Rural Health Original Article
Knowledge and practice of personal hygiene
among secondary school students of grade
nine and ten
Ajay Kumar Rajbhandari,1 Ranju Dhaubanjar,2 Krishna Bahadur GC,1 Maginsh
Dahal3
1Assistant Professor, Patan Academy of Health Sciences, Lalitpur, Nepal; 2Asian
College for Advance Studies, Kathmandu, Nepal; 3PhD Scholar, Nanjing Medical
University, People’s Republic of China
ISSN: 2091-2749 (Print)
2091-2757 (Online)
Abstract
Correspondence Introductions: Personal hygiene deficiency have been found to be a
Mr. Ajay Kumar Rajbhandari serious public health problem and people often affected are school
Department of Community children. These have been attributed to inadequate knowledge of
Health Sciences,
personal hygiene and its practices. This study was designed to explore
School of Medicine,
the existing knowledge and practices of personal hygiene among the
Patan Academy of Health
Sciences, Lalitpur, Nepal students studying at secondary level schools in Bhaktapur district, Nepal.
Email:
ajayrajbhandari@[Link] Methods: This study was a cross- sectional study to investigate personal
hygiene knowledge and practices of secondary level, grades nine and ten
school children, Bhaktapur district, Kathmandu valley, Nepal. Pre-tested,
Peer Reviewers self- administered questionnaire were used. Data were collated and
Prof. Dr. Jay Narayan Shah analyzed descriptively.
Patan Academy of Health
Sciences
Results: The result showed that the secondary school students who
Asst. Prof. Dr. Ashis Shrestha participated in the study were evenly distributed by gender (50.4% males
Patan Academy of Health and 49.6% females), most of the respondents (78.8%) were in the 15-16
Sciences year age bracket. Majority of the respondents (88.5%) had good
knowledge level on personal hygiene. Female students were found
having more knowledge level than male students. Conversely, majority of
Submitted them were noted with moderate to poor level of hygiene practices.
31 Oct 2018
Conclusion: Secondary school students of Bhaktapur have good
Accepted
25 Nov 2018
knowledge on personal hygiene while lot more improvement is required
in terms of practices. Integrated approach by parents, school and social
media to enhance hygiene practices could be useful.
How to cite this article
Ajay Kumar Rajbhandari, Ranju Keywords: knowledge, personal hygiene; practices, students
Dhaubanjar, Krishna Bahadur
GC, Maginsh Dahal. Knowledge
and practice of personal
hygiene among secondary
school grade nine and ten
students. Journal of Patan
Academy of Health Sciences.
2018Dec;5(2):107-113.
107 Journal of Patan Academy of Health Sciences. 2018Dec;5(2):107-113.
Ajay Rajbhandari: Personal hygiene among secondary school students
Introductions confidence level; and, ‘d’ is the level of error
that can be tolerated.
Personal hygiene is the science of healthy
livings and embraces all those day to day A pre-tested, self-administered anonymous
activities that contribute to health and questionnaire was used to collect information
wellbeing of an individual.1 The diseases that from the respondents. The questionnaire was
arise due to deficiency of personal hygiene pre-tested among 10% of the sample size in
remain one of the major public health the local setting. The questionnaire contained
concern, particularly in developing countries.2- three sections, I on demographic
5
While everybody is susceptible, younger characteristics, II on knowledge on personal
children are predominantly more prone than hygiene, III on practice of personal hygiene.
older counterparts.6,7 School children with
better knowledge and practices of personal In total, 13 questions with total score of 0 to
hygiene have fewer sick days and 13 (1 for agree and 0 for disagree/don’t know
absenteeism in school and achieve higher response) was used to assess the existing
grades.8 level of knowledge.9 The score was divided
into three categories; poor knowledge with a
There are limited published studies (Google score less than 50%, moderate knowledge
scholar, PubMed) on personal hygiene from 50-75% and good knowledge more than
focusing youth population locally. Thus, this 75%.
study was aimed to assess the existing
knowledge and practices of personal hygiene The completed questionnaires were collated,
among the school going students in Bhaktapur entered in SPSS 16.0, and analyzed using
district of Kathmandu valley in Nepal. descriptive statistics. The Pearson chi-square
test was used for comparison, P<0.05. was
The information and knowledge generated considered significant.
from this study is expected to be useful for
strategic planning and interventions in future. Institutional ethical clearance was obtained
from research and development committee of
Asian College for Advance Studies, Purbanchal
University, Nepal. Necessary permission was
Methods
taken from school authorities before
conducting the study. The respondents were
This cross-sectional study was conducted in elucidated about the research objectives
May-June 2018. Four schools located in beforehand and confidentiality of personal
Bhaktapur district of Kathmandu valley in identity were assured.
Nepal were included in this research. Schools
were purposively selected using convenient
sampling method and the students studying in
grade nine and ten were considered as Results
sampling units for this school-based study.
Among 36 schools in Bhaktapur, four (around Total of 346 students in class nine and ten in
10%) were included in the study. the schools were included in this study. Out of
which, seven students were absent on the day
of data collection. Thus, we were able to
The sample size was calculated using Kish
interview 339 (97.9%) of the sampled
Leslie’s formula for descriptive studies n=p(1-
population. Out of 339 students participants,
p) z2/d2 where ‘n’ is the minimum number of
171 (50.4%) were boys and 168 (49.6%) were
respondents needed; ‘p’ is the estimated
girls, age ranging from 13 to 18 years (mean
proportion of personal hygiene knowledge
15.38±0.863), (Table 1).
among students from a previous study; ‘z’ is
the standard variation corresponding to
108 Journal of Patan Academy of Health Sciences. 2018Dec;5(2):107-113.
Ajay Rajbhandari: Personal hygiene among secondary school students
Nearly all, 338 (99.7%) followed hand washing
Total 80.2% of student had knowledge that after using toilet, 326 (96.2%) practiced hand
showering everyday helps in maintaining washing before meal and 275 (81.2%) after
cleanliness, washing hand with soap is a playing. One-hundred and twenty-nine
healthy behavior, maintaining hand hygiene (38.1%) students brushed teeth before going
prevents infection transmission, brushing to bed. Majority 332 (97.9%) claimed that
teeth regularly helps avoid dental problems. they wash fruits and vegetables before
Nearly half of the numbers of studies consuming, (Table 4).
surveyed had knowledge of fluoride
containing toothpaste helps in strengthening The hygiene practices of the girls on hand
teeth, consuming raw vegetable could washing after playing or brushing teeth before
adversely affect their health, (Table 2). bed were found higher than that of boys,
(Table 5).
Good knowledge of personal hygiene was
found in 300 (88.5%) students. Overall good One hundred twenty-six (37.2%) students
level of knowledge in 157 (93.4%) girls was visited dentist at least once a year for general
higher than boys 143 (83.7%). Two hundred checkup, 157 (53.7%) when they had
and fifty-seven (75.8%) students problem, remaining 31 (9.2%) had never been
acknowledged their family were primary to dentist.
source of information on personal hygiene, In spite of most of the respondents with good
followed by teacher, (Table 3). knowledge score when it comes to practices
of those hygiene, it was also noticed that 203
Study noted that 39 (11.5%) respondents (59.9%) and 108 (31.8%) had moderate and
bathed every day, 75 (22.1%) on every poor practicing level respectively, (Table 6).
alternate day and remaining 225 (66.4%)
bathed at least once per week.
Table 1. Demographic characteristics of secondary school grade nine and ten students (n=339)
Socio-Demographic Characteristics N %
13 5 1.5
14 41 12.1
15 141 41.6
Age
16 126 37.2
(Completed Year)
17 24 7.1
18 2 0.6
Total 339 100
Male 171 50.4
Sex Female 168 49.6
Total 339 100
Grade Nine 133 39.2
Education Level Grade Ten 206 60.8
Total 339 100
109 Journal of Patan Academy of Health Sciences. 2018Dec;5(2):107-113.
Ajay Rajbhandari: Personal hygiene among secondary school students
Table 2. Knowledge on personal hygiene among secondary school grade nine and ten students (n=339)
Statement Agree Disagree Don’t know
N (%) N (%) N (%)
Neatness helps in keeping us healthy 332 (97.9) 2 (0.6) 5 (1.5)
Showering everyday keeps us clean 272 (80.2) 50 (14.8) 17 (5.0)
Washing hand with soap is a healthy behavior 333 (98.2) 4 (1.2) 2 (0.6)
Biting nail is an unhealthy behavior 300 (88.5) 26 (7.7) 13 (3.8)
Maintaining proper hand hygiene prevents infection 330 (97.3) 9 (2.7) 0 (0.0)
Brushing teeth regularly prevents teeth problems 310 (91.5) 16 (4.7) 13 (3.8)
Regular dental check up is important 333 (98.2) 1 (0.3) 5 (1.5)
Sweets and soft drinks could affects teeth 305 (90.0) 20 (5.9) 14 (4.1)
Microbes causes food poisoning 314 (92.6) 9 (2.7) 16 (4.7)
Consuming raw meat affects health 278 (82.0) 18 (5.3) 43 (12.7)
Consuming raw vegetable affects health 207 (61.1) 75 (22.1) 57 (16.8)
Flies could contaminate food 330 (97.3) 2 (0.6) 7 (2.1)
Leftover food should be reheated before consuming 186 (54.9) 113 (33.3) 40 (11.8)
Table 3. Sex-wise level of knowledge of personal hygiene among secondary school grade nine and ten
students (n=339)
Variables Male 171 Female 168 Total 339 P
N (%) N (%) N (%)
Existing knowledge level
Good 143 (83.7) 157 (93.4) 300 (88.5)
Moderate 24 (14.0) 10(6.0) 34 (10.0) 0.017
Poor 4 (2.3) 1 (0.6) 5 (1.5)
Primary source of information
Family 116 (67.8) 141 (83.9) 257 (75.8)
0.007
Teacher 24 (14.0) 19 (11.3) 43 (12.7)
Book, Television, Newspaper, Social media, internet 31(18.2) 8 (4.8) 39 (11.5)
Table 4. Practices of personal hygiene among secondary school grade nine and ten students (n=339)
Statement Always Sometimes Never
N (%) N (%) N (%)
I wash my hands before having meal 326 (96.2) 11 (3.2) 2 (0.6)
I wash my hands after using toilet 338 (99.7) 0 (0.0) 1 (0.3)
I wash my hands after playing 275 (81.2) 52 (15.3) 12 (3.5)
I use soap for washing hands 271 (79.9) 64 (18.9) 4 (1.2)
I brush my teeth after waking up 253 (74.6) 41 (12.1) 45 (13.3)
I brush my teeth before going to bed 129 (38.1) 97 (28.6) 113 (33.3)
I brush my teeth after having sweets 63 (18.6) 138 (40.7) 138 (40.7)
I wash fruits vegetables before eating 332 (97.9) 0 (0.0) 7 (2.1)
I wash my hand with soap after handling raw meat 289 (85.3) 0 (0.0) 50 (14.7)
I taste food by finger while cooking 65 (19.2) 0 (0.0) 274 (80.8)
I eat half cooked eggs 83 (24.5) 0 (0.0) 256 (75.5)
I drink raw milk 40 (11.8) 0 (0.0) 299 (88.2)
110 Journal of Patan Academy of Health Sciences. 2018Dec;5(2):107-113.
Ajay Rajbhandari: Personal hygiene among secondary school students
Table 5. Sex-wise practices of personal hygiene among secondary school grade nine and ten students
(n=339)
Variables Male 171 Female 168 Total 339 p
N (%) N (%) N (%)
Washing hand after playing
Always 134 (78.4) 141 (83.9) 275 (81.1)
Sometimes 28 (16.4) 24 (14.3) 52 (15.3) 0.177
Never 9 (5.3) 3 (1.8) 12 (3.5)
Brushing teeth after wake-up
Always 120 (70.2) 133 (79.2) 253 (74.6)
Sometimes 23 (13.5) 18 (10.7) 41 (12.1) 0.139
Never 28 (16.4) 17 (10.1) 45 (13.3)
Brushing teeth before going to bed
Always 58 (33.9) 71 (42.3) 129 (38.1)
Sometimes 46 (26.9) 51 (30.4) 97 (28.6) 0.066
Never 67 (39.2) 46 (27.4) 113 (33.3)
Brushing teeth after having sweets
Always 22 (12.9) 41 (24.4) 63 (18.6)
Sometimes 65 (38.0) 73 (43.5) 138 (40.7) 0.002
Never 84 (49.1) 54 (32.1) 138 (40.7)
Table 6. Distribution of students according to knowledge and practices of personal hygiene among
secondary school grade nine and ten students (n=339)
knowledge Practices Total 339 p
level N (%) N (%)
Poor Moderate Good
Poor 3 (60.0) 2 (40.0) 0 (0.0) 5 (1.5)
0.014
Moderate 19 (55.9) 13 (38.2) 2 (5.9) 34 (10.0)
Good 86 (28.7) 188 (62.7) 26 (8.7) 300 (88.5)
Total 108 (31.8) 203 (59.9) 28 (8.3) 339 (100.0)
Discussions knowledge of personal hygiene. This finding
correlate with the studies from UAE8 and
Our study revealed 88.5% of grade 9-10 of India11, but in disagreement with the findings
secondary schools students had good level of from Egypt8. This discrepancy in knowledge
knowledge on personal hygiene. This was very score could be due to variation in family
encouraging finding, similar to the study orientation, socio-cultural differences and
which reports good knowledge level among physiologically higher need for cleanliness
52% in Angolela, Ethiopia.11 Notably higher among adolescent female.
findings in this study could be due to greater
integration of personal hygiene component in In the current study, the main sources of
school curriculum and school health program, information regarding basic personal hygiene
plus the urban setting of schools, as were family followed by school teachers,
Bhaktapur is one of three districts in similar to the findings from Jordan and
Kathmandu valley, capital of Nepal. Columbia.12,13 These observations clearly
demonstrated that the parents and school
In the study female students obtained teacher plays instrumental role in imparting
significantly higher average knowledge score the knowledge and practices of personal
(93.4%) than the male (83.7%) regarding the hygiene early in the child’s life. They could be
a crucial role model because clean parents
111 Journal of Patan Academy of Health Sciences. 2018Dec;5(2):107-113.
Ajay Rajbhandari: Personal hygiene among secondary school students
and teachers tend to transmit their attitude than the study in Nigeria where 46%
and practices.1,3,6 responded they often see their dentist in a
year in the absence of illness.20
When it comes to hand hygiene practices, the
self-reported frequency of hand washing Several limitations must be considered while
before meals among children in our study is interpreting findings of this study. First, the
notably higher (96.2%) compared to other study is based on self-reported information
studies. For instance, studies from the and thus is subject to over-reporting of their
Bangladesh,1 Philippine14 and Colombia13 actual hygiene practices (self-report bias).
indicated that 91%, 75.9% and 46.9% of Second, as data collection was based on self-
students, reported washing hands before administer questionnaire, the study was
meals. This can be explained by cultural limited to students enrolled in grade nine and
practices, the types of food and use of hands ten only assuming that they could respond to
or utensils while eating food. In Nepal, most the research tool independently. Thirdly, the
of the meals are eaten with hands thus, findings may not generalizable to other
greater emphasis is on washing hands before secondary school students because our
meals. sample was from urban setting, as Bhaktapur
is one of three districts in Kathmandu valley,
More than half (60.9%) of the students who capital of Nepal.
reported no regular hand washing after
playing, said that they often forget to wash, Even with good knowledge, majority of
and one-fourth (29.7%) students mentioned students exhibited moderate to poor level of
that they do not have time to wash hands and personal hygiene practices and there is need
only few (9.4%) thought it was not really for appropriate educational methods to
required. motivate these adolescents to improve
personal hygiene practices.
Our study also noted that 99.7% practiced
hand wash after using toilet. This finding was
in harmony reported studies which showed Conclusions
99.2%1, 98%15 and 91.6%17 respectively.
However, one study reports only 18.1%,18 The current study shows that majority of
possibly due to different study design. secondary level school going children of
Bhaktapur districts in Kathmandu valley Nepal
In our study, 79.9 % of students who washed had good level of knowledge on personal
their hands reported using soap. This is hygiene. Female students appear to be more
substantially greater than Philippines14 and knowledgeable than the male students.
Turkey studies18 where an average of 37.7% However, in the practice dimension, majority
and 42.2% of children, respectively, washed of them exhibited moderate to poor level of
their hand with soap. Again, this may be personal hygiene.
because in Nepal, culturally we use hands for
eating.
Acknowledgements
A total of 74.6% were regularly brushed teeth
early in the morning, while only 38.1% We thank the staffs, administrations, students
brushed before going to bed. In addition, of the participating schools for their
female children tendency to brush before bed cooperation to make this study possible.
was higher (42.3%) than males (33.9%). This
study finding is similar to Bangladesh study.19
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