Knowledge Attitude and Practice of The Secondary Students About Personal Hygiene in Bogura

Abstract

This qualitative cross-sectional study “Knowledge, attitude and practice of the secondary school students about personal hygiene in Bogura city in Bangladesh” was conducted among 100 respondents of who are student of Govt. Pilot High School(boys)  in Bogura city. Objective of the study was to see the knowledge of personal hygiene among the secondary school student, what are the motivations of school student to maintain hygiene behaviors and to analyze how school student practice personal hygienic behaviors. The study Methodology was to conduct interview on total 100 adolescent boys who were chosen by random sampling and interviewed on their knowledge about personal hygiene and practice. Findings of the study suggested that, 99% respondents know how to wash the hands properly, whereby only 5% respondents mentioned their reluctance about the hand washing after defecation. 97% of the respondent use to practice washing their hands properly after coming out from the toilet or after defecation and 91% respondents used to wash their hands before meal, but in reality only 5% respondents were found who practice the hand washing properly, with soap and water. 62% respondents also instructed that they use to brush twice a day, whereby only few % do not brush every day. 40% of the respondents have the habit of trimming nail by mouth, which may lead them toward the infection transmission.51% of the other respondents mentioned that, they use tube well water as their source of water for drinking purpose while 75% of the respondents used to wash it with water supply. 47% respondents mentioned that they have faced diseases in the previous 6 months. Only 21% respondents know about the ejaculation or wet dream incidents, whereas, 56% of the respondents claims that wet dream is not a diseases whereas 18% percentage of respondents group was also found which strictly noted masturbation as harmful to human body. Conclusions The study finds that, adolescents needs appropriate knowledge for maintaining their personal hygiene. It is necessary to ensure the proper hygiene and health for the adolescents so that they can stay away from the misconceptions and can maintain their health as secured and sound. Initiating proper motivation and self interest among the adolescents to maintain health and hygiene practice is thus the vital investment, for them and for healthier society in tomorrow.

Introduction

Hygiene refers to the set of practice of keeping oneself and one’s living and working areas clean in order to prevent illness and disease to maintain one’s freshness and healthy this set of practices associated with the preservation of health and healthy living. Hygiene is an old concept related to medicine, as well as to personal and professional care practices related to most aspects of living, although it is most often wrongly associated with cleanliness.

In medicine, hygiene practices are employed as preventative measures to reduce the incidence and spreading of disease. Other uses of the term appear in phrases including: body hygiene, mental hygiene, domestic hygiene, dental hygiene, and occupational hygiene, used in connection with public health.

The term “hygiene” is derived from Hygeia, the Greek goddess of health, cleanliness and sanitation. Hygiene is also the name of a branch of science that deals with the promotion and preservation of health, also called hygienic. Hygiene practices vary widely, and what is considered acceptable in one culture might not be acceptable in another.

Body hygiene pertains to hygiene practices performed by an individual to care for one’s bodily health and well being, through cleanliness. Motivations for personal hygiene practice include reduction of personal illness, healing from personal illness, optimal health and sense of well being, social acceptance and prevention of spread of illness to others

Personal hygiene may be described as the principle of maintaining cleanliness and grooming of the external body. It is in general looking after you. Personal hygiene can be controlled by sustaining high standards of personal care and humans have been aware of the importance of hygiene for thousands of years. The ancient Greeks spent many hours in the bath, using fragrances and make-up in an effort to beautify themselves and be presentable to others. In fact, hygiene is actually a scientific study. Maintaining a high level of personal hygiene will help to increase self-esteem and confidence whilst minimizing the chances of developing imperfections.[1]

Personal hygiene is the first step to good grooming and good health. Elementary cleanliness is common knowledge. Neglect causes problems that you may not even be aware of. Many people with bad breath are blissfully unaware of it. Some problems may not be your fault at all, but improving standards of hygiene will control these conditions. Dandruff is a case in point. More often than you know, good looks are the result of careful and continuous grooming.

Justification of the Study

The perceptions and practices of hygiene are frequently related with cultural values and religious perspectives. Cultural and religious views of society often define the perception of hygiene with the ideas of ‘purity’ and ‘pollution’. Purification is often required for religious activities like saying prayers and worship, rather than for living a healthy life. As a result, people – and especially children – suffer from chronic malnutrition and repeated. There are many contributory factors that make up personal hygiene with the main ones being washing, oral care, hair care, nail care, wound care, cleansing of personal utensils and preventing infection. Personal hygiene is as it says, personal. Everybody has their own habits and standards that they have been taught or that they have learnt from others. It is essentially the promotion and continuance of good health.

During students are leisure at home, school students can play an effective role in motivating their parents, relatives and neighbors towards safe water, sanitation and hygiene practices. If their potential is released through a school program there will be adults to guide, to deal with practical issues and to assure sustainability. So how can this potential be used? It is recognized that for schools, water and sanitation facilities are important and that hygiene education should be part of the curriculum, recurring in different subjects and referred to by authority figures. The study will explore the current situation of knowledge of hygiene and practices of the secondary school student. It will help to develop school curriculum for improving the knowledge level as well as the healthy practices.

There are many contributory factors that make up personal hygiene with the main ones being washing, oral care, hair care, nail care, wound care, cleansing of personal utensils and preventing infection. Personal hygiene is as it says, personal. Everybody has their own habits and standards that they have been taught or that they have learnt from others. It is essentially the promotion and continuance of good health.

Given the above factors, there are a number of arenas that need to be addressed in order to adequately influence the health-seeking behaviors of adolescents and to promote a stronger operational commitment from all levels of societies so that they might recognize and meet the specific needs and priorities for adolescents’ knowledge about hygiene practice and management and right to have proper knowledge ensuring these as their health rights.

Literature Review

Personal hygiene is closely linked to home hygiene. An enumeration of personal hygiene practices includes: hand washing; taking a bath daily or a sponge bath if bathing with flowing water is not possible due to circumstances; a change of clothes after each bath or when the clothes get dirty or sweaty; wearing clean clothes; using clean beddings, consuming clean food and water; safe disposal of human waste; brushing the teeth; trimming the nails; rubbing the skin and hair with coconut oil; getting a regular hair cut; having a massage when fatigued; keeping the mind and the emotions clean.

Collectively referred to as a daily cleaning routine or ritual, personal hygiene practices are carried out by both males and females.  Women, however, have more diverse and elaborate hygiene practices associated with beautifying or making themselves feel good considering the numerous chores and responsibilities they face in their daily life.

Every external part of the body demands a basic amount of attention on a regular basis. Here are some grooming routines some complaints associated with neglect. (ICDDR,B, ACPR and Population Council 2006) identified
Head & Hair, Eye & Ear, Skin & Nails. Teeth, Hands , Feet , Shocks & shoes as those factors , Following Conditions that can be controlled by improving personal hygiene.

Head Lice & Dandruff, Bad Breath, Ear Wax, Body Odour, Urinary Infection and Pinworms.

Body hygiene is achieved by using personal body hygiene products including: soap, hair shampoo, toothbrushes, tooth paste, cotton swabs, antiperspirant, facial tissue, mouthwash, nail files, skin cleansers, toilet paper. Kitchen / Cooking hygiene pertains to the practices related to food management and cooking to prevent food contamination, prevent food poisoning and minimize the transmission of disease to other foods, humans or animals. Cooking hygiene practices specify safe ways to handle, store, prepare, serve and eat food. Cooking practices include:

• Cleaning and sterilization of food-preparation areas and equipment (for example using designated cutting boards for preparing raw meats and vegetables). Cleaning may involve use of chlorine bleach, ethanol, ultraviolet light, etc. for sterilization.
• Careful avoidance of meats contaminated by trichina worms, salmonella,and other pathogens; or thorough cooking of questionable meats.
• Institutional dish sanitizing by washing with soap and clean water.
• Washing of hands thoroughly before touching any food.
• Washing of hands after touching uncooked food when preparing meals.
• Not licking fingers or hands while or after eating.
• Proper storage of food so as to prevent contamination by vermin.
• Refrigeration of foods (and avoidance of specific foods in environments where refrigeration is or was not feasible).
• Labeling food to indicate when it was produced (or, as food manufacturers prefer, to indicate its “best before” date).
• Proper disposal of uneaten food and packaging.

Good personal hygiene is the first step to healthy living. We begin learning hygiene techniques as children, and these habits should be continued throughout our lives

Good personal hygiene can make one a healthier person. Regular bathing and hand washing will prevent many illnesses by killing the unseen germs found on our bodies. Hands should wash frequently specially after latrine use, before and after taking meal

Good personal hygiene will prevent body odor. Washing every day and using a good soap or deodorant will remove the body chemicals that cause odor. Good personal hygiene also improves self-esteem and confidence. If you now you are clean, you can go about your daily activities without worrying that body odors may be offending others.

Good personal hygiene may prevent athlete’s foot and other skin conditions that are caused from lack of washing and useable cloths such as handkerchief, towels ,pillow and bed sheet etc should be clean regularly & properly,

Good personal hygiene will prevent bad breath and tooth decay. Brushing and flossing your teeth three times after taking meal a day and also before go to bed at night will keep your breath smelling clean.

Factors for achieving personal hygiene are Knowledge, Awareness, Dedication and Practice. Positive personal hygiene will prevent water disease eg  Diarrhoea , Dysentery. Typhoid , hyper acidity ,U,T, Infections etc by Using sanitary latrine,  safe drinking water( after boiled & cool ) and effective immunization. (Barkat et al. 2000; Bhuiya et al. 2004; Haider et al. 1997; Nahar et al. 1999; Rahman et al. 2006).

Several studies show that Personal hygiene practices include: seeing a doctor, seeing a dentist, regular washing / bathing, and healthy eating. Personal grooming extends personal hygiene as it pertains to the maintenance of a good personal and public appearance which need not necessarily be hygienic. (Chowdhury et al. 1997; ICDDR,B, ACPR and Population Council 2006; Rahman et al. 2006). However, their hygiene health needs are to be acknowledged.

Research question

What is the Present situation of knowledge, attitude & practice about personal hygiene  in the high school student in Bogura urban area of Bangladesh ?                                                                         

General Objective

To know the in-depth information on how high school children in Bogura city perceive personal hygiene.

Specific Objective

1. To see the knowledge of personal hygiene among the secondary school student of Bogura Govt. Pilot High school (boys).
2. To examine what are the motivation of school children to maintain hygiene behaviours who studied in Bogura Govt.PilotHigh school (boys).
3. To analyse how school children practice personal hygienic behaviours who studied in Bogura Govt.PilotHigh school (boys).
4. To examine the barriers of socio-demographic parameters affect practice Personal hygiene among the students who studied in Bogura Govt.PilotHigh school (boys).

Operational Definition:

Knowledge:

Information, understanding and skill that a person has acquired through education or experience about the fact.

Perception: Awareness, a way and the ability to see, hear or understanding something

Attitude: Behaving towards, a way of thinking about somebody or something

Knowledge on HIV/AIDS: As the knowledge of HIV/AIDS, this study includes the signs and symptoms of AIDS, ways of spread, ways of prevention, name of other non-HIV STIs, ways of spread of non-HIV STIs, know the sources of services for HIV and non HIV STIs.

RTIs: Reproductive tract infection (RTIs) are infections that affect the reproductive tract, which is part of the Reproductive System. For females, reproductive tract infections can be in either the upper reproductive tract (fallopian tubes, ovary and uterus), and the lower reproductive tract (vagina, cervix and vulva); for males these infections are at the penis, testicles, urethra or the sperm tube. The three types of reproductive tract infections are endogenous infections, iatrogenic infections and the more commonly known sexually transmitted infections. Each has its own specific causes and symptoms, caused by a bacterium, virus, fungus or other organism. Some infections are easily treatable and can be cured, some are more difficult, and some are non curable.

STIs: A sexually transmitted disease (STD), also known as sexually transmitted infection (STI) or venereal disease (VD), is an illness that has a significant probability of transmission between humans or animals by means of sexual contact, including vaginal intercourse, oral sex, and anal sex. While in the past, these illnesses have mostly been referred to as STDs or VD, in recent years the term sexually transmitted infection (STI) has been preferred, as it has a broader range of meaning; a person may be infected, and may potentially infect others, without showing signs of disease. Some STIs can also be transmitted via use of an IV drug needle after its use by an infected person, as well as through childbirth or breastfeeding. Sexually transmitted infections have been well known for hundreds of years.

HIV: Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections. Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unsafe sex, contaminated needles, breast milk, and transmission from an infected mother to her baby at birth (Vertical transmission). Screening of blood products for HIV has largely eliminated transmission through blood transfusions or infected blood products in the developed world.

AIDS: Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus. This condition progressively reduces the effectiveness of the immune system and leaves individuals susceptible to opportunistic infections and tumors. HIV is transmitted through direct contact of a mucous membrane or the bloodstream with a bodily fluid containing HIV, such as blood, semen, vaginal fluid, preseminal fluid, and breast milk. This transmission can involve anal, vaginal or oral sex, blood transfusion, contaminated hypodermic needles, exchange between mother and baby during pregnancy, childbirth, breastfeeding or other exposure to one of the above bodily fluids.

Study Design

A cross sectional school based descriptive study was conducted in Govt.SecondaryBoysSchool in Bogura city. The objective of such study design aimed to focus cross cutting issues that come across for assessing the knowledge of personal hygiene practice and level of awareness found among the School student.

Sampling Techniques

In compliance with the study objectives, selected 100 male adolescent students were selected purposively from GovernmentboysHigh School in Bogura city.

Sampling formula

The sample size was calculated on basis of the following formula:

Where,

n          = Sample size estimate

Z   = Z for level of significance alpha (at 0.05 level of significance value of Z is 1.96)

p= 50%

q= 1-p

d= acceptable margin of error (.05)

Actual sample size was

(n) = Z² pq/d²

= (1.96) ² × 0.5 × 0.5/ (0.05) ²

= 3.84 × 0.25 / 0.0025

=385

Using this formula, the sample respondents are approximately 384. But due to limitation of time and budgetary constraint number of respondents was limited within 100 students in Bogura city. The study utilized random sampling method to identify the respondents from the coastal areas.

Study population

100 male adolescent students were selected purposively, as the study population or the sample size for the study. The respondents were selected randomly from Bogura GovernmentBoysHigh School in Bogura city.

Location of the Study:

The study was conducted in Bogura city and more specifically in the Bogura city Metropolitan area.

Inclusion criteria

• Adolescent boy school students from GovernmentBoysHigh School in Bogura city.
• Willing to participate in the study and to provide personal hygiene information required for the study.

Exclusion criteria

• Unwilling to participate in the study
• Not fallen under the random sampling procedure and not presented in the interview.

Data Collection, Management & Analysis

Data was collected through a structured questionnaire prepared by the interviewer and approved by the examination board. Baseline information on socio-demographics, knowledge, attitude and practice towards adolescent personal hygiene, reproductive health will be collected from the study participants through interviewer-administered questionnaire through face to face interview. Questions will be asked about the personal hygiene, reproductive health issues like pubertal changes.

Data analysis was carried out using SPSS (version 15.0).

Data Collection Procedure

After explaining the purpose of the study to the respondents, data was collected through face to face interview using Bengali and English structured questionnaire.

Conduction of the study, quality control and monitoring

The data was collected from selected areas by the interviewer. The collected data was checked and verified by the investigator at the end of the work every day. Any inaccuracy and inconsistency was corrected in the next working day. However, cross checking of the collected data was done randomly.

Data Processing and data analysis

The data entry process started immediately after the completion of data collection. The collected data was checked, verified and then entered into the computer. Only fully completed datasheet was entered into the computer for the final analysis.

Ethical consideration

Prior to the commencement of this study, the research protocol was approved by the research committee (Local Ethical committee). The aims and objectives of the study along with its procedure, risks and benefits of this study was explained to the respondents in easily understandable local language and then informed consent was taken from each student. Then it was assured that all information and records will be kept confidential and the procedure will be used only for research purpose and the findings will be helpful for developing policy to increase the knowledge about personal hygiene among the school students.

Informed Consent

A well and clearly understood inform consent form will be filled in up by the respondents and interviewer. However, translations might be carried out after the according to the need of the respondents. This ensures that each of participants will get the information they need to make an informed decision.

Variables

The study comprised of both independent and dependent variable

Dependant Variable:

Knowledge of adolescent on personal hygiene and its improvement

Independent Variables:

• Age
• Education
• Perception about hygiene practice
• Hygiene Education
• Hygiene practices
• Cleanliness
• Knowledge on hygiene management
• Knowledge about adolescent changes

IEC related factors

• Health education
• counseling
• mass media, TV, radio, poster, billboard, banner, campaign

Results

Age and Gender status of the respondents:

Gender Status: Before starting the result analysis, the gender status and age of the respondents were calculated.  It was evident from the study that, the study was conducted Bogura name Bogura Govt.PilotHigh school. Total number of school student participated in the study was 100 in number. It was also found that all of the respondents were school going adolescent children in between 13 to 19 years.

Table : Age of the respondents

Age of the respondent

While addressing the age of the respondents from the study, it was observed from the study that, the age range of the respondents was limited within 10 to 19 years. While it was found that 86% of the respondents’ age was in between 16-18 years, and 7% of the students were aged 13-15 years. Only 5% respondent’s age was 10-12 years. It was also found that only 2% respondent’s age was in the age group of 19-21 years.

Table : What class do respondent read in?

In order to assess about the level of education among the respondents, it was found from the study that the respondent students were the students of class VII, VIII, IX and X. However, in much deeper observation, it was found that 93% of the students belonged to class X. 5% respondents reads in class VIII. Only 1% respondents were drawn from each of class VII and class IX.

Respondent’s attachment to IEC:

With a view to assess respondents attachment to information, education and communication activities, respondents were asked few questions for mentioning their involvement and level of participation in different activities through which they maintain their socialization process.

Table : Respondents exposure and frequency to IEC Medias                          

To know about the respondents contact with the IEC media, which can help them to increase their knowledge about their personal hygiene and cleanliness and claiming it to be as their right, few questions were asked to the respondents.

At first respondents were asked to tell about their interest in listening radio. In response to the query, about 68% respondents urged that, they used to listen to radio frequently. About 32% respondents mentioned that they regularly used to listen to radio. Respondents those who are listening to it regularly, also mentioned that their recent trend toward listening radio is due to popularity of radio and availability of it in the mobile hand set.

In order to find out how frequently do the respondents used to watch the television, 89% respondents mentioned that they used to watch television everyday, whereas, 11% of the respondents mentioned that they used to watch televisions frequently.

 To examine the practice of the respondents regarding newspaper reading, it was observed that most of the respondents (87%) of the respondents mentioned that they used to read it regularly, whereas 12% respondents urged that they frequently used to read newspaper. Only 1% respondents mentioned that they used to read newspaper not often.

Table : Whom do you feel comfortable in discussing your personal health?

Respondents were also asked to tell that whom do they feel comfortable in discussing their personal health problem, and in response to the query, 67% respondents mentioned that, they feel comfort to tell it to their mother, and 4% of them noted that they feel comfort to share the personal health problem to their sister. 3% of the respondents feel comfort to tell it to their male relatives, whereas telling it to their friend was reported by 21% of the respondents. Respondents were also asked that, whether they know about the health problem in relation to poor personal hygiene or not and in responding the question, 98% respondents urged that they feel that, they are acquainted to the health problems

Table : Respondents perception about Hand washing 

In order to know the respondents perception about the hand washing practice, this is to be regarded as one of the crucial factor that contributes toward the overall hygiene practice and personal healthiness as well. Respondents were also asked to tell about their hygiene practices, 99% respondents mentioned that they know how to wash the hands properly.

Almost 100% respondents mentioned that, they know what health problem may occur, if they do not wash our hand before meal. Respondents were also asked to tell whether they know what health problem may occur, if you don’t wash hand after defecation, and it was found that almost 95% respondents know about it. Only 5% respondents mentioned their reluctance about the hand washing after defecation.

Table : Respondents practices about Hand washing 

In order to assess the practices of hand washing in different situations and cases, respondents were asked to tell about their practices before taking the meal, after defecation and after cleaning. In response to the question, the study finds from the multiple calculation table that, 91% respondents used to wash their hands before meal, whereas 9% other respondents mentioned that they do not take the problem for cleaning their hands before meals and thus used to fall in problems.

Respondents were again asked to tell whether they practice hand washing after defecation. It was found that, it seems that 97% of the respondent use to practice washing their hands properly after coming out from the toilet or after defecation. Only 3% respondents mentioned that they could not practice it due to their ignorance or lack of willingness.

Meanwhile, respondents were also asked to mention about their practice of cleaning the hands after cleaning something.  In response to the query, it was found that, 95% respondents were found cleaning their hands properly after cleaning something and only 5% respondents mentioned that they are not used to clean their hands after cleaning something, but this is not even their regular practice.

Table : Process of Hand washing of the respondents

In order to measure the how the respondents used to clean their hands and ensures their proper hygiene practices, it was found 27% of the respondents use to wash their hands with water only before having the meal, whereas 73% respondents used to wash their hands with soap and water before the meal, which is to be regarded as the proper hygiene practices.

Respondents were also asked to tell how they wash their hands after cleaning, and it was found that 95% respondents did not practice the proper hygiene, as they used to clean their hands only with water. Only 5% respondents mentioned that they practice the hand washing properly, with soap and water.

Table : Do you wear sandal/shoes during use of toilet? 

Do you wear sandal/shoes during use of toilet?

In aligned with the hand washing practices, it is also important to use or wear sandal/shoes while using the toilet, because the germs in the toilet can also be transmitted into human body through the feet. Thus, respondent’s awareness about prevention of infections through using the sandals at the toilet was measured by asking them the question about their habit of using sandal during use of toilet, and it was found that only 44% respondents used to wear shoes/sandals while using the toilets. However, 56% respondents mentioned that they do not even use the sandals/shoes during using the toilet.

Table : Perceptions and practices of bathing among the respondents

Bathing is treated as one of the basic required practice for ensuring the regular cleanliness and proper hygiene practice. But, respondents were asked to demonstrated different aspects of bathing. About mentioning their bathing practice, it was found from the study that, almost 98% respondents used to take bath regularly, whereas it was also found only 2% respondents were not careful about taking their bath in a regular manner. Rather, each of the respondent was asked, whether they knows that how many times it is necessary to take bath, daily and in response to that, it was found that, all of the unanimously informed that, they knows about it. However, regarding their personal practice before going to or after returning from school, it was observed that 98% respondents mentioned that they used to do it.

Table : Bathing practice of the respondents

 In order to know about where the respondents used to take their bath, it was found that only 2% respondents used to bath in the pond or other external water sources or bathing place, but rest of 98% respondents used to take their bath at the bathrooms. It is also evident, bathing in external bathing places like pond and river possesses much risk of being infected by different germs, and people who usually use bathroom are less prone to skin diseases and other germs.

Respondents were also asked about how they takes their bath and it was found that, 98% respondents are used to bathe with soap and water, whereas, it was found that only 5% respondents bathe with water only.

 Table : Bathing practice of the respondents

In order to know how the respondents are informed about the practice of brushing their teeth and knowledge about the importance of the teeth in keeping free from the health problems, it was found that, 96% of the respondents did know irregular brushing of teeth may cause health problem. 4% respondents mentioned they did not either know that brushing can even cause health problem.

100% of the respondents insisted on to the point that they knows that, how many

times it is necessary to brush daily.

Table : How many times do respondents brush everyday? 

To assess, respondents practice of brushing teeth, it was found that 98% of the respondents used to brush twice a day, which is regarded as a standard practice. It was also surprising to see that only 1% respondents used to brush their teeth once a day. Besides, 1% respondent do not brush regularly, that means, only few respondents were found who did not practice proper care for their teeth.

Table : When do respondents used to brush their teeth?

To know about the timing, when respondents brush their teeth, it was found that 33% respondents mentioned that they use to brush only after awaking in the morning. 62% respondents also instructed that they use to brush twice a day, and the brushing usually takes place in both morning and evening. Only 5% respondents mentioned that, they used to brush only after the dinner.

Table : Respondents care about the nail          

Respondents were also asked to tell, whether they care about their nails or not, and in response to the question, it was found that 97% of the respondents were known to the system that, how they can take care of their nail. Besides, 89% of the respondents know that health problem can occur if nails are not trimmed timely and properly, as the nails works as the agent to transmit the germs to mouth and into the body through hands. Only 11% respondents were found who did not have proper knowledge about the health problem can be caused if nails are not cared off.

It was found from the study that, 40% of the respondents have the habit of trimming nail by mouth, which is very bad habit for health, whereas 60% used to cut it off properly.

Table : Respondents care about the hair

With a view to know, what the respondents do know or do care about their hair, it was found from the answer of the questions asked that, 63% respondents know how to take care of their hair and 54% of the respondents mentioned that, health problem may occur for them. 46% respondents mentioned that, they do not think if anybody doesn’t care about the hair.

Table :   What is the source of drinking water in your house?

To know about, the source of drinking water, and assess the safety of drinking water, respondents were asked this question and responding this question, it was found that, almost 49% respondents use supply water as a source of their drinking water. 51% of the other respondents mentioned that, they use tube well water as their source of water for drinking purpose.

Respondents were also asked that where they used to wash their utensils, and in response to the question, it was found that, 75% of the respondents used to wash it with water supply. 25% of the respondents also mentioned that, they used to wash their utensils with pond water and soap.

Table : Prevalence of diseases and its treatment

Respondents were asked whether they have been suffering from any diseases in the previous 6 months, and in response to the question, it was found that almost 47% respondents mentioned that they have faced diseases in the previous 6 months. 53% of the respondents mentioned that they have not faced any diseases in the previous 6 months.

“What do the respondents used to do when they become ill?” Answering this question, it was found that 72% of the respondents used to consult it with the doctors, whereas, 28% respondents mentioned that they did not used to go to the doctors whenever they fall ill.

Table : Respondents knowledge about adolescent changes  

In order to know about the gender specific changes (male) during the adolescent transition period, respondents were asked that whether they know about the ejaculation processor the wet dreams. In responding the question, it was found that more than 79% of the respondents do not know about ejaculation or the wet dreams, whether it was also been mentioned by 21% respondents that, they know about the ejaculation or wet dream incidents.

Figure : Is wet dream a disease?

Respondents were asked to answer whether they feel wet dream as a disease or not, and in responding to the question, it was found that only 8% of the respondents were reluctant about the wet dream and they did not whether it is a disease or not. 36% of the respondents agreed on the point that wet dream is a disease. 56% of the respondents showed there counter argument and to them, and claims that wet dream is not a diseases.

In response to the question about masturbation, it was found in the study that 34% respondents mentioned that they heard about masturbation whereas 66% of the respondents have not experienced it either or have heard about it.

Figure 2: Is masturbation a good practice?

To count the opinions of the respondents about masturbation, it was found that only 1% respondents do not have any knowledge about masturbation and whether it is good or bad. Most of the respondents (63%) mentioned it as to be a good practice. Besides, 18% respondents were mixed who used to believe it is neither a good practice nor a bad practice indeed. A similar percentage of respondents group was also found on the debate of masturbation as a practice but that group strictly noted masturbation as harmful to human body.

Discussion

While addressing the age of the respondents from the study, it was observed from the study that, the age range of the respondents was limited within 10 to 19 years. (study by UNICEF in 1992), While it was found that 86% of the respondents’ age was in between 16-18 years, and 7% of the students were aged 13-15 years. Only 5% respondent’s age was 10-12 years. It was also found that only 2% respondent’s age was in the age group of 19-21 years.

In order to assess about the level of education among the respondents, it was found from the study that the respondent students were the students of class VII, VIII, IX and X. However, in much deeper observation, it was found that 93% of the students belonged to class X. 5% respondents reads in class VIII. Only 1% respondents were drawn from each of class VII and class IX.

To know about the respondents contact with the IEC media, which can help them to increase their knowledge about their personal hygiene and cleanliness and claiming it to be as their right, few questions were asked to the respondents.

At first respondents were asked to tell about their interest in listening radio. In response to the query, about 68% respondents urged that, they used to listen to radio frequently. About 32% respondents mentioned that they regularly used to listen to radio. Respondents those who are listening to it regularly, also mentioned that their recent trend toward listening radio is due to popularity of radio and availability of it in the mobile hand set.

In order to find out how frequently do the respondents used to watch the television, 89% respondents mentioned that they used to watch television everyday, whereas, 11% of the respondents mentioned that they used to watch televisions frequently.

To examine the practice of the respondents regarding newspaper reading, it was observed that most of the respondents (87%) of the respondents mentioned that they used to read it regularly, whereas 12% respondents urged that they frequently used to read newspaper. Only 1% respondents mentioned that they used to read newspaper not often.

Health education has often become the scapegoat for all kinds of program failures. It is easy to blame people for program failures. People’s behavior to fit program requirements, technology is really necessary as health education can become a tool of compulsion’ (Kochar, 1981: 8). Respondents were also asked to tell that whom do they feel comfortable in discussing their personal health problem, and in response to the query, 67% respondents mentioned that, they feel comfort to tell it to their mother, and 4% of them noted that they feel comfort to share the personal health problem to their sister. 3% of the respondents feel comfort to tell it to their male relatives, whereas telling it to their friend was reported by 21% of the respondents. Respondents were also asked that, whether they know about the health problem in relation to poor personal hygiene or not and in responding the question, 98% respondents urged that they feel that, they are acquainted to the health problems.

Hand hygiene is an important element of infection control. Hand washing with soap has proved effective in preventing facial-oral transmission of disease (Uddin, 1982).In order to know the respondents perception about the hand washing practice, this is to be regarded as one of the crucial factor that contributes toward the overall hygiene practice and personal healthiness as well. Respondents were also asked to tell about their hygiene practices, 99% respondents mentioned that they know how to wash the hands properly.

Almost 100% respondents mentioned that, they know what health problem may occur, if they do not wash our hand before meal. Respondents were also asked to tell whether they know what health problem may occur, if you don’t wash hand after defecation, and it was found that almost 95% respondents know about it. Only 5% respondents mentioned their reluctance about the hand washing after defecation.

Particularly important is the washing of hands after defecation and before food preparation and eating, and the manner in which the washing is done. Hand washing after defecation is important for all user groups. Hand washing after latrine use is not universal and often only water is used (IMRB, 1994; Wijk, 1985; Wilson and Chandler, 1993; Zeitlyn and Islam, 1991). Also, the practices reported may be ideal rather than real behaviour. Kirimbai and Wijk, (1983) and Therkildsen and Laubjerg (1982) found, for example, that householders would say that they washed hands with soap but that there was no soap present in these households. In order to assess the practices of hand washing in different situations and cases, respondents were asked to tell about their practices before taking the meal, after defecation and after cleaning. In response to the question, the study finds from the multiple calculation table that, 91% respondents used to wash their hands before meal, whereas 9% other respondents mentioned that they do not take the problem for cleaning their hands before meals and thus used to fall in problems.

Often boys and girls cannot or do not use toilets hygienically and cannot wash hands with soap, or a good soap substitute such as ash, clean sand, with firm rubbing using plenty of water, and not all using the same water. Respondents were again asked to tell whether they practice hand washing after defecation. It was found that, it seems that 97% of the respondent use to practice washing their hands properly after coming out from the toilet or after defecation. Only 3% respondents mentioned that they could not practice it due to their ignorance or lack of willingness.

Elsewhere, hand washing with soap has also been promoted, though soap is either not easily available, or is expensive (Hannan, 1984; Kirimbai and Wijk, 1983; NICED, 1982; Morgan, 1995; Zeitlyn and Islam, 1991).Meanwhile, respondents were also asked to mention about their practice of cleaning the hands after cleaning something.  In response to the query, it was found that, 95% respondents were found cleaning their hands properly after cleaning something and only 5% respondents mentioned that they are not used to clean their hands after cleaning something, but this is not even their regular practice.

In order to measure the how the respondents used to clean their hands and ensures their proper hygiene practices, it was found 27% of the respondents use to wash their hands with water only before having the meal, whereas 73% respondents used to wash their hands with soap and water before the meal, which is to be regarded as the proper hygiene practices.

Respondents were also asked to tell how they wash their hands after cleaning, and it was found that 95% respondents did not practice the proper hygiene, as they used to clean their hands only with water. Only 5% respondents mentioned that they practice the hand washing properly, with soap and water.

In aligned with the hand washing practices, it is also important to use or wear sandal/shoes while using the toilet, because the germs in the toilet can also be transmitted into human body through the feet. Thus, respondent’s awareness about prevention of infections through using the sandals at the toilet was measured by asking them the question about their habit of using sandal during use of toilet, and it was found that only 44% respondents used to wear shoes/sandals while using the toilets. However, 56% respondents mentioned that they do not even use the sandals/shoes during using the toilet.

Bathing is treated as one of the basic required practice for ensuring the regular cleanliness and proper hygiene practice. But, respondents were asked to demonstrated different aspects of bathing. About mentioning their bathing practice, it was found from the study that, almost 98% respondents used to take bath regularly, whereas it was also found only 2% respondents were not careful about taking their bath in a regular manner. Rather, each of the respondent was asked, whether they knows that how many times it is necessary to take bath, daily and in response to that, it was found that, all of the unanimously informed that, they knows about it. However, regarding their personal practice before going to or after returning from school, it was observed that 98% respondents mentioned that they used to do it.

In order to know about where the respondents used to take their bath, it was found that only 2% respondents used to bath in the pond or other external water sources or bathing place, but rest of 98% respondents used to take their bath at the bathrooms. It is also evident, bathing in external bathing places like pond and river possesses much risk of being infected by different germs, and people who usually use bathroom are less prone to skin diseases and other germs.

Respondents were also asked about how they takes their bath and it was found that, 98% respondents are used to bathe with soap and water, whereas, it was found that only 5% respondents bathe with water only. In order to know how the respondents are informed about the practice of brushing their teeth and knowledge about the importance of the teeth in keeping free from the health problems, it was found that, 96% of the respondents did know irregular brushing of teeth may cause health problem. 4% respondents mentioned they did not either know that brushing can even cause health problem.

100% of the respondents insisted on to the point that they know that, how many times it is necessary to brush daily. To assess, respondents practice of brushing teeth, it was found that 98% of the respondents used to brush twice a day, which is regarded as a standard practice. It was also surprising to see that only 1% respondents used to brush their teeth once a day. Besides, 1% respondent do not brush regularly, that means, only few respondents were found who did not practice proper care for their teeth.

To know about the timing, when respondents brush their teeth, it was found that 33% respondents mentioned that they use to brush only after awaking in the morning. 62% respondents also instructed that they use to brush twice a day, and the brushing usually takes place in both morning and evening. Only 5% respondents mentioned that, they used to brush only after the dinner.

Respondents were also asked to tell, whether they care about their nails or not, and in response to the question, it was found that 97% of the respondents were known to the system that, how they can take care of their nail. Besides, 89% of the respondents know that health problem can occur if nails are not trimmed timely and properly, as the nails works as the agent to transmit the germs to mouth and into the body through hands. Only 15 respondents were found who did not have proper knowledge about the health problem can be caused if nails are not cared off.

It was found from the study that, 40% of the respondents have the habit of trimming nail by mouth, which is very bad habit for health, whereas 60% used to cut it off properly. With a view to know, what the respondents do know or do care about their hair, it was found from the answer of the questions asked that, 63% respondents know how to take care of their hair and 54% of the respondents mentioned that, health problem may occur for them. 46% respondents mentioned that, they do not think if anybody doesn’t care about the hair.

To know about, the source of drinking water, and assess the safety of drinking water, respondents were asked this question and responding this question, it was found that, almost 49% respondents use supply water as a source of their drinking water. 51% of the other respondents mentioned that, they use tube well water as their source of water for drinking purpose.

Respondents were also asked that where they used to wash their utensils, and in response to the question, it was found that, 75% of the respondents used to wash it with water supply. 25% of the respondents also mentioned that, they used to wash their utensils with pond water and soap. Respondents were asked whether they have been suffering from any diseases in the previous 6 months, and in response to the question, it was found that almost 47% respondents mentioned that they have faced diseases in the previous 6 months. 53% of the respondents mentioned that they have not faced any diseases in the previous 6 months.

“What do the respondents used to do when they become ill?” Answering this question, it was found that 72% of the respondents used to consult it with the doctors, whereas, 28% respondents mentioned that they did not used to go to the doctors whenever they fall ill.

In order to know about the gender specific changes (male) during the adolescent transition period, respondents were asked that whether they know about the ejaculation processor the wet dreams. In responding the question, it was found that more than 79% of the respondents do not know about ejaculation or the wet dreams, whether it was also been mentioned by 21% respondents that, they know about the ejaculation or wet dream incidents.

Respondents were asked to answer whether they feel wet dream as a disease or not, and in responding to the question, it was found that only 8% of the respondents were reluctant about the wet dream and they did not whether it is a disease or not. 36% of the respondents agreed on the point that wet dream is a disease. 56% of the respondents showed there counter argument and to them, and claims that wet dream is not a diseases.

In response to the question about masturbation, it was found in the study that 34% respondents mentioned that they heard about masturbation whereas 66% of the respondents have not experienced it either or have heard about it. To count the opinions of the respondents about masturbation, it was found that only 1% respondents do not have any knowledge about masturbation and whether it is good or bad. Most of the respondents (63%) mentioned it as to be a good practice. Besides, 18% respondents were mixed who used to believe it is neither a good practice nor a bad practice indeed. A similar percentage of respondents group was also found on the debate of masturbation as a practice but that group strictly noted masturbation as harmful to human body.

Conclusion

Recent studies have identified many positive aspects of current hygiene practices. They have shown that such studies can be useful.  It is recommended that personal and home hygiene practices be documented among the adolescent boys and that could help enhance and sustain WASH programs.

It is known that new hygiene practices are most likely to be sustained when they are related to existing practices. Thus, the recommended strategy is to build upon adolescent’s personal capability and promoting knowledge in healthy hygiene behavior and hygiene practices.  This should allow for various options, and will help to sustain and promote hygiene behavior.

It is recommended that strong partnerships is to be initiated between and among communities, adolescent boys and their  parents or guides for promoting and implementing awareness package for developing the personal awareness and attitudes for hygiene promotion, and maintaining the healthy life.

Involving schools and students as community motivators is a powerful weapon in improving personal hygiene practices. Increased knowledge about related diseases, an increase in the use of hygienic latrines, proper hygiene practices. Improvements have to be ensured in terms of sanitation behaviors and it should begin through process of motivation started from the top and continued to the bottom.

Recommendations

1.As, students knowledge about personal hygiene still lies with some misconceptions, thus, it is necessary to provide hygiene education to the adolescent students that changes their attitudes towards regular practices concerning water, latrines and personal hygiene; This might encourage them in motivating use safe water and maintain cleanliness.

2. Strong commitment and dedication is needed between the community, teachers and students enhance the knowledge and skills to improve the health situation, lowering student dropout and illness and for ensuring personal cleanliness.

3. The school teachers and the students are to be highly encouraged to unite in promoting safe water, environmental sanitation and personal hygiene, ensuring an enabling environment for continual awareness-raising campaigns

4. As, hygiene promotion is not simply a matter of providing information and its more a dialogue with a particular community about hygiene and related health problems, to encourage improved hygiene practices. So, the capacity of the school students to understand about hygiene practice is to be increased through their exposure to IEC Medias and observing hygiene promotion as a vital investment.