A cross-sectional study assessing the effectiveness of hygiene related interventions and education delivered in an afterschool club in urban slums of Gurugram
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20230635Keywords:
Out of school children, Vulnerable children, Urban slums, Hygiene education, Non formal education and healthAbstract
Background: There is insufficient evidence about the effectiveness of hygiene related interventions and education delivered to out of school children, attending non-formal schools in urban slums.
Methods: This cross sectional, interventional study was conducted from January 2022 to April 2022 in a non-formal school in an urban slum in Gurugram, Haryana. A validated questionnaire about hygiene related practices was used to record the behavioural practices of these children before and after education about hygienic practices. The children were also provided with soap, detergent, and four sets of clothes to enable them to follow the hygienic practices. The pre and post intervention status of various hygiene variables was compared. A p<0.01 was considered as statistically significant.
Results: Of the 97 children included in this interventional study, 54 were boys. All of them were from the lower socioeconomic class, with 93% of the mothers and 98% of the fathers being illiterate. The percentage of unhygienic practices decreased significantly post intervention. All the p values for comparison between the pre and post intervention status of various hygiene variables were highly significant statistically (p=0.001). Maximum improvement was seen in case of brushing teeth, cutting nails, using footwear and bathing (2.86). Similarly, the total mean score for unhygienic practices (higher score indicating more unhygienic practices) for pre intervention was 30.62 which decreased to 10.54, indicating a total improvement of 20.08.
Conclusions: Hygiene related interventions including continuing education, and provision of clothes and detergent, can improve hygienic practises in out of school children who attend non-formal schools in slums.
References
Bhutta ZA, Sommerfeld J, Lassi ZS, Salam RA, Das JK. Global burden, distribution, and interventions for infectious diseases of poverty. Infectious Diseases Poverty. 2014;3:21.
Hansen C, Paintsil E. Infectious Diseases of Poverty in Children: A Tale of Two Worlds. Pediatr Clin North Am. 2016;63(1):37-66.
Alsan MM, Westerhaus M, Herce M, Nakashima K, Farmer PE. Poverty, global health, and infectious disease: Lessons from Haiti and Rwanda. Infectious Disease Clin North Am. 2011;25(3):611-22.
“National Sample Survey of Estimation of Out-of-School Children in the Age 6-13 in India. Accessed 10 October 2022. Available at: https://www.education.gov.in/en/sites/upload_files/mhrd/files/upload_document/National-Survey-Estimation-School-Children-Draft-Report.pdf. Accessed on 25 January, 2023.
Out-of-School Children. Available at: https://uis.unesco.org/sites/default/files/documents/estimating-the-number-of-out-of-school-children-india-case-study-2016-en.pdf Accessed 10 October 2022. Accessed on 25 January, 2023.
Minakshi. Slums in Haryana: A Geographical Study. Minakshi. Int J Recent Res Aspects. 2015;2(3):118-21.
Primary Census Abstract for Slums. Census of India Website. Available at: http://www.censusindia. gov.in/2011‑Documents/slum‑26‑09‑13pdf. Accessed 10 October, 2022.
Padaruth SK, Biranjia-Hurdoyal SD. Hygiene practices and faecal contamination of the hands of children attending primary school in Mauritius. Int Health. 2015;7(4):280-4.
Hughes RC, Kitsao-Wekulo P, Muendo R, Bhopal SS, Kimani-Murage E, Hill Z et al. Who actually cares for children in slums? Why we need to think, and do, more about paid childcare in urbanizing sub-Saharan Africa. Philos Trans R Soc Lond B Biol Sci. 2021;376(1827):20200430.
Dicker D, Nguyen G, Abate D, Abate KH, Abay SM, Abbafati C et al. Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018;392:1684-735.
Lassi ZS, Mallick D, Das JK, Mal L, Salam RA, Bhutta ZA. Essential interventions for child health. Reprod Health. 2014;11:S4.
Victora CG, Wagstaff A, Schellenberg JA, Gwatkin D, Claeson M, Habicht J-P. Applying an equity lens to child health and mortality: more of the same is not enough. The Lancet. 2003;362:233-41.
Besnier E, Thomson K, Stonkute D, Mohammad T, Akhter N, Todd A et al. Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low- and middle-income countries (LMICs): An umbrella review. PLoS One. 2021;16(6):e0251905.
Welch V, Tugwell P, Petticrew M, de Montigny J, Ueffing E, Kristjansson B et al. How effects on health equity are assessed in systematic reviews of interventions. Cochrane Database Syst Rev. 2010;2010(12):MR000028.
Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Backgrounders–Key concepts. Geneva: World Health Organization. World Health Organization; 2008. Available at: http://www.who.int/ social_determinants/thecommission/finalreport/key_concepts/en/. Accessed 10 October, 2022.
Bosch-Capblanch X, Zuske M-K, Auer C. Research on subgroups is not research on equity attributes: Evidence from an overview of systematic reviews on vaccination. Int J Equity Health. 2017;16(1):95.
Besnier E, Thomson K, Stonkute D, Mohammad T, Akhter N, Todd A et al. Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low-income and middle-income countries (LMICs): protocol for an umbrella review. BMJ Open. 2019;9(12):e032981.
Blas E, Sivasankara Kurup A, World Health Organization. Equity, social determinants and public health programmes / editors Erik Blas and Anand SivasankaraKurup. World Health Organization. 2010. Available at: https://apps.who.int/iris/ handle/10665/44289. Accessed 10 October, 2022.
Luby SP, Agboatwalla M, Raza A, Sobel J, Mintz ED, Baier K, Hoekstra RM, Rahbar MH, Hassan R, Qureshi SM, Gangarosa EJ. Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan. Epidemiol Infect. 2001;127(2):237-44.
Ilika AL, Obionu CO. Personal hygiene practice and school-based health education of children in Anambra State, Nigeria. Niger Postgrad Med J. 2002;9(2):79-82.
Pati S, Kadam SS, Chauhan AS. Hand hygiene behavior among urban slum children and their care takers in Odisha, India. J Prev Med Hyg. 2014;55(2):65-8.
Sarkar M. Personal hygiene among primary school children living in a slum of Kolkata, India. J Prev Med Hyg. 2013;54(3):153-8.
Dambhare DG, Bharambe MS, Garg BS. Intestinal parasites prevalence and related factors among school children in the rural area of central India. J Commun Dis. 2010;42(4):281-6.
