Analysis Of Knowledge Of Women Aged (15-49 Years) About Personal Hygien And The Incident Of Vucility In The Krian Health Center Area Sidoarjo

The high rate of vaginal discharge in the Krian Sidoarjo Community Health Center area is because many women of childbearing age do not know about vaginal discharge so they consider vaginal discharge as something normal and trivial. In addition, the feeling of shame when women experience vaginal discharge often makes these women reluctant to consult a doctor. This research aims to analyze the knowledge of women aged 15-49 years about personal hygiene and the incidence of vaginal discharge in the Krian Sidoarjo Community Health Center area. Research uses analytical methods with a cross sectional approach . The sample used a sampling technique with a stratified random sampling method, namely 98 samples from a total population of women of childbearing age (15-49 years) of 4870 people. This research uses a questionnaire instrument and data analysis uses the Chi Square test. The research results based on the Chi Square test show that the statistical test results obtained a sig (2-tailed) value of 0.001, which indicates that the value is smaller than 0.05 so that the p value is < α (0.05), so H1 is accepted. From this research there is a relationship between the knowledge of women aged 15-49 years about personal hygiene and the incidence of vaginal discharge in the Krian Sidoarjo health center area.


INTRODUCTION
The high rate of vaginal discharge in the Krian Sidoarjo Community Health Center area is because many women of childbearing age do not know about vaginal discharge so they consider vaginal discharge as something normal and trivial.In addition, the feeling of shame when women experience vaginal discharge often makes these women reluctant to consult a doctor.Even though vaginal discharge cannot be considered trivial, because the consequences of this vaginal discharge are very fatal if treated too late, not only can it result in infertility and ectopic pregnancy (Helmi, 2016) Personal hygiene is one of the external factors that can change the pH balance of the vagina, characterized by the use of underwear that is too tight or other bad personal hygiene behavior (Prasetyowati & Katharini, 2010).Apart from that, the impact of having poor personal hygiene is getting cervical cancer due to errors in cleaning the vagina after defecating or urinating (Hidayati et al, 2010).Currently, only around 30% of people carry out reproductive examinations, namely VIA, compared to the 100% expected by the government, this is due to the still weak public awareness of carrying out early reproductive health examinations (al Mangindo, 2017) The number of women in the world who have experienced vaginal discharge is 75%, while European women who experience vaginal discharge are 25%.In Indonesia, as many as 75% of women have experienced vaginal discharge at least once in their lives and 45% of them have experienced vaginal discharge twice or more (BKKBN, 2011).
The regularity of menstruation experienced by women of childbearing age, physiologically has the potential to cause vaginal discharge in women.Vaginal discharge or flour albus is any discharge from the genital organs that is not blood.Physiological vaginal discharge is found before menstruation, when sexual desire increases, and during pregnancy (Manuaba, 2010).In Indonesia itself, data has been found that 75% of women have experienced vaginal discharge at least once in their lifetime and the remaining 45% can experience vaginal discharge twice or more in their lifetime (BKKBN 2009in Adawiyah, 2015).Based on research results by Khuzaiyah, et al (2015).Pathological vaginal discharge is caused by the presence of a tumor or cancer, and infection occurs.Therefore, every woman must undergo diagnostic tests in the laboratory and a pap smear for possible malignancies.West Kalimantan is one of the provinces that has quite high cases of sexually transmitted infections and is increasing every year.In 2010 there were 2,567 cases .(Fatimah, 2013) In Sidoarjo district, the coverage of early detection of uterine cancer using the IVA method was found to be positive for IVA in mothers aged 30-50 years, found at 230 people, most of which were found at the Wonoayu Community Health Center with 76 people, at the Jabon Community Health Center for 38 people and at the Krian Community Health Center, the incidence of positive IVA was found at 8 people ( Sidoarjo Health Office. 2018) Ignorance of women of childbearing age about vaginal discharge or reproductive health will have a big impact on their own health.This ignorance will result in behavior that is not in accordance with what should be done to maintain reproductive health.(Sari, 2012), unbalanced pH levels can cause vaginal discharge, acidity levels are caused by 2 things, namely external factors and internal factors, external factors namely lack of maintaining personal hygiene, tight underwear, use of toilets contaminated with bacteria.( Kristiana , 2013) According to Bahari (2012), several ways to deal with vaginal discharge include: wearing clothes made from synthetic materials that are not tight, don't use dirty toilets because of the possibility of bacteria that can contaminate female organs, changing underwear regularly, especially if you sweat, reducing consumption of sweet foods.because it will increase sugar levels in urine and become a place for bacteria to grow, reduce the use of vaginal cleansers because they will kill normal microorganisms in the vagina, change sanitary napkins regularly during menstruation, avoid changing partners, reduce tiring physical activity, and avoid using tissue which is too often.
Efforts to improve health services for women of childbearing age at the Krian Sidoarjo Community Health Center in the future are to improve the quality of services, carry out promotions and motivate women about the importance of IVA examinations.This research was conducted to increase knowledge related to personal hygiene.Vaginal discharge can be prevented through a healthy lifestyle such as cleaning the vagina after urinating using a front to back movement, drying the vagina with a tissue in one wipe, and not sitting on the toilet because vaginal discharge can be transmitted through toilet lip (Suwanti, 2016) The results of the research from 7 May 2020 -20 May 2020 regarding wus' knowledge about personal hygiene in the community health center area showed that of the 98 respondents studied, 37 people had the least knowledge.55 respondents experienced vaginal discharge.The results of the cross tabulation of respondents' lack of knowledge about personal hygiene with the incidence of pathological vaginal discharge were 28 people.Statistical Test Results Obtained a sig(2-tailed) value of 0.001, which indicates that the value is smaller than 0.05 so that the p value is < α (0.05), so H1 is accepted.Based on the problems above, researchers are interested in conducting research entitled analysis of knowledge of women aged 15-49 years about personal hygiene and the incidence of vaginal discharge in the Krian Sidoarjo health center area in 2020.

METHODS
The research design used in correlational research is a research method to determine the relationship between two or more variables.The approach used in this research is cross sectional.The population in this study were women of childbearing age aged 15-49 years in the Mas Krian Sidoarjo Health Center area.Meanwhile, the sample used in this research was 98 women of childbearing age who had been stratified at the Krian Sidoarjo Community Health Center .The health center area is divided into 12 villages and 3 sub-districts , including : Sedengan Mijen , S Idomulyo , Terung Wetan , Terung Kulon , Kraton , Tarik, Junwangi , Kemasan , Krian , Tambak , Pond K emerakan , K eterungan , Tropodo , Jatikalang and J erukgamping with extensive areas .area of 16,096 km2 with different numbers of WUS, in order to get the same number of samples and opportunities .The sampling technique in this research uses the stratified random sampling method .This research was carried out during the month of May 7 -May 20 2020.Meanwhile, to collect data, the researcher used a questionnaire instrument/measuring tool containing closed ended questions which had been created by the previous researcher (Annisa Nurhayati).used to test "The relationship between knowledge of women aged 15-49 years about personal hygiene and the incidence of vaginal discharge" using the Chi Square statistical test to determine the relationship between the independent and dependent variables with a confidence level of α = 0.05.

RESULT
In this chapter, the results of research regarding women's knowledge about personal hygiene and the incidence of vaginal discharge will be described.Data was taken from 7 May 2020 to 20 May 2020 using a questionnaire.From the research above, 98 samples were obtained.In the characteristics of the respondents, we will discuss WUS' knowledge about personal hygiene, the incidence of vaginal discharge and a cross-tabulation of WUS' knowledge about personal hygiene with the incidence of vaginal discharge.
1. Respondent's knowledge about personal hygiene Based on table 3, it shows that the majority of wus with poor knowledge experienced pathological vaginal discharge as many as 28 people (28.57%) and a small percentage with good knowledge experienced pathological vaginal discharge as many as 9 people (9.18%) and with sufficient knowledge experienced pathological vaginal discharge as many as 15 people (15, 30%) Based on good knowledge of experiencing physiological vaginal discharge as many as 20 people (20.4%) sufficient knowledge of experiencing physiological vaginal discharge as many as 15 people (15.30%) and poor knowledge with physiological vaginal discharge as many as 9 people (9.18%)

1.
Respondents' knowledge about personal hygiene Independent research results based on table.1. shows that the majority of respondents have less knowledge, 37 people (37.8%) are good, 32 people (32.7%) are good, 29 people (29.6%)A person who does not have knowledge has no basis for acting, because their behavior is based on knowledge is more lasting than behavior that is not based on knowledge.Increasing knowledge can be done by increasing education, training, health education and information through mass and electronic media.Health education is carried out by spreading messages and instilling the belief that mothers are not only aware, know and understand, but also willing and able to carry out recommendations related to health (Machfoedz, et al. 2012).Many factors can influence a person's personal hygiene such as body image , knowledge , culture , socioeconomics., and the habits of women of childbearing age themselves .In this research , researchers only discuss more specifically the knowledge of personal hygiene resulting from respondents ' answers to personal questionnaires.hygiene.Other factors such as socio-economics and knowledge , researchers only explain in general the characteristics of respondents based on age, education and occupation .Personal hygiene is selfcare carried out to maintain health , both physically and psychologically.
Factors that influence knowledge can be seen from the age of the respondents, the majority of whom were > 20 years old, namely 41 people (41.8 % ), the education of the WUS, the majority of whom were junior high school , namely 45 people (45.9 % ), and the majority of WUS not working, 6 8 people ( 6 9.4% ).% ) .The respondent's lack of knowledge here can be seen from the very age of the respondent.This is due to the lack of information obtained by the respondent and the lack of willingness to consult with health workers.Counseling is a means of sharing whoosh For get information regarding personal hygiene.Counseling usually carried out in the environment place stay Whoosh , at the hospital or Public health center place they check it out personal hygiene complaints .This This should be done by health workers, so that people can apply personal hygiene .With the development of technology , wus can add their insight into personal hygiene Alone via the internet so whoosh know And if anytime If you experience complaints, you can immediately seek medical help so that it can be treated as early as possible.Knowledge Regarding personal hygiene itself, if applied it can reduce the number of maternal deaths due to cervical cancer.If the knowledge that women have is not applied with appropriate action, it will have an impact on diseases of the female organs .

The incidence of vaginal discharge in women of childbearing age in the Krian Sidoarjo Community Health Center area
Based on table. 2 shows that the majority of 54 people (55.1%) of women with vaginal discharge at the Krian Sidoarjo Community Health Center experienced pathological vaginal discharge.Researchers assume that the number of vaginal discharges in the Krian Community Health Center area is due to the low level of knowledge of vaginal discharge, not knowing the signs and symptoms of vaginal discharge, considering vaginal discharge as a trivial matter that does not need to be checked ., 2012).The cause of vaginal discharge from marked fatigue appears only when the body is very tired and usually again when the body has returned to normal ( Susanto , 2013).Excess hormone progesterone can cause vaginal discharge .Vaginal discharge that comes out of the vagina is caused by the hormone progesterone which Changing vaginal flora and pH , so that fungus can easily grow in the vagina and cause vaginal discharge ( Winkjosastro , 2005).Unhygienic behavior such as unclean toilet water , underwear that does not absorb sweat , using poor sanitary napkins is one of the factors causing vaginal discharge ( Ayuningsih , Teviningrum and Krisnawati , 2010).
The typical characteristics of vaginal discharge, especially pathological vaginal discharge which is white, thick like milk, greenish, has a rancid smell, itching and redness, this is in line with Nur Fadilah's research, the number of respondents with less knowledge was 53 respondents with a percentage of 82.8%.This is different from research.Annisa who showed good knowledge of 60 people and bad knowledge of 60 people, namely 50%.
Researchers assume that the high level of vaginal discharge in the Krian Community Health Center area is caused by the low level of knowledge about vaginal discharge.It was found that many respondents answered incorrectly about the use of cotton underwear which is good for absorbing sweat, what water is good for washing the vagina with the bad habit of washing the vagina as long as you wash without pay attention to the correct technique, namely washing from front to back, using feminine hygiene tools every day thinking that it is good even though it can kill good bacteria that can keep the vagina moist, and the habit of leaving it wet after the chapter or tub without drying with a tissue.Sometimes the tissue used contains fragrance. .

3.
Crosstabulation of knowledge about personal hygiene and the incidence of vaginal discharge in the Krian Health Center area, Sidoarjo .
Based on table 3, it shows that the majority of women's knowledge is lacking with the incidence of pathological vaginal discharge as many as 28 people (28.57%).The research data is in line with research conducted by Nurmah who took data from the BKKBN, which stated that in Indonesia as many as 75% of women have experienced vaginal discharge at least once in their life and 45% of them usually experience vaginal discharge twice or more.The results of research conducted by Nanlessy, in August 2013 in high school are not in line with this research which states that as many as 22 respondents with a percentage of 36.7% experienced pathological vaginal discharge and respondents who did not experience vaginal discharge, as many as 38 respondents with a percentage of 63.3 %.
The results of the research from cross tabulation between lack of knowledge and the incidence of pathological vaginal discharge were 28 respondents (28%) with sufficient knowledge and 17 had good knowledge of pathological vaginal discharge but experienced pathological vaginal discharge as many as 9 respondents (9.18%) from the results of this study the researcher assumed that vaginal discharge Pathology is not only experienced by respondents who have good knowledge but also experienced by respondents who have less knowledge.This is caused by women not protecting their femininity from moisture, wearing underwear that is not made from cotton.The fatigue factor from excessive activity causes underwear to become damp, creating an uncomfortable situation for the wearer and is very conducive to the growth of fungus.It is best to clean the underwear and parts after urinating with running water and dry with an unscented tissue.The factors that influence vaginal discharge are caused by vaginal infections by fungus , candida albicans , poor hygiene , use of drugs, and stress, while the causes of vaginal discharge are due to poor personal hygiene , such as frequently using the toilet.dirty , very tiring activities , not immediately changing sanitary napkins or underwear because the activities are tiring .
Based on the results of the analysis of WUS knowledge about personal hygiene and vaginal discharge , a significant value ( p value) of 0.001 (<0.05) was obtained and the conclusion obtained was that H0 was rejected and H1 was accepted.So the interpretation of this analysis is that there is a relationship between women's knowledge about personal hygiene and the incidence of vaginal discharge in the Krian Sidorjo health center area.This is in accordance with research conducted by the midwifery clinic at A. Yani Metro Hospital on female students at Muhamadyah I Metro High School in 2008, which said that the results Statistical tests prove that there is a relationship between personal hygiene and the occurrence of vaginal discharge with a value of ρ=0.033.(Tanjungkarang Health Department Health Polytechnic, Uploaded on September 5 2014).
Albus flour is divided into two types , namely physiological (normal) albus flour and flour pathological (abnormal) albus, physiological albus flour consists of fluid which is sometimes mucus which contains a lot of epithelium with leukocytes , while pathological albus flour contains a lot of leukocytes (Subagariang, 2010).According to the theory put forward by Dr. Pribakti B, SpOG, vaginal discharge is caused by women of childbearing age not caring for their female organs properly, namely, using the wrong way of washing, using antiseptic solutions, using tight pants and panthyliners.And according to him, one of the factors causing vaginal discharge is poor hygiene due to increased vaginal humidity so that pathogenic bacteria that cause infection easily spread in the reproductive organs.

CONCLUSION
From the results of this research, it can be concluded that of the 98 respondents studied, the respondents with the most knowledge about personal hygiene were 37 people (37.8%).The results of the cross tabulation of respondents' lack of knowledge about personal hygiene with the incidence of pathological vaginal discharge were 28 people (28.57%).The results of this research show that there is a relationship between personal hygiene and the incidence of vaginal discharge .
The calculation process was assisted using the Statistical Program for Social Science (SPSS) for Windows .

Table 1 .
Distribution of Wus personal hygiene knowledge at the Krian Sidoarjo Community Health Center Based on table 1, it shows that the majority of respondents had less knowledge, 37 people (37.8%) 2.

The incidence of vaginal discharge in women of childbearing age in the Krian Sidoarjo Community Health Center areaTable 2 .
Distribution of the incidence of vaginal discharge at the Krian Sidoarjo health center Based on table 2, it shows that the majority of women of childbearing age at the Krian Sidoarjo health center experienced pathological vaginal discharge as many as 55 people (55.1%) 3.

Cross-tabulation of knowledge among women aged 15-49 years about personal hygiene and the incidence of vaginal discharge in the Krian Sidoarjo Health Center area .
About Personal Hygien And The Incident Of Vucility In The Krian Health Center Area Sidoarjo) 207