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The Impact of School Health Education Programme onPersonal
Hygiene and Related Morbidities in Tribal
School Children of Wardha DistrictIntroduction
India has one of the largest groups of school going children,
especially in rural areas. There are about 6.3 lakh rural
schoolsboth primary and upper primary with 80 millions school going
children. But it is also a fact that only 8 percent of schools
havethe sanitation facilities in school premise. Out of 6.3 lakh
primary and upper primary rural schools, only 44 percent have water
supply facilities, 19 percent have urinals and 8 percent have
lavatory facilities. Only 19 percent have separate urinals and
4percent lavatory facility for girls. Under these conditions,
schools and community environment become unsafe places
wherediseases are transmitted. 1
In the present study, an attempt has been made to find out
impact of the "school health education program" on personalhygiene
and related morbidities in a tribal school of Wardha district.
Material and Methods
The present study was undertaken in a state government funded
residential Adivasi Ashram School, of village Mandwa. InFebruary
2003 Kasturba Rural Health Training Center (KRHTC), Anji which is
the peripheral rural center of Department of Community Medicine,
Mahatma Gandhi Institute of Medical Sciences, Sewagram started
"School Health Education Program"with emphasis on improvement in
personal hygiene of school children.
The request by the village Sarpanch and school teachers prompted
us to undertake the study. In February 2003, the baselinehealth
check-up of all 145 children in the school was carried out with the
help of pre-tested and structured questionnaire to findout the
status of personal hygiene and related morbidities. The check-up
was carried out by the team of medical officer, socialworkers and
school teachers through a scheduled visit. Similarly, end line
assessment was carried out after one year in March
2004.
The appropriate, need based, low cost health education materials
(flip books) on water supply, environmental sanitation andpersonal
hygiene were developed according to PATH guide lines 2.
Health education among school children was undertaken with the
use of flip books. The demonstration activities were used for
imparting health education on hand washing, nail cutting, and
cleaning teeth. The planned health education sessions wereconducted
once a week in the school for one hour for the period of six month.
It was carried out by the team of social worker and medical
officer. Posters on personal hygiene were also displayed in the
classrooms. The teachers were motivated tomonitor and facilitate
behavior change of school children for the period of next
six-months.
The data thus collected was entered and analyzed in epi_info
2000. The proportions were expressed in percentages.
Nutritionalstatus was assessed by using CDC 2000 reference and
using nutrition program of epi_info 2000.
Results
We started with 145 students (6-14 years) in February 2003 which
came down to 112 in March 2004 leading to 33 students lost(22.7%)
during follow up.
Table I: Status of personal hygiene among school children in
February 2003 and March 2004
Sr.No.
Indicatorsof personal
hygiene
Year 2003(n=145)
Year 2004(n=112) OR (95% CI) P- value
1 Clean and combed hair 40 (27.6%) 59 (52.7%) 1.91
(1.16-3.14)
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2 Clean and cut nails 43 (29.7%) 54 (48.2%) 1.63 (0.99-2.67)
0.05
4 Clean teeth 49 (33.8%) 56 (50%) 1.48 (0.91-2.39) >0.055 Wax
in Ear 15 10.3% 1 (0.9%) 0.09 (0.00-0.64) 0.05
2 Head lice 62 (42.8%) 21 (18.8%) 0.44 (0.24-0.79) 0.05
6 History of worm infestation 42 (28.9%) 19 (16.9%) 0.59
(0.31-1.10) >0.05
(Figures in parenthesis indicate percentages.)
As seen in the Table I, the point prevalence of clean combed
hair and cut nails were 27.6% and 29.7% respectively in
February2003, which increased to 52.7% (OR = 1.91, CI = 1.16-3.14)
and 48.2% (OR = 1.63, CI = 0.99-2.67) respectively in March2004.
The difference was statistically significant (p
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The proportion of the children with clean teeth increased from
33.8% to 50% (p>0.05). The point prevalence of dental
cariesreduced from 8.3% to 5% (p>0.05). As reported by Rao et al
5 (1993), dental caries were found more prevalent among
urbanchildren than rural and tribal children (22.8% vs. 15.5% and
15%, respectively). Thus, the tribal children showed a better
oralhealth status than urban counterparts. This finding was
comparable with Jalili et al 6 (1993).
The improvement in personal hygiene had significant impact on
reducing related morbidities l ike lice infestation,
worminfestation and scabies. But there was no significant impact on
conditions like fever, diarrhea and aches and pains
(p>0.05).These findings were comparable with the that reported
by Biswas et al. 7
The study concludes that the school health education program
with the active involvement of school teachers leads toimprovement
in personal hygiene in school children and reduction in related
morbidities.
References
1. School water supply, Sanitation and Hygiene Education: India
Technical Note Series, Ministry of Human ResourceDevelopment,
Government of India, 2004.
2. Program for Appropriate Technology for Health (PATH).
Developing health and family planning materials for Low
literate audiences - A guide; 1996.3. Towards Total Sanitation
and Hygiene: A challenge for India, Country paper series, New
Delhi, 2003.4. Nayar S, Singh D, Rao NP, Choudhury DR: Primary
school teacher as a primary health a care worker. Indian J
Pediatr. 1990; 57(1):77-80.5. Rao SP, Bharambe MS: Dental caries
and periodontal diseases among urban, rural and tribal school
children. Indian
Pediatr. 1993; 30(6):759-64.6. Jalili VP, Sidhu SS, Kharbanda
OP: Status of dental caries and treatment needs in tribal children
of Mandu (Central
India). J Pierre Fauchard Acad. 1993; 7(1):7-15.7. Biswas AB,
Roy AK, Das KK, Sen AK, Biswas R: A study of the impact of health,
education imparted to school children
on their knowledge, attitude and practice in regard to personal
hygiene. Indian J Public Health. 1990; 34(2):87-92.
Deptt. of Community MedicineMahatma Gandhi Institute of Medical
Sciences,Sewagram, Wardha (Maharashtra)-442 102.
e-mail: [email protected]: 25.11.2004
mailto:[email protected]:[email protected]
