Socio-demographic Characteristics of Participants
From five primary schools, 534 students were participated in this study with a response rate of 100%. Of 534 participates, 227 (42.5%) were males. The mean and standard deviation of the age of the participants was 14.34 ±1.66 years with the age range of 9 to 22 years. From the total of 534 students, grade five 91(17%), six 159 (29.8%), seven 139 (26%) and eight145 (27.2%) (Table-2).
Table 2:- Socio-Demography of Participants in Fiche town, Oromia, Ethiopia, 2022 (N=534).
Socio-Demographic Characteristics
|
Frequency
|
Percent (%)
|
Sex
|
Male
|
227
|
42.50
|
Female
|
307
|
57.50
|
Age group
|
≤14
|
287
|
53.70
|
>14
|
247
|
46.30
|
Family size
|
≤5
|
272
|
50.90
|
>5
|
262
|
49.10
|
Educational level (grade)
|
5&6
|
250
|
46.80
|
7&8
|
284
|
53.20
|
Family head
|
Father
|
398
|
74.50
|
Mother
|
122
|
22.80
|
Other
|
14
|
2.60
|
Mother’s educational level
|
Unable to read and write
|
266
|
49.80
|
Primary & secondary school
|
145
|
27.20
|
Certificate
|
38
|
7.10
|
Diploma and above
|
85
|
15.90
|
Father’s educational level
|
Unable to read and write
|
188
|
36.00
|
Primary & secondary school
|
179
|
34.30
|
Certificate
|
61
|
11.70
|
Diploma and above
|
94
|
18.00
|
*other (ant, grandfather, brothers, sisters, uncle and relatives)
Knowledge of personal hygiene
The majority of the students got personal hygiene information from their families 332 (65.4%). Nearly half (52.2%) of the students had good knowledge of personal hygiene, while 365 (68.5%) had good hand washing, and 449 (84.1%) had good oral hygiene. The majority of the students (84.1%) knew that hand washing is necessary before eating food, and 352 (65.9 %) after defecation and 322 (60.4%) after eating food. The majority (90.1%) of elementary students understood cleaning teeth with a chewing stick/toothpaste and brush to prevent tooth decay and the unpleasant odor of breathing (Table-3).
Table 3:- knowledge of personal hygiene of Participants in Fiche town, Oromia, Ethiopia, 2022(N=534).
Questions
|
Response
|
Frequency
|
Percent (%)
|
Source of information about personal hygiene
|
Family
|
Yes
|
332
|
65.4
|
No
|
176
|
34.6
|
Teacher
|
Yes
|
281
|
55.3
|
No
|
227
|
44.7
|
Health worker
|
Yes
|
149
|
29.3
|
No
|
359
|
70.7
|
Media
|
Yes
|
132
|
26.0
|
No
|
376
|
74.0
|
School club
|
Yes
|
108
|
21.3
|
No
|
400
|
78.7
|
Heard about personal hygiene
|
No
|
26
|
4.9
|
Yes
|
508
|
95.1
|
Personal hygiene is about general body cleanliness
|
No
|
86
|
16.1
|
Yes
|
448
|
83.9
|
Hand washing after eating prevents communicable disease
|
No
|
97
|
18.2
|
Yes
|
437
|
81.8
|
Proper hand washing is preventing 30-40% of communicable disease
|
No
|
173
|
32.4
|
Yes
|
361
|
67.6
|
Human feces contain germs that could transmit from person to person
|
No
|
149
|
27.9
|
Yes
|
385
|
72.1
|
Keeping your fingernail trimmed and clean shows personal hygiene
|
No
|
39
|
7.3
|
Yes
|
495
|
92.7
|
Hand washing is not required when there is no visible dirty
|
Yes
|
136
|
25.5
|
No
|
398
|
74.5
|
Bathing the body is a part of personal hygiene
|
No
|
53
|
9.9
|
Yes
|
481
|
90.1
|
Well-trimmed/cut hair is a personal hygiene
|
No
|
149
|
27.9
|
Yes
|
385
|
72.1
|
Rinsing the mouth with clean water after a meal protects oral health
|
No
|
59
|
11.0
|
Yes
|
475
|
89.0
|
Cleaning teeth with chewing stick/toothpaste and brush to prevent tooth decay and bad odor breath
|
No
|
53
|
9.9
|
Yes
|
481
|
90.1
|
Brushing teeth everyday causes gum bleeding
|
Yes
|
336
|
62.9
|
No
|
198
|
37.1
|
Poor personal hygiene results water-related diseases like diarrhea, scabies
|
No
|
88
|
16.5
|
Yes
|
446
|
83.5
|
Does not practice personal cleanliness
|
May get sick and smell in class
|
473
|
88.6
|
Will smell in class only
|
24
|
4.5
|
Will be punished by the teacher
|
27
|
5.1
|
Nothing happens
|
10
|
1.9
|
Knowledge of oral hygiene
|
Poor
|
85
|
15.9
|
Good
|
449
|
84.1
|
Knowledge of hand washing
|
poor
|
168
|
31.5
|
Good
|
365
|
68.5
|
Overall knowledge of personal hygiene
|
Poor
|
255
|
47.8
|
The magnitude of personal hygiene practice
More than half of the students had good hygiene practices, while 318 (59.60%) practiced hand washing (Fig 2). Almost all (98.7%) elementary school students had taken a bath. Of the students who took a bath, the majority (76.1%) took it once a week. Most (83.1%) students have experience of hand washing with soap or ash. Among the 401 students, 394 (73.8%) washed their hands after eating and 365 (68.4%) washed their hands after using the toilet. The majority of the students (88.4%) brushed their teeth; of those who brushed their teeth with a brush and soap, 331 (62.0%) and only 147 (27.5%) brushed twice per day (morning and night). Almost all (97.6%) students washed their faces. Among those who washed their faces, 247 (46.3%) washed with soap twice a day, and 520 (97.4%) trimmed their nails regularly (Table 4).
About two thirds (65.5 %) of students stated that there was a weekly personal hygiene inspection in school. All elementary schools had latrine facilities in their compound, but the available latrines were not adequate for the number of students (i.e., the toilet to setting pit ratio was 0.009 for females and 0.008 for male students). One-fourth of the students practiced open field defecation.
Table 4:- Magnitude on personal hygiene practices of primary school students in Fiche town, Oromia, Ethiopia, 2022(N=534)
Personal hygiene practice Response
|
Frequency
|
Percent (%)
|
Take a bath
|
No
|
7
|
1.3
|
Yes
|
527
|
98.7
|
Frequency of take a bath
|
1-2 Times a day
|
65
|
12.3
|
Every week
|
401
|
76.1
|
Every two Weeks
|
34
|
6.5
|
Every month
|
15
|
2.8
|
**Other specify
|
12
|
2.3
|
Hands washing
|
No
|
15
|
2.8
|
Yes
|
519
|
97.2
|
Use soap/ash during hand washing
|
No
|
90
|
16.9
|
Yes
|
444
|
83.1
|
Brushing of teeth
|
No
|
62
|
11.6
|
Yes
|
472
|
88.4
|
Everyday brush of teeth
|
No
|
177
|
33.1
|
Yes
|
357
|
66.9
|
Number of brush teeth in a day
|
Once
|
275
|
58.3
|
Twice
|
143
|
30.3
|
Three or more
|
37
|
7.8
|
Every other day
|
17
|
3.6
|
Duration teeth brushing
|
<60 Second
|
248
|
52.5
|
Between 60-120 Second
|
125
|
26.5
|
>120 Second
|
81
|
17.2
|
I didn’t known
|
18
|
3.8
|
Materials used to brush teeth
|
Sticks
|
146
|
27.3
|
Flossing
|
12
|
2.2
|
Teeth brush with teeth soap
|
331
|
62
|
Teeth brush, soap, and flossing
|
45
|
8.4
|
Dentist check-up
|
No
|
407
|
76.2
|
Yes
|
127
|
23.8
|
Dental follow-up without illness
|
Don't See
|
387
|
72.5
|
Occasionally
|
104
|
19.5
|
Regularly
|
43
|
8.1
|
Nail cut
|
Yes
|
520
|
97.4
|
No
|
14
|
2.6
|
Frequency nails cut
|
Weekly
|
308
|
59.2
|
Every two weeks
|
146
|
28.1
|
Every month
|
66
|
12.7
|
Hair washing
|
Yes
|
526
|
98.5
|
No
|
8
|
1.5
|
Frequency hair washing
|
Every day
|
154
|
28.8
|
Every week
|
338
|
63.3
|
Every month
|
25
|
4.7
|
Other*
|
17
|
3.2
|
Face washing
|
Yes
|
521
|
97.6
|
No
|
13
|
2.4
|
Frequency of face washing in a day
|
Once
|
144
|
27
|
Twice
|
247
|
46.3
|
Three times and more
|
143
|
26.8
|
Wash face material
|
Water only
|
72
|
13.5
|
Water and soap
|
462
|
86.5
|
*other (every three days, every weeks);**other specify (every two days and every three days)
The majority 465 (87.1%) of students have received health education on personal hygiene which given by teachers (81.7%), health professionals (32.3%), non-governmental organizations (6.9%), school clubs (23.4%), and media (23.9%). Most (70%) of the students participated in hygiene-related clubs such as sanitation and hygiene (40.4%) and menstrual hygiene clubs (40.8%). About two third (65.5 %) of students were stated as they had weekly personal hygiene inspection. All elementary schools had latrine facilities in their compound, but available latrines were not adequate for the number of the students (i.e. toilet to setting pit ratio was 0.009 for females and 0.008 for male students). One-fourth of the students practiced open field defecation. Nearly half of students hand washing practice after critical time (Fig-3).
The children in this study area had diarrhea the last two weeks before data collection 43(8.1%) and headaches 86(16.1%) (Fig: 4).
Factors Associated with Personal Hygiene Practice
The factors associated with personal hygiene were assessed as crudely associated and displayed in an odds ratio [95% confidence interval (CI)]. Female students were more likely to associate [crude odds ratio (COR; 1.91, 95% CI (1.34, 2.71); p =.000). The student’s mother educational status Primary &Secondary 2.05, 95%CI (1.35, 3.13); p=.001 Certificate 2.76, 95% CI (1.29, 5.90); p=.009 and Diploma and above 1.90, 95%CI (1.14, 3.16), p=.013. The student’s father educational status Primary and Secondary 1.51, 95% CI (1.00, 2.28), p=.049; Certificate 2.03, 95%CI (1.11, 3.70), p=.021; Diploma and Above 3.29, 95%CI (1.90, 5.71); p=.000. The total families size less than or equal to five 1.81, 95% CI (1.28, 2.57), p=.001.
Received education on personal hygiene 3.16, 95%CI (1.86, 5.37); p=.000, health-related clubs in your school 2.05 (1.41, 2.99); p=.000 Training on personal hygiene 1.53, 95% CI (1.08, 2.16), p=.017 Inspection of personal hygiene 2.11, 95% CI (1.47, 3.04), p=.000. Knowledge of oral hygiene 2.01, 95%CI (1.26, 3.21); p=.000, knowledge of hand washing 2.16, 95%CI (1.49, 3.14), p=.000 Knowledge personal hygiene 2.36, 95% CI (1.66, 3.36), p=.000 were crudely associated with good personal hygiene (Table 5).
The final adjusted odds ratio (AOR) in multilevel logistic regression model analysis of independent variables was associated significantly. Female students (AOR: 1.79, 95% CI (1.13, 2.84); P=.013), school personal hygiene inspection (AOR: 1.91, 95% CI (1.14, 3.21); P=.015), and knowledge of student towards overall personal hygiene (AOR: 2.29, 95% CI (1.28, 4.10); P=.005) were significantly associated with good personal hygiene practice (Table 5).
Table 5:- Multilevel logistic model analysis Factors Associated with Personal Hygiene Practice among primary school students in Fiche town, Oromia, Ethiopia, 2022(N=534)
Characteristics
|
personal hygiene practice
|
COR (95% CI)
|
AOR(95% CI)
|
Poor
|
Good
|
Sex
|
Male
|
113(49.80%)
|
114(50.20%)
|
1
|
1
|
Female
|
105(34.20%)
|
202(65.80%)
|
1.91 (1.34, 2.71)**
|
1.79 (1.13, 2.84)*
|
Mother educational status
|
Unable to read and write
|
132(49.60%)
|
134(50.40%)
|
1
|
1
|
Primary &Secondary
|
47(32.40%)
|
98(67.60%)
|
2.05 (1.35, 3.13)**
|
1.62 (.87, 3.03)
|
Certificate
|
10(26.30%)
|
28(73.70%)
|
2.76 (1.29, 5.90)**
|
.95 (.33, 2.73)
|
Diploma and above
|
29(34.10%)
|
56(65.90%)
|
1.90 (1.14, 3.16)*
|
.88 (.34, 2.32)
|
Father educational status
|
Unable to read and write
|
97(51.60%)
|
91(48.40%)
|
1
|
1
|
Primary And Secondary
|
74(41.30%)
|
105(58.70%)
|
1.51 (1.00, 2.28)*
|
1.15 (.63, 2.08)
|
Certificate
|
21(34.4%)
|
40(65.60%)
|
2.03 (1.11, 3.70)**
|
1.26 (.51, 3.12)
|
Diploma And Above
|
23(24.50%)
|
71(75.50%)
|
3.29 (1.90,5.71)**
|
2.19 (.79, 6.08)
|
Families size
|
≤5
|
92(33.80%)
|
180(66.20%)
|
1.81 (1.28, 2.57)*
|
1.25 (.80, 1.97)
|
>5
|
126(48.10%)
|
136(51.90%)
|
1
|
|
Received education on personal hygiene
|
No
|
45(65.2%)
|
24(34.8%)
|
1
|
|
Yes
|
173(37.2%)
|
292(62.8%)
|
3.16 (1.86, 5.37)**
|
1.89 (.95, 3.78)
|
Health-related clubs in your school
|
No
|
85(53.1%)
|
75(46.9%)
|
1
|
|
Yes
|
133(35.6%)
|
241(64.4%)
|
2.05(1.41, 2.99)**
|
1.24 (.71, 2.15)
|
Training on personal hygiene
|
No
|
114(46.3%)
|
132(53.7%)
|
1
|
|
Yes
|
104(36.1%)
|
184(63.9%)
|
1.53 (1.08, 2.16)*
|
.91 (.57, 1.48)
|
Inspection of personal hygiene
|
No
|
97(52.7%)
|
87(47.3%)
|
1
|
|
Yes
|
121(34.6%)
|
229(65.4%)
|
2.11 (1.47, 3.04)**
|
1.91 (1.14, 3.21)*
|
knowledge of oral hygiene
|
Poor
|
47(55.3%)
|
38(44.7%)
|
1
|
|
Good
|
171(38.1%)
|
278(61.9%)
|
2.01(1.26, 3.21)*
|
1.17 (.62, 2.21)
|
knowledge of hand washing
|
Poor
|
90(53.6%)
|
78(46.4%)
|
1
|
|
Good
|
127(34.8%)
|
238(65.2%)
|
2.16 (1.49, 3.14)**
|
1.41 (.80, 2.47)
|
Knowledge personal hygiene
|
Poor
|
131(51.4%)
|
124(48.6%)
|
1
|
|
Good
|
86(30.9%)
|
192(69.1%)
|
2.36 (1.66, 3.36)**
|
2.29 (1.28, 4.10)*
|
Key: - COR (Crude Odd Ratio), AOR (Adjusted Odd Ratio),