Presentation at IAPSM UP UK Conference held at Subharti Medical College, Meerut

1. Authors:
Dr Megha Luthra, Dr Surekha Kishore, Dr Pankaj Mishra, Dr Jairaj Hanspal
Department of Community Medicine, SGRRIM&HS, Dehradun

2.  Presented at IAPSM UP UK Conference 2011
held at Subharti Medical College, Meerut

3.  Healthy children have higher daily school attendance, learn
better, take full advantage of learning opportunities, excel
academically as well as socially and have better chance of a
balanced development
 WHO global school health initiative was launched in 1995 with
primary goal of increasing “Health Promoting Schools” [Schools
that constantly strengthen their capacity as healthy settings for
living, learning and working]
 School health services have tended to focus on nutritional
support and clinical assessment. It is now known that the state
of personal hygiene is directly or indirectly related to nutritional
status and health problems

4.  In schools health education regarding important aspects of
hygiene, environment and sanitation, as well as social
customs can be imparted
 There are 6.3 lakh schools in India, 128.3 million children
in primary schools. Only 44% have water supply, 19% have
urinals and 8% have lavatory facilities. For girls, 19% have
separate urinals and 4% separate lavatories
 Diarrhoea, typhoid, dysentery, gastroenteritis, hepatitis-A,
intestinal worms and malaria contribute to the high rates of
morbidity, mortality and malnutrition among young children
in the country
 There is also poor cognitive performance
 Majority of these diseases are preventable by promotion of
hygienic practices

5.  We interviewd and examined 139 students of classes I to IV
in two schools (Government Primary School and Sri Guru
Ram Rai School) in catchment areas of RHTC Mothrowala
 Period of study was April to May 2009
 Design of study was Cross Sectional
 After taking necessary permission from school authorities,
a team of doctor and health workers interviewed class
teacher as well as students
 Class teachers were interviewed about performance of
students over last 6 months, any recent changes noted and
history of illness during last 15 days

6.  The children were also interviewed about history of illness
during last 15 days & personal hygiene practices
 General and systemic examination of students including
weight and height measurements were carried out
 Nutritional status of children was charted using IAP method
 Any morbidity suffered by the student during the last 15
days was recorded
 Data thus collected was analyzed using suitable statistical
tests with the help of Microsoft Excel 2007 and spss
version 10.0

7. Name of School GPS GRRIC
Total Number of Students Examined 72 67
Age group of students 5- 12 years 6-10 years
Percentage of female students 40.30% 43.20%
Percentage of Hindu students 91.70% 98.50%
Percentage of students with Father's
Education Matric & Below 33.30% 82.0%
Percentage of students with purely
Vegetarian Dietary Habits 29.20% 22.40%

8. Name of School GPS GRRIC
Prevalence of caries 31.94% 29.0%
Prevalence of Flourosis 9.70% 6.0%
Prevalence of Missing Teeth 43.27% 39.0%
Prevalence of Under Weight (IAP
Classification) 45.82% 42.70%
Prevalence of Poor Personal Hygiene
(score < 2/5) 30.60% 25.21%
Prevalence of Refractive Error 18.06% 15.80%

9. Personal
Hygiene Level
(Score)
No. of Boys No. of Girls
Very Poor (0) 11 06
Poor (1) 23 09
Average (2) 14 15
Good (3) 13 12
Excellent (>=4) 16 16
Total 81 58
Chi Square value= 0.544
P > 0.05

10.  The study included 81 boys and 58 girls
 Personal hygiene was considered poor, average, good or
excellent as per scoring. The maximum and minimum
possible scores were 5 and 0, respectively
 Mean personal hygiene score of girls (2.63+0.98) was not
significantly higher than that of boys (2.02+1.4), P >0.05

11. No. of Girls
(Percentage)
No. of Boys
(Percentage)
Clean & Combed
Hair
39 (67.4) 39 (48.5)
Clean Hands 49 (84.6) 47 (57.9)
Clean & Cut Nails 48(82.9) 62 (76.3)
Regular hand
Washing after
visiting Toilet
54(92.6) 63 (78.3)
Use of Toothpaste
and Toothbrush
37 (64.2) 47 (57.8)

12.  Personal hygiene among girls was better as compared to
boys when it came to clean& combed hair (67.4% vs.
48.5%, P<0.05) and clean hands (84.6% vs. 57.9%,
P<0.05)
 Clean and cut nails were found more in boys as compared
to girls (82.9% vs. 76.3%)
 Girls fared better than boys regarding regular hand washing
after visiting toilet (92.6% vs. 73.8%), P<0.05
 However, more boys used toothpaste and toothbrush
regularly (64.2%) as compared to girls (57.8%)

13. No. of Girls
(Percentage)
No. of Boys
(Percentage)
Morbidity
Experienced in Last
15 Days
43 (74.2) 62 (76.3)
Pallor 32 (55.85) 42 (51.4)
History of Worms 24 (42.1) 29 (36.4)
Under nutrition 27 (46.3) 28 (35.6)

14.  76.3% of the boys and 74.2% of the girls were suffering
from one or more morbidities
 For boys, the most common morbidity was clinically
detected pallor (51.42%), followed by history suggestive of
worm infestation (36.43%)
 The most common morbidity for girls was, again, clinically
detected pallor (55.85%), followed by under nutrition
(46.28%)
 Those who did not suffer from any morbidity over the last
15 days had significantly higher personal hygiene scores
(P<0.05) as compared to those who suffered from one or
more morbidities

15. Nutritional Status
Normally
Nourished
Under-
nourished
Mean Personal
Hygiene Score
Girls 3.06 2.45
Boys 2.78 2.13
Chi Squre value= 0.001
P > 0.05

16.  Girls were more under nourished as per IAP weight for age
classification than the boys (46.28% vs. 35.61%), and this
difference was statistically significant (P<0.05)
 Those normally nourished did not have significantly higher
personal hygiene scores (P>0.05) as compared to the
undernourished

17.  Improvement of nutritional status and some aspects of
personal hygiene (cleanliness of hair, hands and regular
use of toothpaste and tooth brush) are the major thrust
areas for future action
 It was observed that the overall status of personal hygiene
was not better among girls as compared to boys
 Morbidity was significantly higher in the group with poor
personal hygiene score (<2)
 Improvement in status of personal hygiene of school
children through coordinated primordial and primary
preventive measures like health education is a must

18.  The onus lies on teachers and parents. Both need to be
trained adequately
 Simple measures like improvement of personal hygiene and
following safe, hygienic practices by these children can go a
long way in reducing morbidities and thus break the vicious
cycle of infection and malnutrition

19. Thank You