CHAPTER ONE

INTRODUCTION

1.1     BACKGROUND TO THE STUDY

Personal health is a key public health concern that affects people of all ages. It is also recognized as an important component of a person's general well-being. As a result, proper personal cleanliness is a crucial component of achieving ideal general health conditions for an individual (Ephraim-Emmanuel et al 2014). Personal hygiene is the act of keeping ones body, mouth and teeth clean in order to avoid diseases (WHO,2015). The World Health Organization (WHO) highlights the importance of personal hygiene to an individual's health and the health of the entire population. Pregnancy is a special moment in a woman's life, marked by a slew of physiological, anatomical, and hormonal changes that affect the the rest of the female body (Patil, Thakur, Paul, Gadicherla,2013). As a result of pregnancy hormones like oestrogen circulate in the body at extremely high levels, pregnant women are more likely to develop oral health problems, the most prevalent of which are gingivitis and periodontal disease. One of the factors that contribute to the occurrence of gingivitis and periodontitis is poor personal and oral hygiene. Pregnancy gingivitis, which can evolve to periodontitis and pregnancy granuloma, an enlarged lump on the gum that can be uncomfortable, make eating difficult, and cause difficulties owing to excessive bleeding, is a danger for up to 75% of pregnant women as a result of immunological and hormonal changes (American Dental Association Council,2010). Personal hygiene during pregnancy has been identified as a public health concern around the world. Some diseases was originally identified as a possible risk factor for preterm birth in 2012 (Offenbacher, Beck,2012). There is evidence between poor personal health, pregnancy outcomes, and the health of the kid, according to studies. Preterm birth, low birth weight, and an increased incidence of early caries in newborns are all possible negative pregnancy consequences (Maree Johnson, Ajesh George, Hannah Dahlen, Shilpi Ajwan, Sameer Bhole, Anthony Blinkhorn, Sharon Ellis and Anthony Yeo,2015). According to a study done at the Lagos State University Teaching Hospital, just 40 percent of pregnant women had access to personal hygiene information (Braimoh Omoigberai, Bashiru, Ilochonwu and Nzube Anthony,2014).

Hygiene is a term that has been used in medical, as well as in personal and professional care practices in almost every part of life (Mazharul,2012). For optimizing the health benefits of clean water and sanitation facilities, good hygiene behaviors such as hand washing and proper feces disposal are required (Water Aid America; 2011). The number of deaths caused by diarrhea infections is decreased by an average of 65 percent when hygiene education is combined with the supply of water and sanitation. People are encouraged to replace dangerous behaviours with simple and safe alternatives through hygiene education and promotion. Personal health during pregnancy has been identified as a major public health concern around the world(George A, Shamin S, Johnson M,2011). Pregnancy is frequently linked to an increased susceptibility to illness. Pregnancy, for example, was assumed to have a negative impact on the course of tuberculosis in the 19th and early 20th centuries, to the point that therapeutic abortion was suggested in tuberculosis-stricken pregnant women (Shub, Wong, Jennings, Swain, Newnham,2018). This could be due to the various physiological, anatomical, and biochemical happenings that occur in the bodies of a woman during pregnancy, particularly those that have to do with hormone elevation, immune system suppression, and the exaggeration of waste body products such as sweat, urine, etc. Pregnancy is a unique stage in a woman's life that is marked by physiological and emotional changes. Some diseases in the mouth cavity, have been described in pregnant women. According Sowole, Adegbite, Okemakin, Sowemimo (2015) Poor hygiene habits are common among pregnant women, with some of the following examples: a) Pregnant women sharing sanitary facilities without regard for the cleanliness of the facilities. b)Failure to change the pants on a daily basis and when they have discharged. c)Wearing damp pants for whatever reason, such as a lack of sunlight to dry the pants after washing them, or to make them feel more comfortable. d) Depending on whose family or tribe the ladies married from, they used herbal concoctions to bathe their private parts for easier baby delivery or as part of their tradition.

Personal hygiene was observed firstly in terms of maintaining food safety and minimizing the frequency of food-borne illnesses, with hand washing before handling food obtaining the highest ranking. (Medeiros, Kendall, Hillers, Schroeder,2014). Many pregnant women do not adequately clean their hands and frequently contaminate them after they have been washed. Personal hygiene, as demonstrated in daily activities such as the safe practice of washing hands before preparing food, reduces the risk of food poisoning and other form of diseases. (Fawzi, Shama,2018). Hands should be washed  for a duration of  20 seconds with running water and soap. (Badrie, Gobin, Dookeran, Duncan,2016). Females are more open to urinary tract infections than men due to the anatomical configuration of the female urethral. The majority of urinary tract infection isolates are faecal in origin, implying inadequate hygiene among pregnant women. (Raphael, Moghene,2015). As a result, the need of personal hygiene among pregnant women should be emphasized, as bacteriuria, both symptomatic and asymptomatic, can cause cystitis and pyelonephritis. According to a study, most people have a basic understanding of personal  hygiene  and have positive attitudes around it (Thomas, Middleton, Crowther ,2018). Interestingly, the good knowledge and attitudes displayed were not fully reflected in the women’s personal hygiene practices (Shabbir, Masooma, Qazi, Younus,2015). While it was discovered that most women have a solid grasp of hygiene, practice good personal hygiene, attend frequent antenatal services, consume appropriate diet, fruits and vegetables, and only have one sexual partner during pregnancy as a protective step for infection (Natalie, Philippa, Caroline 2018). Evidently, there are few research in the African literature that look into pregnant women's knowledge, attitudes, and practices about personal hygiene. No previous study in Nigeria has addressed this critical topic, as far as we know. This study was carried out to fill that void and to add to our understanding of how seemingly insignificant actions can have disastrous consequences for the mother and unborn child during pregnancy. This is especially crucial because water, sanitation, and hygiene are all linked to mother and child health. Therefore the study centers on assess the knowledge and attitude of personal hygiene among pregnant women attending ante natal at state specialist hospital

1.2 STATEMENT OF PROBLEM

Since Medawar's time, our understanding of the immunological changes that occur during pregnancy has progressed to incorporate increasingly complicated theories of immune change. There's indications that adaptive immune responses are decreased, which could explain why viral clearance isn't as good as it used to be. This emphasizes the significance of being cautious about what pregnant women consume, as well as proper hygiene practices with regard to their bodies and the environment. Unfortunately, being pregnant can make you more prone to bad habits. These habits may include tiredness, a lack of interest in self-care activities such as bathing, tooth brushing, etc., a preference for certain food categories over others, frequent unhealthy eating habits such as licking sweets to relieve nausea, and pica (craving for unhealthy substances or food). Food-borne infections have been on the rise in recent years, with developing countries suffering a bigger impact on their health and economies than developed countries. According to the World Health Organization, 1.8 million people died from diarrheal diseases in 2005 alone, with the majority of these cases being linked to the consumption of contaminated and bad food and water. According to the Centers for Disease Control and Prevention, foodborne infections affect one out of every six Nigerian (about 48 million individuals), resulting in 128,000 hospitalizations and 3000 deaths per year. Only a few of the 10 frequent diseases that cause maternal mortality, as assessed by Sappenfield and his team, have their method of transmission directly related with inadequate hygienic practice; nonetheless, hygienic practice plays an important role in all of them. This study is therefore, intends to assess knowledge and attitude of personal hygiene among pregnant women attending ante natal at state specialist hospital.

1.3 OBJECTIVES OF THE STUDY

The purpose of this study is to assess the knowledge and attitude of personal hygiene among pregnant women attending ante natal at state specialist hospital. Other specific objectives include

1) To assess the knowledge towards personal hygiene among pregnant women attending ante natal at Lagos state university teaching hospital

2) To examine significant impact of the level of awareness on the knowledge of pregnant women towards personal hygiene.

3) To examine the significant relationship between the knowledge and attitude of pregnant women attending ante natal towards personal hygiene

4) To examine the component of personal hygiene

5) To recommend ways in which the government and health professionals can create awareness on the need of personal hygiene among pregnant women attending ante natal in Lagos state university teaching hospitals

1.4 RESEARCH QUESTIONS

Based on the problems discussed above, the study provided answers to the following research questions

1) What is level of knowledge towards personal hygiene among pregnant women attending ante natal at Lagos state university teaching hospital?

2) What is significant impact of the level of awareness on the knowledge of pregnant women towards personal hygiene?

3) What is the significant relationship between the knowledge and attitude of pregnant women attending ante natal towards personal hygiene?

4) What is the component of personal hygiene?

5) What are the ways in which the government and health professionals can create awareness on the need of personal hygiene among pregnant women attending ante natal in Lagos state university teaching hospitals?

1.5     RESEARCH HYPOTHESES

The research following hypothesis were tested:

Hypothesis 1:

HO: There is no significant impact of the level of awareness on the knowledge of pregnant women towards personal hygiene

H1: There is a significant impact of the level of awareness on the knowledge of pregnant women towards personal hygiene

Hypothesis 2:

HO: There is no significant relationship between the knowledge and attitude of pregnant women attending ante natal towards personal hygiene

H1: There is a significant relationship between the knowledge and attitude of pregnant women attending ante natal towards personal hygiene

1.6 SIGNIFICANCE OF STUDY

The current study looked at pregnant women's personal hygiene knowledge and attitudes while they were receiving antenatal care at a state specialty hospital. The expected data on personal hygiene knowledge and attitudes among pregnant women attending antenatal at a state specialist hospital that emerged from this study are important not only to childbearing women, but also to the Lagos State Ministries of Health and Information, the Lagos State Hospitals Management Board, policymakers, health educators, and all female reproductive health intervention.

1.7   SCOPE OF THE STUDY   

The study would cover knowledge and attitude of personal hygiene among pregnant women attending ante natal at state specialist hospital

1.8 LIMITATION OF THE STUDY

The researcher was faced with the following constraints in carrying out this study:

Time: The time within the researcher is too short to carry on the detail study on this topic.

Resources: Another constraint of the researcher is financial resources to carry on the detail study of this topic. Data: Another limitation to this study will be lack of data to make valid study on the research problem.

1.9 OPERATIONAL DEFINITION OF KEY TERM

ANTE NATAL: Prenatal care, commonly referred to as antenatal care, is a sort of preventative medicine. It is provided in the form of medical checkups, which include recommendations on how to live a healthy lifestyle and medical information such as maternal physiological changes in pregnancy, biological changes, and prenatal nutrition, including prenatal vitamins, which helps to prevent potential health problems and promotes the health of both the mother and the child throughout the pregnancy.

PREGENANCY: The period during which a fetus develops inside a woman's womb or uterus is referred to as pregnancy. From the last menstrual cycle to delivery, a pregnancy normally lasts about 40 weeks, or just over 9 months. Trimesters are the terms used by doctors to describe the three stages of pregnancy.

KNOWLEDGE: A familiarity, awareness, or comprehension of someone or something, such as facts, skills, or things, is referred to as knowledge. Knowledge can be acquired in a variety of ways and from a variety of sources, according to most accounts, including but not limited to perception, reason, memory, witness, scientific research, education, and practice.

ATITUDE: In psychology, attitude is a psychological construct, a mental and emotional entity that inheres in or characterizes a person. They are complex and are an acquired state through experience

PERSONAL HYGIENE: Personal hygiene refers to the way you look after your body. Bathing, hand washing, tooth brushing, and other hygiene practices are all part of this routine. Personal cleanliness habits can assist you and those around you avoid getting sick. They can also make you feel better about yourself