Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018

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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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On Sep 2018

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Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
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An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

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Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

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Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
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Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Important Notice

Original article / research
Year : 2012 | Month : August | Volume : 6 | Issue : 6 | Page : 1038 - 1040

Effectiveness of the Training Course of ASHA on Infant Feeding Practices at a Rural Teaching Hospital: A Cross Sectional Study

Sushama S. Thakre, Subhash B. Thakre, Amol D.Thakre, Samir H. Golawar, Suresh M. More, Arun Y. Humne

1. Associate Professor, Preventive and Social Medicine, Indira Gandhi Government Medical College, Nagpur, India. 2. Associate Professor, Preventive and Social Medicine, Government Medical College, Nagpur, India. 3. Assistant Professor, J.N. Medical College, Wardha, India. 4. Assistant Professor and IMNCI/BPNI trainer, Preventive and Social Medicine, Government Medical College, Nagpur, India. 5. Statistician Cum Lecturer, Preventive and Social Medicine, Government Medical College, Nagpur, India. 6. Professor and Head, Preventive and Social Medicine, Government Medical College, Nagpur, India.

Correspondence Address :
Dr. Subhash B. Thakre
Plot. No.9, Swami Swarupanand Society,
Narendra Nagar, Ngpur-15 (India).
Phone: 9822366532


Introduction: Accredited Social Health Activists (ASHA) is the key functionaries for the effective implementation of maternal and child health care services at the grass root level in India.
Method: The effectiveness of this training programme was assessed by conducting a pre-test and post-test assessments. The correct responses to the test items in the questionnaire were given one mark, with a maximum of 20 marks.
Results: The training on the knowledge, attitude and practices of breast feeding was found to be effective. The difference in the pre and the post test score of the participants was found to be statistically significant (p<0.05).
Conclusion: The ASHA workers and their supervisors gained the knowledge and skills on breastfeeding and complementary feeding after the training.


ASHA, Infant feeding, Exclusive breastfeeding, Action cards

How to cite this article :

Sushama S. Thakre, Subhash B. Thakre, Amol D.Thakre, Samir H. Golawar, Suresh M. More, Arun Y. Humne. EFFECTIVENESS OF THE TRAINING COURSE OF ASHA ON INFANT FEEDING PRACTICES AT A RURAL TEACHING HOSPITAL: A CROSS SECTIONAL STUDY. Journal of Clinical and Diagnostic Research [serial online] 2012 August [cited: 2018 Oct 20 ]; 6:1038-1040. Available from

Introduction The ASHA workers are undergoing a series of training episodes to acquire the necessary knowledge, skills and the confidence for performing their spelled out roles. They can educate and support new mothers on the early establishment of breastfeeding, the feeding of colostrum and the recognition of breast feeding problems (1). Evidence has suggested that the early breastfeeding (2), and the exclusive breastfeeding (3) rates in Maharashtra ranged from 52%-53% (4). ASHA work includes health and nutrition education on various aspects of the health of a mother and her child. Therefore, it is important for the ASHA workers to have adequate scientific knowledge about infant breastfeeding (5). The objective of the present study was to assess the knowledge (scientific and latest) and the attitude of the ASHA workers with regards to infant feeding, to identify the gaps in their knowledge and also to assess the effectiveness of the training course of ASHA on infant feeding practices.

Material and Methods

A community based, cross sectional study was undertaken at the Rural Health Training Centre, Saoner, District Nagpur, India during January to March 2011. 94 ASHA workers and 5 supervisors from the Saoner taluka, Nagpur district were the participants. The institutional ethics clearance and the participants’ informed consent were sought before the start of the study. A pre-designed, pretested and structured schedule was used for the data collection. A pretested questionnaire was administered to the participants for the data collection. The questionnaire consisted of 20 multiple-choice questions which covered issues on the entire IYCF (infant and young child feeding). After the pretest, the sessions on breast feeding, complementary feeding, and breast feeding attachment and positioning were under taken. The effectiveness of the training programme was assessed by conducting a post-test assessment by using the same questionnaire after the training programme. The correct responses to the test items in the questionnaire were given one mark, with a maximum of 20 marks. We divided the participants on the basis of their pre- and post-test scores into ‘very good score’ (if the participant secured ≥18), ‘good score’ (15-17) ‘average’ (12-14) and ‘below average’ score (≤11). The pre- and post-answer sets were evaluated, marked, and compared. Statistical analysis: The data were analyzed by using the Statistical Package for Social Science (SPSS), version 10 and the categorical data were analyzed by using Mc Nemar’s test.


A total of 99 ASHA supervisors and ASHA workers were enrolled in the study. The demographic characteristics revealed that 100% of the ASHA workers were literate; however, a majority were only 10th and 12th standard passed and only 5% were graduates. Almost all had one year of experience in health and social services. (Table/Fig 1) reveals the comparative score of the participants before and after the training on the breast feeding knowledge, attitude and practices. Earlier, the special training scores were as follows: very good 3(3.03%), good 65(65.66%), average 28(28.28%) and below average 3(3.03%). Immediately after the special training, 64 (64.45%) participants got very good scores, 31 (31.31%) got good scores and 4 (4.04%) got average scores (Table/Fig 2). This difference was found to be statistically significant (P=0.001). There were no below average scores in the post-test. The mean pretest score was 15.11 ± 1.89, which had risen significantly (P=0.001) post-test to a mean of 17.30 ± 1.59.


The ASHA workers are the key functionaries for the effective implementation of maternal and child health care services at the grass root level in India. They are formally trained for basic health care, predominantly for mothers and their children. The ASHA workers are the key functionaries who mobilize mothers and other stake holders of the community. They counsel women on breast-feeding and complementary feeding (1). The nutritional counseling of mothers of children who are aged 0–2 years is effective for a positive behavioural modification and it should be actively incorporated and emphasized. The children need to be fed more and this can be achieved by the counseling of mothers by ASHA, AWWs, auxiliary nurse-midwives, or supervisors. Social mobilization and community participation are critical for the success of any public health programme (6),(7). In the present study, all the ASHA workers had an accurate knowledge on the fact that breastfeeding had to be started as early as possible, immediately after the child’s birth. Similar findings have been reported among other health care personnel (8),(9). 94.44% of the workers had proper knowledge on the fact that pre-lacteal feeds needn’t be given. 55.55% of the ASHA workers knew that breastfeeding had to be given on-demand and similar findings have been reported by other workers also (9),(10). The results also suggested that the training on infant and young child feeding practices had significantly (P=0.001) improved the theoretical as well as the practical knowledge on breastfeeding in the trainees. These findings were similar to those of another study; however, that study was conducted for the supervisors of AWWs (11).In our study, ‘take action’ cards and simple key messages were used for the teaching sessions and they probably helped in a better transfer of knowledge.


The ASHA workers and their supervisors gained the knowledge and skills on breastfeeding and complementary feeding after the training.


The development of ideas and the mode of their presentation in this work owe much to Dr. Archana Patel, M.D. Paediatrics, Professor and Head, IGGMC, Nagpur from whom I have learned and continue to learn a great deal. Her kin interest, constructive criticism and constant encouragement were the prime factors that made my task easy and enabled me to complete this work successfully. With great pleasure, I acknowledge my gratitude to respected Dr. Arun Humane, Professor and Head, Department of community medicine, Government Medical College, Nagpur for his encouragement. My special thanks to all the staff members of rural health Training Centre, Saoner. I take this opportunity to thank all study participants for their support.
ASHA: Accredited Social Health Activist
AWW: Anganwadi Worker
IYCF: Infant and young Child feeding Practices
NFHS: National Family Health survey


ASHA Training module – 1 and 2 Government of Maharashtra, Health Services, National Rural Health Mission, Sathi publication 2008.
Maternal and child health: community update No.53 January 2011 Available from
Government of India. 2004. National Guideline on Infant and Young Child Feeding, .
Kotecha PV. Information, education and communication in the promotion of breast feeding. MCH Community News letter Breastfeeding 2008;WHO Special issue:4-6.
Phatak A. The economic and ecological effects of breastfeeding. J Obstet Gynaecol India. 1999;49:35–8.
Wynne G. The training and retention of skills. British Medical Journal. 1986;293:29–31.
Laurence RA. Human milk as the gold standard for infant feeding. J Obstet Gynaecol India. 1999;49:30–4.
Mullick DN. Attitudes of the medical and the nursing personnel to the breastfeeding practices. Indian Paediatr. 1987;24: 911–6.
Kapil U, Bhasin S. The perception towards breastfeeding amongst the working women of a public school in Delhi. Indian Paediatr. 1992;29:753–6.
Arnawat BS, Singh RN, Gupta BD, Chaudhary SP. The knowledge and the attitudes of hospital employees regarding infant feeding practices. Indian Paediatr. 1987;24:938–48.
Taksande A, Tiwari S, Kuthe A. The knowledge and the attitudes of the anganwadi supervisor workers on infant (breastfeeding and complementary) feeding in the Gondia district. Indian J Community Med. 2009 July; 34(3): 249.

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Date of Submission: Apr 25, 2012
Date of Peer Review: May 16, 2012
Date of Acceptance: Jun 06, 2012
Date of Online Ahead of Print: Jun 20, 2012

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