Strengthening Child Protection at Community Level: Impact of Educational Intervention on Knowledge, Attitudes, and Practices among Anganwadi Workers and Auxiliary Nurse Midwives—A Prospective Cohort Study from Bangalore, India

Background Anganwadi workers (AWW) and auxiliary nurse midwives (ANM) serve as the primary interface between children and India's healthcare system. Despite high child abuse prevalence (52.22% sexual abuse, 67% physical abuse per 2007 national survey), these frontline workers often lack knowledge, attitudes, and procedural competence for early detection and reporting. Objective To evaluate the impact of a structured educational intervention on knowledge, attitudes, and practices (KAP) regarding child abuse prevention among AWW and ANM in Bangalore, India. Methods Prospective cohort study among 117 participants (65 AWW, 52 ANM; mean experience 4.2 ± 2.1 years). Baseline KAP assessed via validated 20-item self-administered questionnaire (knowledge: 10 items; attitude: 5 items; practice: 10 items). Intervention included 7-day formal education (printed materials, lectures, visual aids) + 3-day refresher after 1 month. Follow-up at 3 months. Analysis: χ²-test, ANOVA, Spearman correlation (SPSS v26.0; p < 0.05). Results Significant knowledge improvement: 60.6% AWW and 20.8% ANM achieved higher competency (p = 0.03). Practice domain showed largest gains: 84% AWW and 69.9% ANM gained detection/reporting competence (p = 0.02). Attitude improvements positive but non-significant (p = 0.08; ceiling effect). Experience modified learning trajectories. Conclusion Structured interventions rapidly enhance child abuse prevention KAP among primary care workers. Integrating child protection training into AWW/ANM curricula, with standardized referral pathways and performance monitoring, will strengthen India's child protection system.