the other districts of the state. The high incidence of mortality and morbidity among tribals due to unsafe drinking water is also an important factor which led to the selection of this particular location. Tribal mandals selected for the study were Rebbena, Tandur and Kerameri. 22

40 3.3 Sampling procedure Selection of sample and sample size A total of 90 sample comprising 60 tribal women and 30 grass root level women extension personnel (Anganwadi workers - operationally defined as per3.9.7) from three mandals of Adilabad district were selected using random sampling technique. Adilabad Tribal women Rebbena Thandur Anganwadi workers Kerameri Kerameri tribal women and 30 Anganwadi workers Figure 3.1 Selection of sample and sample size 23

41 Selection of subject experts Thirty subject experts from faculty of Home Science were randomly selected for identifying the tribal water sanitation issues and analyzing the content effectiveness of the developed multimedia module. 3.4 Variables and their empirical measurement The variables for the study were selected based on the review of literature and in consultation with various experts in the field. The variables selected for the study along with their empirical measurement are given below Table 3.4.1Variables and their empirical measurement S. No Variable Measurement tools Statistical tools Profile Characteristics: Age, Interview schedule was Education, Type of house, Size developed for the study of family, Occupation Frequency Existing domestic water sanitation practices Interview schedule was developed for the study Frequency (a) Content Analysis Score card was developed for the study Mean score (b) Module analysis Score card was developed for the study Mean score (c) Pre & Post test Questionnaire was developed for the study Mean scores Score card was developed for the study Rank order Percentage Percentage Content effectiveness Perception of the respondents Paired t-test Z test Mean score Quartile Deviation 24

42 3.4.1 Profile characteristics Age Age was operationalised as the number of years completed by the respondent at the time of interview. Based on the age, the respondents were grouped as young, middle and old age. Result was tabulated as shown below. S.No Age Category 1. Young age Below 30 years 2. Middle age 31 to 50 years 3. Old age Above 50 years Education Education was operationalised as the academic qualification of the respondent; the questionnaire developed to measure the education level of the respondents was furnished in the Annexure-1. The respondents were grouped into five categories. S. No Education Level 1. Illiterate - 2. Primary education Class (1-5) 3. Upper primary education Class (6-7) 4. High school education Class (8-10) 5. Intermediate Intermediate and above Type of house It refers to the belongingness of dwelling of the respondents. These are classified into two categories namely kachha and pucca. S. No Type of house Kachha Pucca 25

43 Size of Family It refers to family size of the respondent and operationalised as number of persons living together in one house and to which, respondents belonged to. A questionnaire was developed to know the family size of the respondents and was asked to indicate their family size. S. No Size of Family 1. Small (1-3) 2. Medium (4-6) 3. Large (7-10) Occupation It refers to the livelihood undertaken by individuals to earn money to meet the monetary needs of the family. A questionnaire was developed to know the occupation of the respondents and was asked to indicate their occupation. S.No. Occupation 1. Agriculture 2. Farm Labor 3. Forest based livelihood 4. Business 5. Service in public/private sector Existing domestic water sanitation practices Existing practices of tribal women and Anganwadi workers were collected mainly on the issues like water collection, storage, handling, purification methods and water & hygiene practices followed by respondents at household level. An appropriate interview schedule was developed to elicit the information on existing practices in domestic water sanitation covering the below areas. Water collection practices - water source for drinking and household purposes, distance from water source, frequency of waiting and waiting duration for water collection, gender role in water fetching. 26

44 Water storage practices - type of water storage containers, water storage duration, and frequency of storage vessel cleaning. Water handling practices - method of handling water for taking out the water for consumption, washing hands before handling water and material used for hand washing before handling water. Water and hygiene practices - hand washing practice of the respondents before eating food and after defecation, disposal of waste water. Water purification practices - is the process of removing undesirable chemicals, materials, and biological contaminants from contaminated water. The goal is to produce water fit for a specific purpose. Mostly water is purified for human consumption. The responses of the respondents were collected, analyzed and presented using frequency and percentages as below. S.No Practice Frequency Percentage Content effectiveness Content effectiveness of the developed module was studied in terms of content analysis and module analysis. A total of thirty experts from the faculty of home science were selected for conducting beta test for quality assurance of the developed multimedia module Content analysis Content analysis has been carried out covering the indicators like content sequence, informative, adequacy, relevancy, practical utility, length of sentence, readability and language. The mean scores of each major indicator were computed. S.No Indicators Highly satisfied Satisfied Not satisfied

45 Module analysis Module analysis was measured using multimedia building blocks like module design, illustrations or images, animation and video as major indicators. Each major indicator was assessed using its sub indicators. The mean scores of sub-indicators and average mean scores of each major indicator were computed. The percent contribution of each major indicator for the effectiveness was also calculated for multimedia module. S.No Major Indicators Sub indicators Highly satisfied Satisfied Not satisfied Pre & Post test To assess the efficacy and impact of the multimedia module in imparting education to ultimate clientele, pre and post tests were conducted before and after screening of the multimedia module. Fifteen dichotomous questions covering the key messages were framed and used in the study. S.No Question True / False Perception of the respondents on domestic water sanitation practices To measure the perception level of respondents on domestic water sanitation practices, a list of eleven statements seeking different key messages were prepared. These listed statements were administered to the respondents. The score card consisted of 11 statements with their perception on three point continuum scale i.e. highly favorable, favorable and unfavorable towards the statements, with a score of values 3, 2 and 1 for the responses respectively. This was collected to measure the acceptance levels of respondents towards various recommended practices related to effective domestic water sanitation management. 28

46 S.No. Statement Highly favorable Favorable Un favorable Statements with high scores were identified and ranked as per their perception levels towards each individual statement. 3.5 Development of multimedia module Identification of tribal domestic water sanitation issues Issues of tribal domestic water sanitation (Annexure-1) were the relevant areas that address and promote effective domestic water sanitation for tribals. An exhaustive list of items were collected, grouped under various subheads and presented to the experts for their opinion on two point continuum, whether required or not required. The items with equal and higher than mean score were selected as issues of tribal domestic water sanitation. S.No. Issue Required Not required Development of multimedia module on tribal domestic water sanitation Based on the selection of tribal domestic water sanitation issues by the subject experts, the tribal domestic water sanitation issues were listed into five topics water sanitation scenario, Water born diseases - symptoms, preventive and controlling measures, water purification methods, water testing methods at domestic level and Sanitation and hygiene at household level content was collected and key messages were developed for each topic. Incorporating these domestic water sanitation issues, multimedia module was developed in vernacular language of the respondents, i.e., telugu. Though the local dialect of the respondents were gond, telugu and lambadi, the common known language is telugu which is more comfortable for the all respondents. 29

47 Based on the content collection, outlines were prepared for the content development. Flow charts and story boards were prepared incorporating multimedia elements. For the multimedia module development, a page based authoring tool - Power point software was used as it has many user friendly features. 3.6 Methods used for data collection Questionnarie, Interview schedules and score cards were used as data collection tools for the study. Detailed description, variable wise is presented below Profile characteristics of tribal women An interview schedule (Annexure-2) was developed for study of profile characteristics of the tribal women in terms of their Age, Education, Type of house, Size of family and Occupation Existing domestic water sanitation practices An interview schedule (Annexure-2) was developed for the study to collect information on the existing domestic water sanitation practices of the tribal women and Anganwadi workers on the issues like water collection, storage, handling, purification methods and water & hygiene practices followed by respondents at household level Content effectiveness Content effectiveness of the developed module was studied in terms of content analysis and module analysis by the experts from the faculty of Home science Content analysis A score card (Annexure-3), was developed to measure the content analysis of the multimedia module which was measured with its percent contribution of each indicator to overall effectiveness. It was measured in three point rating Highly satisfied 3 Satisfied-2 Not satisfied-1 with maximum score of15 and minimum score of 5. S.No Indicators Highly satisfied Satisfied Not satisfied

48 Module analysis A score card (Annexure-3), was developed to measure the module design of the multimedia module. The module design was measured with its percent contribution of indicator which are measured and developed with three point rating highly satisfied -3 satisfied-2 not satisfied-1with maximum score of 45 and minimum score of 15. S.No Major Indicators Sub indicators Highly satisfied Satisfied Not satisfied Pre & Post tests The questionnaire (Annexure-5) was administered to 60 tribal women and 30 Anganwadi workers, before and after screening of the module to measure the increased knowledge level of the respondents. The dichotomous True or False responses were collected and scored 1 and 0 respectively for each question the maximum and minimum scores for the pre and post tests were 15 and 0 respectively Perception of the respondents The Score card (Annexure-4), was developed to measure the perception level of the respondents on domestic water sanitation practices. Eleven statements were framed using three point continuum scale i.e highly favorable, favorable and unfavorable with scores of 3, 2 and 1 for the responses respectively with maximum score 33 and minimum score 11. S.No. Statement Highly favorable Favorable Un favorable Statistical procedure The following statistical tools were used to analyze the data collected for the study. 31

49 3.7.1 Mean score The mean scores were calculated to select the relevant tribal water sanitation issues for development of multimedia module and to assess the content effectiveness of the module. They were also used in finding out the knowledge gain in pre and post tests Frequency Frequency was used to know the distribution pattern of the respondents according to the variables Percentage Percentages were used for standardization of size by calculating the number of individuals that would be in a given category if the total number of cases were Paired t- test Paired t-test was used to measure the significance of difference in mean scores of respondents between pre test and post test scores Quartile deviation Quartile deviation was used to identify the third and first quartile ranges in the data set of the perception of the respondents Z-test Z-test was used to measure the significance difference between perceptions of both tribal women and Anganwadi workers on domestic water sanitation. 3.7 Conceptual frame work In the present study, relevant issues on domestic water sanitation were identified by the experts with the help of checklist. Based on the experts recommendations, information was collected in various forms like text, images, videos etc. Incorporating all the elements,multimedia module was developed and given to the experts forassessing the content effectiveness through beta testing.with the modifications suggested by the experts the module was refined. Before execution, pre test was conducted using a questionnaire on domestic water sanitation. Later with the help of the developed module, respondents were imparted education through interpersonal communication approach. After execution also the same questionnaire was administered as post test to identify the 32

50 increase in knowledge levels. Perception of the respondents was collected to identify their acceptance levels towards the key messages presented through multimedia module. 33

51 Identification of Tribal domestic water sanitation issue Excution Post- test Pre- test Content collection(text, images, videos etc.) Development of multimedia module Perception of respondents Beta testing for content effectiveness Figure 3.2 Conceptual frame work of the study 34

52 3.9 Operational definitions 3.9.1Water sanitation Water sanitation is operationally defined as the collective recommended package of practices to be followed in collection, storage, handling, purification methods and water & hygiene behavior at household level for reducing water related problems in the community Existing domestic water sanitation practices Existing practices are the practices followed by the respondents with regard to water sanitation at domestic level Water purification Water purification is the process of removing undesirable contaminants from the drinking water. The goal is to produce water fit for a drinking purpose Water borne diseases Water borne diseases are caused by pathogenic microorganisms that are transmitted through water either through external and internal consumption by the human body Content effectiveness Content effectiveness is operationally defined as the content efficacy of the multimedia module in terms of its content and module design in increasing the knowledge and sustaining the interest of the respondents Multimedia module A computer based instructional tool with multiple content forms like text, images, animation, video etc., on a specific topic which supports the teacher in creating effective teaching learning process Grass root level extension personnel Grass root level extension personnel are the change agents of the government sector who are working at village level with an objective of health education. For this 35

53 particular study here after Anganwadi workers were called as grass root level extension personnel Perception of the respondents Perception of the respondents is operationally defined as the acceptance levels of the respondents towards the key messages on domestic water sanitation which were disseminated through multimedia module Beta Testing Once the project is in a final draft form, copies should be made available to a group of potential users called a beta-testing group. Standardized questionnaires should be used for collating feedback. Beta testers check all possible paths of navigation and log all events that strike them as unusual. Quality Assurance is the formal name given to the process of beta testing. When the beta version of a multimedia application is released and the functionality testing starts, the Quality Assurance process has formally begun. 36

54 Chapter IV RESULTS AND DISCUSSION The present chapter deals with the findings and their interpretations of the study. Data regarding the profile characteristics of the tribal women and their existing domestic water sanitation practices were collected and analyzed. was develop of Multimedia module with relevant domestic water sanitation management issues were identified, compiled and incorporated in the module. The developed module was subjected to analysis for its effectiveness in terms of content and module. Pre and post evaluation tests were carried out to assess the knowledge levels of the respondents before and after execution of the module. Perceptions of the respondents on water sanitation at domestic level were also presented and discussed. The results thus obtained are presented along with interpretations in the following sections. 4.1 Profile characteristics and existing domestic water sanitation practices. 4.2 Development of multimedia module on domestic water sanitation management. 4.3 Analysis of the content effectiveness of the developed multimedia module. 4.4 Assessment of the perception of the respondents on domestic water sanitation practices. 4.1 Profile characteristics and existing domestic water sanitation practices 4.1.1Profile characteristics of the tribal women The general profile included the variables like age of the respondents, education, occupation, family size, type of house. The following tables present the general profile data of the tribal respondents Age Age of the respondents was measured as revealed by the respondents in the form of no of completed years at the time of interview. The table clearly indicated that majority (46.6%) of the selected tribal women were middle aged followed by young age (35%) and old age (18.3%). 37

55 Table Distribution of the tribal women based on their age N=60 S.No Age Frequency % 1. Young age ( below 30) Middle age (31 to 50) Old age (above 50) Total This might be due to the fact that, as the children grow older, women in middle age are relatively free from responsibilities and they would like to have more real life experiences. At the same time they could easily convince their family members and participate in the developmental activities. The findings were in line with the results reported by Kumari (2004). 18% 35% Young age 30) ( below Middle age (31 to 50) Old age (above 50) 47% Figure 4.1 Age categorization of the respondents Education It refers to the academic qualification of the respondents, who were classified into five categories namely illiterate, primary school, upper primary, higher secondary school, and college education. Results are tabulated as shown below. It is observed from the table that majority (48.33%) of the selected tribal women were illiterate, followed by high school education (23.33%) primary schooling 38

56 (18.00%). Only 8.33 per cent and 1.6 percent of the tribal women have completed their upper primary schooling and intermediated education respectively. Table Distribution of the tribal women based on their education N=60 S.No. Education Frequency % Illiterate Primary education(1-5) Upper primary education (6-7) Highschool education(8-10) Intermediate Total The possible explanation for this could be that most of the women in tribal areas were not aware of the importance of education. Further cultural barriers also hinder girl s education. This finding was in conformity with the findings reported Lalitha(2014), Dhanasree et al. (2014) and Kumari (2004) Primary education (1-5) Upper primary education (6-7) High school education (8-10) Intermediate Figure 4.2 Educational levels of the respondents Size of family It refers to the number of persons living together in one house and to which respondent belonged to. 39

57 It is observed from the table that more than half of the tribal women belonged to medium size family with 4 to 6 members followed by small size (43.3%) with below three members in a family and only 5% of them belonged to large size family with 8 to 10 members. Table Distribution of the tribal women based on their size of family N=60 S.No. Size of family Small (1-3) Medium (4-6) Large(8-10) Total Frequency % The above results are a clear evidence for the structural changes in tribal families too where large families are slowly coming down and joint families are gradually disappearing.poor economic condition accompanied by monitory incentives for adoption of family planning was the important factor for decline in tribal family size.the other reason may be due to the practice of small family norms, their awareness regarding the cost of living and difficulties in maintenance of large family Datenreihen1 Small (1-3) Medium (4-6) Large(8-10) 5 Figure 4.3 Size of family of the respondents The findings were in line with the results reported by Dhanasreeet al. (2014). 40

58 Type of house It refers to the belongingness of dwelling of the respondents. Type of house is classified into two categories namely kachha and pucca and the results were as follows. Table Distribution of the tribal women based on their type of house N=60 S.No Type of house Frequency % Kachha Pucca Total It could be vividly seen from the table that66.66 percent of the tribal women were living in the pucca houses while33.33 per cent of the tribal women had kachha houses.the reason for having more number of pucca houses is bedue to the fact that the selected villages were covered under tribal housing scheme which was implemented through tribal welfare department Kachha Pucca Figure 4.4 Type of house of the respondents The results are supported by findings of the Ministry of tribal affairs (2013) and Lalitha (2014) Occupation It refers to the livelihood undertaken by individuals to earn money to meet the monetary needs of the family. These are classified into three categoriesas given below. 41

59 Table Distribution of the tribal women based on their occupation. N=60 S.No Occupation Agriculture Farm Labor Forest based livelihood Business Total Frequency % The results seen in the table indicatedthat % of the tribal women s main occupation wasagriculture followed by farm labor(25.00%) and forestbased livelihood (3.33). Obviously agriculture was the most seen occupation in the tribal community. Earlier they used to depend on the minor forest produce like tamarind, firewood, fruits and other plant material.thesesituations might change in the next generation as majority of the respondents preferred salaried jobs for their children instead of agriculturedue to the increased education and awareness. Agriculture % Farm Labor 50.00% Forest based livelihood 0.00% Business Figure 4. 5 Occupation of the respondents The findings were in line with the results reported by Bhattacharya et al. (2011)Dhanasree et al.(2014) Existing practices Existing practices of tribal women were collected mainly on the issues like water collection, storage, handlingand purification methods followed at domestic level. 42

60 Water collection Existing practices in watercollection was studied in terms of the water source for drinking and household purposes, distance from water collection, frequency of waiting and waiting duration for water collection. Table Distribution of respondents based on the water sources S.No. Particulars Tribal women (N=60) Frequency % Water sources 1. Drinking purpose Primary- Hand pump Secondary- pond 2. Household purpose Primary- Hand pump Secondary- Tap Anganwadi workers (N=30) Frequency % It is clear from the table that all the tribal women and Anganwadi workers expressed that hand pump was the primary source of water for drinking and household purpose.while 33.33% of the tribal women and 36.66% of Anganwadi workers stated pondas secondary water source for drinking. Primary- Hand pump Secondary- pond Tribal women Anganwadi workers Figure 4.6 Drinking purpose of the respondents Twenty percent of the tribal women and percent of the Anganwadi workers used tap as the secondary source of water for household purpose. This might be due to the fact that the above respondents had household tap connection for which they were paying Rs.30 per month and they preferred to use tap water for the household purposes. 43

61 Household purpose 160% 140% 46.66% 120% 20.00% Secondary- pond Primary- Hand pump 100% 80% 60% 100% 100% Tribal women Anganwadi workers 40% 20% 0% Figure 4.7 Household purposes of the respondents The findings were in line with the results reported by Ministry of tribal affairs (2013). Table Distribution of respondents based on the water fetchingpractices S.No. Particulars Tribal women (N=60) Frequency 1. Frequency of fetching water Less than 3 times times 20 More than 5 times 28 Total Frequency of waiting Always 8 Some times 47 Never 5 Total Waiting time Less than 15 minutes 55 Above 15 minutes 5 Total 60 % Anganwadi workers (N=30) Frequency % With regard to frequency of water fetching, nearly half of the tribal women expressed that they fetch water more than 5 times a day for drinking and household use from water source followed by 3 to 5 times (33.33%) and less than 3 times(20%) a day. 44

62 The reason for fetching water more than 5 times a day might be because of their family size and lack of household tap connection. It was also observed from the study area that majority of the tribal women depended on hand pump for drinking and household purposes. 60% 53.33% 46.66% 50% 40% 33.33% 26.66% 30% 20% 20% 20% 10% 0% Less than 3 times 3-5 times Tribal women More than 5 times Anganwadi workers Figure 4.8Frequency of fetching water of the respondents Whereas in the case of Anganwadi workers, more than half of them fetch water less than 3 times a day from water source followed by 3-5 times a day (26.66%) and more than 5 times(20.00%) a day. The reason for low frequency of water fetching i. e less than 3 times a day among them might be due to their regular incomewhich madethem to possess household water tap connection. It was apparent from the table that a great majority(78.33%) of the tribal women expressed that the frequency of waiting for water fetching was sometimes followed by Always (13.33 %)and never (8.33%). The reason for waiting might be that in tribal and rural areas usually they collect water in the morning and evening. Rush was observed in the study area in the mornings and evenings because of the existence of less number of community hand pumps in theirvillages. 45

63 Tribal women Anganwadi workers 78.33% 63.33% 20% 16.66% 13.33% 8.33% Always Some times Never Figure 4.9Frequency of waiting of the respondents It was also evident from the table thata great majority of the tribal women (91.66%) andanganwadi workers(83.33%) used to wait for less than 15 minutes for fetching the water from the community water source.very meager percent of the respondents expressed that they waited more than 15 minutes to fetch water at the water source. Less than 15 minutes Above 15 minutes 91.66% 83.33% 8.33% Tribal women 16.33% Anganwadi workers Figure 4.10Frequency of waiting time of the respondents Gender role in water fetching As per the table seventy per cent of the tribal women were responsible for fetching water (70.00%) in their households fallowed by adolescent girls (20.00%) 46

64 and adolescent boys (8.33%). It was also observed from the table that very negligible (1.66%) percent households it was the responsibility of men. Table Distribution of respondents based on the gender role in water fetching S.No Particulars Tribal women (N=60) Gender role Women Adolescent girls Adolescent boys Men Total Anganwadi workers (N=30) Table also revealed that43.33% of the Anganwadi workers households, women were responsible for water fetching followed by adolescent girls (26.66%), adolescent boys (20.00%) and men (10.00%). There is a little change in the role of men in Anganwadi workers households. Because of the nature of work and busy schedule of the working women, men took responsibility of fetching water in the households of Anganwadi workers. Tribal women Anganwadi workers Women Adolescent girls Adolescent boys Men Figure 4.11Gender role of the respondents The above results once again proved gender disparity in performing household chores like fetching water, washing clothes etc.,where women were expected to perform 47

65 and largely responsible for most of the household activities.but education and awareness makes a difference in gender roles. The results were in line withmishra andnandeshwar (2013) and Joshiet al.(2014) Water Storage With regard to water storage practices of therespondents, information onpractices liketype of storage container used for drinking water, storage duration and frequency of storagevessel cleaning were collected and presented below. As per the table majority of the tribal women (80.00%) in this study stored drinking water in steel containers with lid followed by mud pot with lid (20.00%). Similarly great majority of the Anganwadi workers (86.66%) stored drinking water in steel containers with lid followed by mud pot with lid (13.33%). Covering the vessel with a tight fitting lid is of important to prevent contamination of the water. Contamination of water quickly increases when the water is stored in a vessel without any lid. Majority of women did fetch and stored the drinking water in the same vessel. Table Distribution of the respondents based on theirwater storage practices S.No Particulars Tribal women (N=60) Water storage container Drinking purpose Steel with lid 48 Mud pot with lid 12 Household purpose Plastic 27 Drinking water storage duration 1 day 60 2 days 20 Storage vessel cleaning Daily 39 Once in two days 13 Once in three days 8 Anganwadi workers (N=30) The second most common container for storage mainly for household use was plastic containers like buckets, cans, and bottles. The results in the table also revealed 48

66 that 45.00% of the tribal women and fifty percent of the Anganwadi workers used plastic containers for storing water for the household use. Of the remaining 55.00% of the tribal women and fifty per cent of the Anganwadi workers fetch water then and there whenever they required. With regard to the drinking water storage duration, all the respondents including tribal women and Anganwadi workers did fetch water several times every day and never stored the water for more than a day. On the otherhand 33.33% of the tribal women and 26.66% of the Anganwadi workers stated that during the dry season they do stored the water for two days. About 65% oftribal women and 73.33% of Anganwadi workers had the practice of cleaning their drinking water container daily. This might be due to reason that they collected water frequently from water source which is very nearer to their households. It is also observed from the study area that tribal respondents used ash or soil for cleaningthe water storage containers. The remaining 21.66% of tribal women and 26.66% ofanganwadi workers cleaned their drinking water containers once in 2 days. Very few tribal women had the practice of cleaning waterstorage containers once in three days. Tribal women Anganwadi workers 73.33% 65% 26.66% 21.66% 13.33% 0% Daily Once in two days Once in three days Figure 4.12Storage vessels cleaningof the respondents Water Handling 49

67 Since the water handling practices increase the risk of microbial contamination of drinking water by contact with potentially contaminated hands. Water handling practices of the respondents were collected and presented in the given below table. Table Distribution of the respondents based on their water handling practices S.No Particulars Tribal women (N=60) Anganwadi workers (N=30) Handling Water Dipping glass /tumbler with hand Using handled donga Using mud pot with tap Total Washing hand before handling water Yes No Total Material used for hand washing With water only With soap and water Ash/Soil and water Total It was clear from the table that only 3.33per cent of tribal women and 13.33% of the Anganwadi workers used mud pot with tap and 6.66per cent of the tribal women used handled jug for taking out the drinking water from the container. A great majority of the tribal women (90.00%) and Anganwadi workers (86.66%) had the practice of taking out drinking water by dipping glass/tumbler held in hand. 50

68 90% 86.66% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 13.33% 6.66% 0% Dipping glass with hand Using handled donga Tribal women 3.33% Using mud pot with tap Anganwadi workers Figure 4.13Handling water of the respondents With regard to hand washing practice before handling water, a small percentage of the tribal women (15.00%) and (40.00%) of the Anganwadi workers had the practice of hand washing. While a great majority (85.00%) of the tribal women and sixty percent of the Anganwadi workers did not wash their hands before handling drinking water. Among those who practice hand washing, only two tribal women and seven Anganwadi workers had the practice of washing hands with soap Tribal women 40 Anganwadi workers Yes No Figure 4.14Washing hand before handling water of the respondents Similar results were found in Bhattacharya et al.(2011) where only 38% of households used handled jug to take out drinking water from water container and most of the respondents interviewed took out water by dipping glass held in hand without washing their hands. This practice of handling water increases the risk of microbial contamination of drinking water by contact with potentially contaminated hands. 51

69 100.00% 90.00% 80.00% 70.00% Tribal women 60.00% Anganwadi workers 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% With water With soap only and water Ash/Soil and water Figure 4.15Material used for hand washing of the respondents World health organization(2009)also stated that washing hands with soap has been found to reduce water born diseases by approximately 23 percent and estimated 297,000 people die every year from preventable cases of diarrhea caused by inadequate hand hygiene. Hence there is a huge need to educate and empower tribal and rural community regarding the water related sanitation practices Waterand hygiene practices Hand washing is an easy, inexpensive, and effective way to prevent the spread of germs and keep people healthy which are a root cause for many of the health problems.practices like Washing hands before eating food, Washing hands after defecation and Disposal of waste water were collectedand presented in the given below table. Table Distribution of the respondents based on their water and hygiene practices S.No. Particulars Tribal women Anganwadi workers (N=60) (N=30) 1. Washing hands before eating food With water only With soap and water Ash/Soil and water Total Washing hands after defecation With water only With soap and water Ash/Soil and water

70 3. Total Disposal of waste water Open drain Close drain Any other Total On assessing the practices related to water and hygiene, it was evident from the table that a great majority (96.66%) of the tribal women washed hands with water only followed by with soap and water (3.33%) before eating. More than fifty percent of the tribal women were still practicing the indigenous method like washing hands with ash/soil after defecation. While an equal percentage of the tribal women washed their hands with soap and water (25.00%) and with water only (25.00%) after defecation. Whereas in case of Anganwadi workers, majority (83.33%) of them washed their hands with normal water followed by soap and water (16.66%) before eating. But after defecation all the Anganwadi workers had the practice of hand washing with soap and water. The reason for this practice might be due to their education level and area of work. Tribal women Anganwadi workers With water only With soap and water 0 0 Ash/Soil and water Figure 4.16Washing hands before eating food of the respondents 53

71 Tribal women 40 Anganwadi workers With water only With soap and water Ash/Soil and water Figure 4.17Washing hands after defecation of the respondents With regard to disposal of waste water, majority of the tribal women (91.66%) and Anganwadi workers (86.66%) disposed waste water in an open drains followed by other practices like disposal at backyard garden. Disposal of waste water in front of their houses leads to potential breeding ground for mosquitoes which also cause airborne diseases Tribal women Anganwadi workers Open drain Close drain 0 0 Any other Figure 4.18Disposal of waste waterof the respondents In India lack of access to safe water supply and inadequate sanitation facilities together with unhygienic conditions have contributed to high morbidity amongst the tribal population especially in children less than 5 years of age. A simple measure like hand washing with soap after defecation, waste water management can prevent 54

72 transmission of organisms that cause diarrhea and other communicable diseases. Effective communication strategies are needed for bringing desirable behavioral changes in the community Water purification From the table it was evident that all respondents had access to community water source like hand pump.the water quality was probably improved compared to other surface sources like canal, river etc. However, it is important to remember that even if the water quality was improved, there are a lot of other factors that have to be taken into consideration to make sure that the water is safe for drinking. The tribal women were asked how they purify water before drinking, to this majority of the tribal women (83.33%) stated that they filtered their drinking water using cloth or sieve at collection point in order to filter the solid dust particles. Along with cloth filtration about 44.00% of the tribal women practice boiling of drinking water followed by using chlorine tablets (34.00%) and use of water filter device (4.00%). Table Distribution of the respondents based on their water purification methods S.No. Particulars Tribal women (N=60) purification method followed 1. No purification Filtering with cloth 50 /sieve Total Filtering with cloth and Boiling Filtering with cloth and water Filter device Filtering with cloth and using chlorine tablets Anganwadi workers (N=30) With regard to Anganwadi workers, majority of them (66.66%) stated that they filtered their drinking water using cloth or sieve. Along with cloth filtration about 55

73 35.00%of the Anganwdi workerspractice boiling of drinking water followed by usingchlorine tablets (35.00%) and use of water filter device (20.00%). Filtering with cloth /sieve was the common water purification practice observed in the tribal area irrespective of the source of collection. They expressed the reason for purifying the water is mainly to prevent diarrhea. The results were in line with Bharti et al.(2013) No Filtering Filtering Filtering Filtering purificat with with with with ion cloth Boiling Filter using /sieve device chlorine tablets Tribal women Anganwadi workers Figure 4.19 Distribution of the respondents based on their water purification methods 4.2 Development of multimedia module on domestic water sanitation management. In the present study, for selection of the suitable content for development of multimedia module on tribal domestic water sanitation, key issues were collected and compiled and then were given to the selected experts with a check list on two point continuum Required & Not required. The content which was mostly stated as required by the experts was identified and incorporated in the module. The content which was stated by majority as Not required was discarded. 56

74 Based on the suggestions of the experts the content was developed in various forms like text, images, videos etc. Maximum effort was taken in the collection of vernacular words for development of the module. Content for identified tribal domestic water sanitation management were translated into a vernacular language i.e. telugu for module development and finalized for the production of multimedia module. Relevant images and graphics and videos were also collected from various sources. Based on the content collection, outlines were prepared for the development of the multimedia module. Flow charts and story boards were also prepared incorporating multimedia elements. For the multimedia module development, a page based authoring tool - Power point software was used as it has many user friendly features. According to (Ron Leunissen,2013)Power Point has got several strong points over other e- Learning authoring tools. E.g. PowerPoint has got extended features for shaping and formatting objects. Shadows, mirror-effect, fill colors, see-through-colors, layers, it can all easily be done within this one authoring tool. No need for another imaging tool. Because of this shaping ability, PowerPoint is the only authoring tool thus far, which can produce hot spots in any shape you want. All building blocks of multimedia like video, audio, text, animation and interactivity can be incorporated in powerpoint. Beta testing was done for quality assurance that the developed module was given to the selected thirty experts for analyzing the content effectiveness interms ofcontent analysis and module analysis. Based on the suggestions the module was modified and used in dissemination process in tribal area. The following flow chart explains the process of development. 57

75 Identification of Tribal domestic water sanitationissues Content collection (Text, Images, Videos etc.) Preparation of outline Flow chart Story board Video Text Images Development of multimedia module Music Interactivit y Animation Beta testing by experts Content analysis Module analysis Figure (4.20) Process of development of multimedia module on tribal domestic water sanitation 58

76 Figure (4.21) Story board for development of multimedia module 59

77 4.3 Analysis of the content effectiveness of the developed multimedia module. Content effectiveness of the developed module was studied in terms of content analysis and module effectiveness. The content analysis and module analysis were done with its percent contribution to overall content effectiveness. The five major indicators of the module analysis with sub indicators was developed with score card with three point rating i.e., highly satisfied -3, satisfied-2 and not satisfied-1. A total of thirty experts from the faculty of home science were the sample for analyzing the content effectiveness of the developed module. After developing multimedia module the experts rated the content effectiveness of the module in terms of content analysis and module analysis with the sub-indicators for each major indicator on the three point continuum. The mean scores of sub-indicators and average mean scores of each major indicator were computed. The percent contribution of each indicator for the effectiveness was also calculated for multimedia module. The mean scores on each indicator with its perecent contribution towards content effectiveness is tabulated below Content analysis Content analysis has been carried out on the areas like content sequence, informative, adequacy, relevancy, practical utility, length of sentence, readability and language. Table Content analysis with indicators contribution towards content effectiveness N=30 Percent S.No Indicators Mean Score Contribution of indicator 1. Content sequence Informative Adequacy Relevancy Practical utility Total 60

78 The table showed that the content analysis indicator Practical utility (22.0%) had high percentage contribution towards content effectiveness followed by its informativeness (21.7%) and adequacy (21.0%). The reason for attaining high contribution of practical utility might be due to the nature of the clientele who are not well educated with low socio- economic background. Imparting education to those clientele obviously need diverse communication strategies which provide more of practical utility, informativeness and adequacy. Keeping the nature of the clientele in mind the content was developed in the module. The indicators content sequence (17.6%) and relevancy (17.4%) contribute to content effectiveness with almost equal percentile; however their contribution was little lower when compare to other indicators of the content analysis due to its generalized nature Module analysis Module analysis was measured using multimedia building blocks like module design, illustrations or images, animation and video as major indicators. Table Module analysis with indicators contribution towards module Effectiveness. S.No Major Indicators 1. Module design 2. Text 3. Illustration 4. Animation 5. Audio & Video Sub indicators Mean Score Attractiveness Relevancy Logical sequence Length of sentence Readability Local dialect Appropriate Relevancy No.of illustrations Speed Position Liveliness Voice Average Mean Score 2.13 Percent contribution of indicator

79 Clarity Synchronization Total N=30 It is evident from the table that, in module analysis the major indicator use of illustrations contributed 22.6 percentage module effectiveness. The sub indicators like number of illustrations (2.90%), appropriateness (2.70%) and relevancy (2.54%) were highly contributed through its major indicator called illustrations to module effectiveness followed by animation (20.81%), andaudio and video (20.48%). The main reason for their high contribution was intended clientele for whom the module was developed. Since the module is specifically designed and developed for the tribal women, ut most care has been taken in using more of visual communication with motion rather than textual and overall design. Use of illustrations and animations in multimedia module certainly enrich the teaching learning experience with sustained interest. Similar results were observed in the study conducted by Emma et al. (2000) who developed a computer aided learning module for educating diabetic patients. They found that multimedia module with more of visuals is very effective, colorful and useful in teaching practical skills and in promoting theoretical understanding. Jyothi and Annamma (2004) studied the effectiveness of animated video film on anemia for adolescent girls. The results show that the video film is highly effective in imparting nutrition education since it involves hearing and seeing Significant difference between pre and post level knowledge of the tribal women and Anganwadi workers on domestic water sanitation management To assess the efficacy of the module in increasing the knowledge levels of the respondents, suitable questionnaires was prepared with fifteen dichotomous questions, this questionnaire was used to test the knowledge differencebefore and after intervention through multimedia module. The respective mean scores were computed and presented in the below table. The mean scores of tribal women and Anganwadi workers were compared with the help of paired t-test to know the significant increase in the knowledge after screening of multimedia module. 62

80 The table shown that the mean scores of the pre test and post test indicated that significant improvement was observed in knowledge levels of the tribal women and the Anganwadi workers on domestic water sanitation management. With regard to tribal women s knowledge, the mean score of pre test was 3.7 which was rapidly increased to 8.65 at post test. Similar results were observed with Anganwadi workers where their knowledge levels were tremendously increased from mean score of 6.23 of pre test to mean score of in post test. Table significant difference in knowledge between pre and post tests of the respondents N=90 S.No Name of the respondents Pre test mean score 1 2 Tribal women Anganwadi workers **significant at 1% level Knowledge gain T (cal) P (probability) 3.70 Post test mean score ** **0.000 It was evident from the table that there is a 4.95 difference of knowledge gain among tribal women and 8.13 difference of knowledge gain among the Anganwadi workers on domestic water sanitation management. These results proved the quantitative efficacy of the multimedia module which was supported by the t- values presented in the table4.3.3 which were highly significant at 1% level. Testing of hypothesis Null Hypothesis There will not be any significant increase in knowledge level of the tribal women and Anganwadi workers after screening of multimedia module on domestic water sanitation management. Empirical Hypothesis There is a significant increase in knowledge level of the tribal women and Anganwadi workers after screening of multimedia module consisting of domestic water sanitation management. 63

81 4.4Assessment of the perception of the respondents on domestic water sanitation practices. To measure the perception level of respondents on domestic water sanitation practices, a list of eleven statements seeking different key messages were prepared. These listed items were administered to the respondents. The individual respondent was asked to state on a three point continuum highly favorable, favorable and unfavorable towards the statements, with a score of 3, 2 and 1 for the responses respectively. This was collected to measure the acceptance levels of tribal women towards various information recommended practices related to effective domestic water sanitation Perception of the tribal women on domestic water sanitation after exposure to multimedia module With regard to the statement Collection of water from safe water sources only majority (70.00%) of the tribal women expressed highly favorable perception followed by favorable perception (30.00%). With respect to statement Boiling of drinking water for 10 minutes three fourth (78.33%)of the tribal women expressedhighly favorable perception followed by per cent of them had favorable perception. About the statement Drinking chlorinated water majority (61.66%) of the tribal women had highly favorable perception while remaining per cent of them had favorable perception. With regardto the statement Cleaning of water container regularly more than half (63.33%) of the tribal women expressed highly favorable perception followed by favorable perception (36.66%). Regarding the statement Use of handle donga or pot with tap for taking out water majority (60.00%) of the tribal women expressed highly favorable perception while forty percent of them expressed favorableperception. With regards to the statement Conducting the biological test once in 3 months more than half (56.66%) of the tribal women expressed highly favorable perception fallowed by favorable perception (43.33%). 64

82 The statement Use of O.R.S as first aid for diarrhea patient was accepted by majority (51.66%) of the tribal women followed by favorable perception (48.33%). It could be seen for the statement washing hands with soap before handling water and food a greatmajority (81.66%) of the tribal women expressed highly favorable perception followed by favorable perception (18.33%). Table Distribution of tribal women based on their perception on domestic water sanitation N=60 S.No. 1. Statements Collection of water from safe water sources only Use of handle donga or pot with tap for taking out water Conducting the biological test once in 3 months 7. Use of O.R.S as first aid for diarrhea patient 8. Washing hands with soap before handling water and food 9. Washing hands with soap after defecation 10. Diverting waste water to backyard garden Unfavorable 18 (70.00%) (30.00%) 13 2 (78.33%) (21.66%) 23 7 (61.66%) (38.33%) 38 Cleaning of water container regularly Favorable 5 37 Drinking chlorinated water 6. Rank 47 Boiling of drinking water for 10 minutes 5. Highly favorable (63.33%) (36.6%) (60.00%) (40.00%) (56.66%) (43.33%) (51.66%) (48.33%) (81.66%) (18.33%) (73.33%) 43 (26.66%)

83 (71.66%) 11. (16.66%) (11.66%) (36.66%) (18.33%) 27 Construction of soakage pit 11 (45.00%) For the statement Washing hands with soap after defecation nearly three fourthof the tribal women expressed highly favorable perception followed by favorable perception (26.66%). For the statement Diverting waste water to backyard garden it is clear that majority (71.66%) of the tribal women expressed highly favorable perception followed by favorable perception (16.66%) and unfavorable perception (11.66%). The statement Construction of soakage pit was highly perceived by percent of the tribal women as highly favorable while per cent of them felt favorable perception followed by unfavorable perception (18.33%). On the whole, the statements Washing hands with soap before handling water and food, Boiling of drinking water for 10 minutes and Washing hands with soap after defecation were perceived highly favorable and were ranked as 1, 2 and 3 respectively by the tribal women. The probable reason for their ranking might be due to the fact that the said three statements were crucial recommended practices for reducing the incidents of mortality and morbidity caused by water borne diseases. The other reason might be that in the multimedia module the key messages on the said statements were showed through illustrations with animation repeatedly. This might be resulted due to the change in their perception made them convinced and accepted the practice which leadto highly favorable perception. These results supported the statements of Meier (2000) where he mentioned a large body of research indicated that visual cues help us to better retrieve and remember information. The research outcomes on visual learning make complete sense when you consider that our brain is mainly an image processor (much of our sensory cortex is devoted to vision), not a word processor. In fact, the part of the brain used to process words is quite small in comparison to the part that processes visual images.use of integral feature of the visuals with text and other multimedia elements will certainly accelerate the learning and leads to good learning outcomes. 66

84 4.4.2 Perception of the Anganwadi workers on domestic water sanitation practices. The statement Collection of water from safe water sources only majority (66.66%) of the Anganwadi workers who expressed highly favorable perception followed by favorable (33.33%) perception. Regarding the statement Boiling of water along with cloth filtration a great majority (80.00%) of the Anganwadi workers expressed highly favorable perception followed byfavorable (33.33%) perception. For the statement Drinking chlorinated water more than half (56.66%) of the Anganwadi workers expressed highly favorable perception while per cent of them had favorable perception. About the statement Cleaning of water container regularly per cent of the Anganwadi workers expressed highly favorable perception followed by favorable (33.33%) perception. With the statement Use of handle jug or pot with tap for taking water majority (63.33%) of the Anganwadi workers expressed highly favorable perception followed by 36.66% of them had favorable perception The statement Conducting the biological test once in 3 months majority (70.00%) ofthe Anganwadi workers expressed highly favorable perception followed by favorable perception (30.00%). Regarding the statement Use of O.R.S as first aid for diarrhea patient majority (60.00%) of the Anganwadi workers expressed highly favorable perception while per cent of them had favorable perception. With regards to the statement washing Hands with soap before handling water and food more than half (76.66%) of the Anganwadi workers expressed highly favorable perception followed by favorable perception (23.33%). With respect to statement Washing hands with soap after defecation more than half (66.66%) of the Anganwadi workers expressed highly favorable perception followed by favorable perception (33.33%). For the statement Diverting waste water to backyard garden it is clear that majority (80.00%) of the Anganwadi workers expressed highly favorable perception 67

85 while per cent of them had favorable perception followed by unfavorable perception (6.66%) With regard to the statement Construction of soakage pit (33.33%) of the Anganwadi workers expressed highly favorable perception while 16.66per cent favorable perception followed by unfavorable perception (16.66%) Table Distribution of Anganwadi workers based on their perception on domestic water sanitation S.No Statement Collection of water from safe water sources only Boiling of water for 10 minutes Drinking chlorinated water Cleaning of water container regularly Use of handle donga or pot with tap for taking out water Conducting the biological test once in 3 months Highly favorable 20 (66.66%) 24 (80.00%) 17 (56.66%) 20 (66.66%) 19 Rank Favorable 4 10 (33.33%) (20.00%) 13 (43.33%) 10 (33.33%) 5 11 (36.66%) 21 (70.00%) 3 9 (30.00%) Use of O.R.S as first aid for diarrhea patient 18 (60.00%) 6 12 (40.00%) washing hands with soap before handling water and food 23 (76.66%) 2 7 (23.33%) Washing hands with soap after defecation 20 (66.66%) 4 10 (33.33%) Diverting waste water to backyard garden Construction of soakage pit 24 (80.00%) 20 (66.66%) (63.33%) 1 8 N=30 Unfavorable 4 (13.33%) 5 (16.66%) 2 (6.66%) 5 (16.66%) Speaking about the overall perception of the Anganwadi workers, out of eleven given statements the statements Boiling of water for 10 minutes, Diverting waste water to backyard garden were rated highly favorable and were equally ranked 1 by the Anganwadi workers. The statements washing hands with soap before handling water 68

86 and food and Conducting the biological test once in 3 months were ranked 2 and 3 respectively by the Anganwadi workers. The reason for ranking those statements might be due to the fact that, being the Anganwadi workers at village level they continuously communicate health and sanitation recommended practices and mobilize the tribal community towards adoption. It was also discussed during interview with the Anganwadi workers, they expressed that they were involved in educating tribal women in health and sanitation issues as part of their job. They also felt that the key messages disseminated using multimedia modules were in their job chart but they are imparting through conventional methods of discussion which is not that much effective as multimedia module. On the other hand the statements Construction of soakage pit and Use of O.R.S as first aid for diarrhea patient were ranked least by the tribal women and Anganwadi workers. For this they expressed that they didn t have any problem with disposable of waste water in the open drain because the amount of water they disposed is very less and they also expressed that the construction of soakage pit practice would be more recommendable near water sources like hand pumps and piped water at community level Quartile Range in perception on domestic water sanitation The quartile range is the most obvious measure of dispersion and is the difference between the lowest and highest values in a dataset Quartile Range in perception of tribal women on domestic water sanitation practices The quartile deviation of the tribal women s perception towards the practices of domestic water sanitation revealed that the sixty tribal women rated their perception favorable to highly favorable with 33 as obtained maximum score and 23 as minimum score against the actual maximum score 33 and 11 score as minimum. It was very clear from the Figure (4.22). That 25 % of the tribal women fell under Q1 (first quartile) range with a score value of less than or equal to 25. The median value 29 is scored by 50% of the respondents. While 75 percent of the respondents fell under Q3 (third quartile) range with a score value of less than or equal to

87 Maximum Third quartile Median First quartile Minimum Figure (4.22) Quartile deviation in perception of tribal women Quartile Range in perception of Anganwadi workers on domestic water sanitation practices. The quartile deviation of the Anganwadi worker s perception towards the practices of domestic water sanitation revealed that the thirty Anganwadi workers rated their perception with favorable to highly favorable 33 as obtained maximum score and 22 as minimum score against the actual maximum score 33 and 11 score as minimum. It was very clear from thefigure(4.23). That 25 % of the tribal women fell under Q1 (first quartile) range with a score value of less than or equal to 26. The median value 31 is scored by 50% of the respondents. While 75 percent of the respondents fell under Q3 (third quartile) range with a score value of less than or equal to 32. Most of the tribal women and Anganwadi workers stated their perception from highly favorable to favorable. They accepted the key messages after exposure to the multimedia module. 70

88 Maximum Third quartile Median First quartile Minimum Figure (4.23)Quartile deviation in perception of Anganwadi workers Perceptional differences between tribal women and Anganwadi workers on domestic water sanitation Perceptional differences between tribal women and Anganwadi workers were calculated using the Z test and the results were presented in the below table Table significant difference in perception level of tribal women and Anganwadi workers on domestic water sanitation N=90 Variable Perception of Tribal women respondents Anganwadi workers *significant at 1% level Z-tab 1.64 Z- cal 1.75 An inference could be drawn from the above table that there was a significant difference between the perception of tribal women and Anganwadi worker as the Z values were found significantly different at 0.01 level of probability. Thus, null hypothesis was rejected and empirical hypothesis accepted. 71

89 Testing of Hypothesis Null hypothesis There will not be any significant difference between the perception of tribal women and Anganwadi workerswith regard to water sanitation practices. Empirical Hypothesis There is a significant difference both tribal women and Anganwadi workers with regard to water sanitation practices. 72

90 Plate 4.1 Researcher interviewing tribal women Plate 4.2 Screening of module on tribal domestic water sanitation in tribal women 73

91 Plate 4.3 Conducting pre test to Anganwadi workers Plate 4.4 Screening of video on construction of soakage pit 74