Personal Hygiene In Public Schools And Effectiveness Of Public Health Intervention

Project and Seminar Material for Public Health

Personal Hygiene In Public Schools And Effectiveness Of Public Health Intervention


Abstract


The study revealed into personal hygiene in public schools and effectiveness of public health intervention where the following aspects were investigated: (1). personal hygiene practices among public primary school children, (2). occurrence of disease among public primary school, (3). relationship between hygiene practices and effectiveness of public health intervention, (4). difference between personal hygiene practices between private and public primary schools. The study employed descriptive comparative and correlation design. Twelve teachers were chosen purposively in six public primary schools and three hundred sixty-eight pupils were selected from both public and private primary schools. Questionnaires were used to gather data. Frequency, percentage, means, Pearson correlation coefficient was used to determine the relationship between the variables and t-test was used to determine the difference between variables. Findings showed that the personal hygiene practices among public primary school children was rated good with a mean of 2.07. The occurrence of diseases was high with a mean 1.71. As to personal hygiene practices between private and public primary school children, private school public primary school has very good personal hygiene practices compared to public school children with a mean of 2.19. Null hypothesis of no relationship between personal hygiene practices and effectiveness of public health intervention was rejected. Based on the findings of the study the following conclusions were made Personal hygiene practices among public primary school children was rated good which means that Public primary school children are aware of the importance of practicing proper personal hygiene. The occurrence of diseases among public primary school children was high despite practicing personal hygiene children are affected by diseases like bacterial diseases, waterborne diseases and fungal or infectious diseases. This means that the diseases affecting school children are not only due to personal hygiene but other factors like dirty surroundings and malnutrition. There is a relationship between personal hygiene practices and effectiveness of public health intervention. The occurrence of disease like bacterial infection, water borne diseases and other infections among public primary school children is caused by poor personal hygiene practices.


Chapter One


Introduction

1.1 Background to the Study

The concept of hygiene dates back to the time when first man has moved into the caves to protect himself from the forces of nature that acts against his survival. The word hygiene comes from Hygeia, the Greek goddess of health (Beumer, Stanwell Smith R, Bloomfield SF, 2009).

Globally, since the arrival of the Industrial Revolution and the discovery of the germ theory of disease in the second half of the nineteenth century, hygiene and sanitation have been at the forefront of the struggle against illness and disease. Elaborate codes of hygiene can be found in several Hindu texts, such as the Manusmritia nd the Vishnu Purana. Bathing is one of the five Nitya karmas (daily duties) in Hinduism, and not performing it leads to sin. Regular bathing was a hallmark of Roman civilization. Elaborate baths were constructed in urban areas to serve the public, who typically demanded the infrastructure to maintain personal cleanliness. The complexes usually consisted of large swimming pool-like baths, smaller cold and hot pools, saunas, and spa-like facilities where individuals could be depilated, oiled, and massaged. Water was constantly changed by an aqueduct-fed flow (Prüss-Üstün et al, 2008).

Between 1550-1200B.C., the Ancient Israelites took a keen interest in hygiene. Moses gave the Israelites detailed laws governing personal cleanliness. He also related cleanliness to health and religious purification. Biblical accounts suggest that the Israelites knew that mixing ashes and oil produced a kind of hair gel. Records show that ancient Egyptians bathed regularly. The Ebers Papyrus, a medical document from about 1500 B.C describes combining animal and vegetable oils with alkaline salts to form a soap-like material used for treating skin diseases, as well as for washing. Public baths began in Greece in the sixth century B.C., where men and women washed in basins near places of exercise. The Ancient Greeks also start using chamber pots. In 400A.D. Medieval Britain, the population had begun various habits to keep their teeth clean. This included rinsing your mouth out with water, or a mixture of vinegar and mint, to remove gunk. Bay leaves soaked in orange flower water were also used, and the teeth would often be rubbed with a clean cloth too (Aiello AE, Larson EL, Sedlak R., 2008).

Toilet and the moral imperative that bathrooms should be indoors and as private as possible (Philippe Braunstein et al, 1988).

In Africa, during the 18th century Egyptian played a key role in the production of cosmetic and hygienic practices. A preserved traveler‟s box from Egypt‟s 18th Dynasty reveals their priorities: pumice, tubes of eye paint and a comb were featured as contents (Smith, 2008). The Egyptians also noticed that using normal ash and fat-based soap on their hair left an unsightly dull residue. They added citrus juice to soap to cut through the oil on the scalp and received shiny and fragrant hair as a result. Thus, the first rudimentary shampoo was born. According to Curtis (2007), ancient Egyptians stressed the importance of hygiene. Herodotus described how the Egyptians, and especially the priests, washed frequently. They associated water with health and life because they relied on the river Nile for so many things, for example the irrigation of their crops. Egyptians also used cosmetics regardless sex and social status for both aesthetic and therapeutic reasons. Oils and unguents were rubbed into the skin to protect it from the hot air. Most frequently used were white make-up, black make-up made with carbon, lead sulfide or manganese oxide and green make-up from malachite and other copper based minerals. Red ochre was ground and mixed with water, and applied to the lips and cheeks, painted on with a brush. Henna was used to dye the fingernails yellow and orange (Alfredo, G. T., 2004).

In Nigeria, before the colonialrule, efforts ranging from coercion to persuasion in villages were made by chiefs and other local leaders to encourage citizens to build, maintain, and use latrines, keep themselves and their environment clean, and use clean sources of water. From the 1900 to the 1960‟s, Nigeria was no different from most other countries under a colonial government who held sanitation and hygiene high on their political and social agendas. First, keeping proper hygiene meant that the local population would be less exposed to tropical and common diseases (Smith, 2008). Secondly, with good hygiene, the indigenous population would become stronger and healthier, thus a better source of labour and income generation. And thirdly, good personal hygiene was a sign of „civilizing‟ the country and, just as importantly, it went hand in hand with Christian ideals of cleanliness being next to godliness. Also in order to get the local people to „understand‟ how and why to keep clean, ministries were established, public-health rules written and made official in Parliament, and inspectors appointed to enforce the standards.

On the occurrence of disease, the manifestation of both arteriosclerosis and cardiac disease was observed in mummies of ancient Egypt. Ötzi the Neolithic Ice man who lived around 3300 BC was found to have arthritis. At the beginning of the twentieth century, infectious diseases were the leading cause of death worldwide. In the United States and most of Western Europe, three diseases, tuberculosis, pneumonia, and diarrheal disease, caused 30% of deaths (Eppig, Fincher and Thornhill (2010). By the end of the twentieth century, most of the developed world, mortality from infectious diseases had been replaced by mortality from chronic illnesses such as heart disease, cancer and stroke. In Africa, G. W. Hartwig and K.D. Patterson (2008), asserted that it was possible to reconstruct some healthy living among young people through effective health control and regulation. In Nigeria, like the rest of Sub Saharan Africa, the burden of diseases has historically been high, particularly due to the high burden of infectious diseases. It then falls on the shoulder of the authorities to act and drum up more awareness on personal hygiene as it reduces their job (Gangestad and Buss, 2009).

In Abuja, slum settlements are characterized by extreme poverty, lack of property tenure, lack of services and infrastructure and an informal economy. There has been failure by urban local authorities to enforce development control and to provide effective municipal services due to corruption, low revenue collections and poor civic competence among the population (Isunju et al, 2014). In most cases, shared human excreta facilities provide an uncertain degree of improvement in sanitation. In Abuja, majority (70%) of the urban poor use shared latrines; with less than half (47%) of the latrines clean enough to be used and another 45% of the facilities being abandoned. The various sanitation initiatives in urban poor areas have not emphasized improved use, cleaning and maintenance of the available facilities; emphasis seems to be on mere sanitation infrastructure (Tumwebaze et al, 2015).

The WHO/UNICEF (2015) report on the trend in sanitation coverage in Nigeria shows that on-site sanitation facilities are predominant and mainly consist of traditional pit latrines of varying standards. Morella et al. (2016) evaluated progress from open defecation to use of on-site sanitation in Nigeria and found that it meets six sanitation indicators in the sanitation index. This index is a simple scoring system used to evaluate the progress of reforms and focuses specifically on on-site sanitation systems. The six main indicators are: existence of a hygiene promotion programme; existence of an accepted definition of sanitation; existence of a specific fund for sanitation; involvement of utilities in on-site sanitation; and clear cost recovery policies for on-site sanitation.

The practice of open defecation is generally declining in most parts of Abuja, and Wuse District in particular, this practice remains quite widespread in slum areas in the municipality, and is still practiced by about 23% of the population (WHO/UNICEF 2015). During the period 1990–2015, there were notable demographic changes in Wuse District where the population doubled during this period but access to improved sanitation has merely kept pace with population growth (Tumwebaze IK et al. (2015).Abuja city set targets of 80% sanitation coverage by 2015. However, different figures on progress towards this target have been presented by key national and international actors in the sector, indicating massive under-performance, particularly in Wuse District.


1.2 Problem Statement

Children’s ability to learn is affected by inadequate water, sanitation and hygiene conditions in several ways. These include infectious diseases which affect hundreds of millions of school-age children, long-term exposure to contaminants in water, diarrheal diseases and malaria infections, all of which force many school children to be absent from school. Improvement in personal hygiene practices can significantly reduce the incidence of childhood infectious disease. Many households and schools, particularly those in rural and slum areas, often completely lack safe drinking-water and sanitation and hand washing facilities; alternatively, where such facilities do exist they are often inadequate in both quality and quantity. Schools with poor water, sanitation and hygiene conditions, and intense levels of person-to-person contact, are high-risk environments for children and staff, and exacerbate children’s particular susceptibility to disease infection (WHO/UNICEF, 2015).

Proper personal hygiene is the most effective and easiest way to control the occurrence of many diseases and public health intervention is imperative. Only about half of the schools in low-income countries have provided access to water and sanitation facilities to their students and the authorities are yet to any anything about it. These means millions of children go to school either with the water that they will consume for the rest of the day, or with no water at all. According to Water Aid (2010), many of these children lack access to safe water at home too, often suffering from chronic diarrhoea and are at risk to intestinal parasitic infestation. The two biggest killers of children in the developing world today are diarrheal disease and respiratory tract infections. However, there are no studies evaluating the connection between personal hygiene practices and the occurrence of diseases among school children. This study therefore explores the relationship between personal hygiene in public schools and effectiveness of public health intervention


1.3 Purpose of the Study

This study investigated the relationship between personal hygiene and effectiveness of public health intervention among public primary school children in Wuse District, Abuja, Nigeria.


1.4 Specific Objectives

The study aimed at achieving the following objectives;

  1. To identify the various personal hygiene practices among school children.
  2. To examine the occurrence of diseases associated with personal hygiene practices among school children
  3. To establish the relationship between personal hygiene and effectiveness of public health intervention among school children
  4. To find out the difference of personal hygiene practices and occurrence of diseases between public and private primary school children

1.5 Research questions

The study answered the following research questions;

  1. What are the various personal hygiene practices among school children?
  2. What is the occurrence of diseases associated with personal hygiene practices among school?
  3. What is the relationship between personal hygiene and effectiveness of public health intervention among school children?
  4. What is the difference in personal hygiene practices and the occurrence of diseases among public and private primary school children?

1.6 Hypotheses

Ho:: There is no significant relationship between personal hygiene and effectiveness of public health intervention among school children.


1.7 Scope of the Study

1.7.1 Geographical Scope

The study was carried out in selected public and private primary schools in Wuse District, Abuja, Nigeria. It’s a densely populated, mainly low income neighbourhood. Sanitation and hygiene in this area is a huge challenge, given the fact that there are many people living in the area with, inadequate sanitation facilities. Six public primary schools were selected, with three public primary school and three private primary schools, as a way of acquiring a balanced picture of the hygiene situation in both schools.

1.7.2 Content Scope

The study focused on examining the various personal hygiene practices and effectiveness of public health intervention public primary school children in Wuse District, Abuja, Nigeria


1.8 Significance of the Study

The findings of this study will benefit the following stakeholders:

School Administrators / Teachers

This study will help the school administrators and teachers in understanding the personal hygiene practices of their pupils. This will enable the school administrators and teachers to plan activities to sensitize the pupils about personal hygiene to avoid acquiring diseases.

Parents

The findings of the study will generate new information about the real dangers of poor hygiene in the environment. This helps to shape parents‟ attitudes and teach their children on proper hygiene practices.

Pupils

The study will enlighten the pupils about the importance of proper hygiene practices. With this information pupils will be in better position to stay healthy and perform better in class.

Academicians

The findings of the study will contribute to new knowledge to the existing one. It will also serve as a reference for future researches in relation to personal hygiene and occurrence of diseases.

Researchers

It will benefit the researcher by helping her acquire practical research skills and also served as a partial requirement for the award of a Master’s degree of Education (in Biology) of Abuja International University.


1.9 Limitations in the Study

In the course of carrying out this study, the researcher anticipates several constraints, which may in one way or the other, limit the findings of the research.

The findings of the study may be limited by the fact that situation in selected public primary schools in Wuse District might not be identical to other regions of the country, for example in the countryside. In that case, the findings might not bring out the true reflection of the entire country. The researcher addressed the above limitations so that they wouldn’t compromises the research exercise and the findings of the study in any way.


Chapter Five


Discussions, Conclusions and Recommendations

5.0 Introduction

This part deals with the discussions conclusions, recommendations and suggested areas that need further research.


5.1 Discussions

From the findings of the study, it was concluded that personal hygiene practices among public primary school children in both public and private schools was good. The findings contradicts with the findings of Sarkar (2013) in which he found out that personal hygiene practices among public primary school children in India were not satisfactory although he found out that female pupils were better compared to male pupils in their personal hygiene practices. But in the study of Ghanim, et al. (2016) among public primary school children in Sharjan, United Arab Emirates have a good personal hygiene practices. Personal hygiene is not an isolated behavior instead it varies from person to person according to different factors intervention programs raising the awareness and importance of personal hygiene among school children through coordinated education measures by parents, teachers and media will be beneficial to impart these early in life.

In the study conducted by UNICEF (2015) among school children in the Philippines it shows that most of the children wash their hands using soap were 73.2% from Luzon, 75.6% from Visayas and 74.4% from Mindanao. And tooth brushing habits had dropped by 86% percent of all ages. In the study conducted by Vuan (2012) in Hanoi found that children that practice good personal hygiene resulted in good health. The results indicated that 81.4% of school children wash their hands after using the toilets and 85.9% washed their hands before eating. Only 39.5% regularly trimmed their fingers and toenails, 83.2% of children took bath daily and 83.8% wore slippers and shoes most of the time. In the study conducted among 0ne thousand six hundred eight 1608 school children for the items on nails, scalp, hairs and teeth relating to personal hygiene from two sets of villages that is one set where public primary school teacher were working and primary care workers and the other where community health volunteers were delivering primary health care to evaluate the efficiency of school teacher role and the community health volunteers in improving health education to school children. Results was evident that children of group 1 village were better with respect to all items related to personal hygiene and ineffective conditions except with the scalp where the children had infection. The result showed that teachers are effective in their role as primary care workers compared to community health volunteers in imparting health education to school children, (Awate, R.V, Ketkar Y.A, Somalya P.A, 2012).

The utilization of water and sanitation facilities at schools is mainly influenced by the availability and level of such facilities at the school. When the school has enough latrines for both boys and girls this stimulates the utilization among student. In enclosed communities such as schools the presences of latrines attracts pupils to use them even when at home they do not have such facilities at home. Also, due to the fact that school acts as a training institution, school train pupils on how to use latrine facilities and teach the pupils on the importance of such facilities in the prevention of diseases. This is in agreement with Sarkar, M. (2013) who indicated that the provision sanitation facilities in schools is a basic step towards a healthy physical learning environment benefiting both the learning process and health of the students.

However, mere provision of sanitation facilities with adequate knowledge and training of pupils on how to use such facilities might not yield the desired benefits of rising responsible future citizens among pupils who adhere to sanitation practices of utilization latrine facilities. But the challenge of space within public primary schools whereby most schools are located on limited piece of land hindered the construction of rubbish pits in some schools. The use of the trucks provided by Abuja Capital City Authority was another opportunity for schools to dispose of their rubbish. However, the use of these trucks was also limited because they had specific days such as Tuesdays and Thursdays when they moved around to collect the rubbish. This increased accumulation of rubbish within the school without disposing it waiting for the trucks. This could attract flies which could contribute to the transmission of diseases among pupils.

Hand washing practices of pupils were mainly affected by the presence of hand washing facilities at the school. The availability of handing washing facilities like water tanks specifically designated for hand washing for pupils attracted pupils to wash their hands before and after every meal. However, the location of hand washing facilities next to the latrines increased the likelihood of pupils washing their hands after a latrine visit. This is because pupils could immediately realize the need for hand washing after the latrine visit due to the physical presence of the hand washing facility. However, when the hand washing facilities were located away from the latrine, pupils were likely to forget about hands hand or just neglect the practice due to the distance and movement involved to get to the hand washing facility. This reduced the likelihood of pupils washing hands which could contribute to morbidity of sanitation and hygiene diseases among the pupils.

However, in other cases, improving sanitation is still a big challenge, particularly in rapidly growing urban slums. Even though building improved sanitation facilities is a crucial health intervention, the full health benefits will not be realized without proper use and maintenance of the facilities and good personal and domestic hygiene (Carr and Strauss, 2001). Having a good personal hygiene practices means taking care of yourself and leading a healthy lifestyle. According to Boelhlke, Julie ( July, 2017) that personal hygiene habits and techniques should be instilled by parents to their children at a very young age . Personal hygiene includes cleaning all the areas of the body on a daily or regular basis to prevent odor and keeping up with your appeara . Personal hygiene is more than just staying clean it can affect the self esteem and how others view and approach you.


5.2 Conclusions

Based on the findings of the study, the following conclusions were made:

  1. Personal hygiene practices among public primary school children was rated good which means that public primary school children are aware of the importance of practicing proper personal hygiene.
  2. The occurrence of diseases among public primary school children was high despite practicing personal hygiene children are affected by diseases like bacterial diseases, waterborne diseases and fungal or infectious diseases. This means that the diseases affecting school children is not only due to personal hygiene but other factors like dirty surroundings and malnutrition.
  3. There is a relationship between personal hygiene practices and effectiveness of public health intervention. The occurrence of disease like bacterial infection, water borne diseases and other infections among public primary school children is caused by [poor personal hygiene practices.

5.3 Recommendations

Based on the findings and conclusions of the study the following were the recommendations:

  1. Educational authorities can develop and adopt policies and guidelines that will make way to adequate access to resources, items and opportunities to maintain personal hygiene at school and home.
  2. Schools should provide hygiene education to kindergarten and early grade school children to supplement the training provided by parents and guardians to ensure that all children at an appropriate age learn how to protect themselves and others from preventable exposure to illness and other hygienic hazards.
  3. School based health children education program may be useful effort. The role of parent-teacher association should be emphasized where teachers and parents play a pivotal role in personal hygiene of the children.

5.4. Areas for Further Research

  1. Family Background and Personal Hygiene Practices among Public primary school Pupils
  2. Knowledge, Attitudes, Personal Hygiene and Occurrence of Diseases of Diseases Among Students in Secondary Schools

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