Research Paper
Assessment of personal hygiene and sanitation using a
composite index among adolescent girls and their
households in urban slums of Pune, Maharashtra
Angeline Jeyakumar and Padmini Ghugre
ABSTRACT
The assessment of hygiene and sanitation in urban slums is essential to identify adolescent health
needs. A tool that comprised of three domains and 13 variables including drinking water index (DWI),
personal hygiene index (PHI) and household hygiene index (HHI) was developed and tested among 60
households. Observations were repeated after 6 weeks. Cronbach’s alpha was used to test the
reliability and Inter Class Correlation Coefficient was used to assess repeatability of the
questionnaire. The tool was used to assess the personal hygiene of adolescent girls (n ¼ 565) and
their household sanitation in nine slums of Pune city. Excellent reliability (α ¼ 0.9) was obtained for
four variables, two observations obtained good (α ¼ 0.8), two scored acceptable (α ¼ 0.7) and one
scored questionable (α < 0.6) reliability. No variance was observed among four variables. DWI and
PHI scores were average (between 2 and 3). About 40% of the households scored the least (between
zero to one) in HHI. History of malaria was reported among 3%, one year prior to the study period and
30% minor infections were reported. The composite index developed was valid to assess hygiene
and sanitation of this population. Measures to improve household hygiene would contribute to
integrated approaches in improving adolescent health.
Angeline Jeyakumar (corresponding author)
Interdisciplinary School of Health Sciences,
Savitribai Phule Pune University,
Pune,
Maharashtra,
India
E-mail: angelinejaykumar@gmail.com
Padmini Ghugre
Department of Foods and Nutrition,
S.N.D.T. Women’s University,
Santa Cruz (W),
Mumbai 400 049,
India
Key words | adolescent health, personal hygiene, sanitation, urban slums
INTRODUCTION
The World Health Organization (WHO UNICEF a, b)
reports that worldwide about 700 million people do not have
access to safe drinking water and other improved water
sources. About 2.4 billion people lack access to adequate
sanitation. According to the World Bank (), promotion of
better hygienic practices is the third most productive method
of preventing infectious diseases. It has been projected that
providing adequate water and sanitation to the deprived com-
munities would prevent the global disease burden by 9.1%
(Global Water, Sanitation and Hygiene (WASH) ).
In India, there has been a disproportionate growth of the
slum population due to urbanization. Large disparities in
health indicators have been reported among the slum and
non-slum population (Agarwal ). Among those vulnerable,
the migrants who settle in slums are deprived of basic needs
such as water and sanitation that subsequently affect health.
Adolescent girls in these resource poor settings are sus-
ceptible to infections and therefore are of public health
concern. Frequent infections may affect their health
and micronutrient status. The USAID reports that about
10–15% of maternal deaths are due to infections associated
with unhygienic conditions and practices (USAID ).
Therefore, interventions in maternal and child health aim
to provide clean and safe conditions.
In the Sustainable Development Goals (SDGs), Target
6.1 aims at achieving universal access to safe drinking
water (www.un.org/sustainabledevelopment/sustainable-
development-goals/). Target 6.2 aims to achieve improved
323 Research Paper © IWA Publishing 2017 Journal of Water, Sanitation and Hygiene for Development | 07.2 | 2017
doi: 10.2166/washdev.2017.127
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