Knowledge Analysis of Women of Childbearing Age (15-49 Years) about Personality Hygiene with the Incident of Vaginal Discharge in the Krian Sidoarjo Health Center Area

The high rate of vaginal discharge in the Krian Sidoarjo Health Center area is due to the fact that many women of childbearing age do not know about vaginal discharge, so they perceive vaginal discharge as something that is normal and trivial, besides that the feeling of embarrassment when women experience vaginal discharge often makes these women reluctant to consult a doctor. This study aims to analyze the knowledge of youth aged 15-49 years about personal hygiene with the incidence of vaginal discharge in the Krian Sidoarjo Health Center area. Research using analytical methods with the approach cross sectional . The sample used a sampling technique with stratified random sampling method, namely 98 samples from a total population of women of childbearing age (15-49 years) of 4870 people. This study used a questionnaire as an instrument and data analysis used a test Who Square. The results of the research based on the test Who Square shows Statistical Test Results A sig(2-tailed) value of 0.001 was obtained which indicated that the value was less than 0.05 so that the p value <α (0.05), then H1 was accepted. From this study, there is a relationship between knowledge of young people aged 15-49 about personal hygiene and the incidence of vaginal discharge in the Krian Health Center, Sidoarjo


BACKGROUND
The high rate of vaginal discharge in the Krian Sidoarjo Health Center area is due to the fact that many women of childbearing age do not know about vaginal discharge, so they perceive vaginal discharge something that is normal and trivial, besides that the feeling of embarrassment 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 it is handled slowly, not only can it lead to 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 behaviors (Prasetyowati & Katharini, 2010). Besides that, the impact if you have poor personal hygiene is getting cervical cancer due to mistakes in cleaning the vagina when you have finished defecating or urinating (Hidayati et al, 2010). Currently, only about 30% of people carry out reproductive examinations, namely IVA, out of the 100% expected by the government, this is due to the lack of public awareness to carry out early reproductive health checks (al Mangindo, 2017).
The number of women in the World who Once experiencing vaginal discharge 75%, while European women who experience vaginal discharge 25%. In Indonesia, as many as 75% of women have experienced vaginal discharge at least once in their life and 45% of them can experience vaginal discharge twice or more (BKKBN, 2011).
Menstrual regularity experienced by women of childbearing age, physiologically has the potential to cause vaginal discharge in women. Leucorrhoea or vaginal discharge is all genital discharge that is not blood. Physiological vaginal discharge is found before menstruation, when sexual desire increases, and during pregnancy (Manuaba, 2010). In Indonesia alone, it was found that 75% of women have experienced vaginal dischargeat least once in their lifetime and the remaining 45% may experience vaginal dischargetwice or more in their lifetime (BKKBN 2009in Adawiyah, 2015. Based on research results by Khuzaiyah, et al (2015). Pathological vaginal dischargeis caused by a tumor or cancer, and infection occurs. Therefore, every woman must do laboratory diagnostic tests and pap smears for possible malignancy. In West Kalimantan is one of the provinces that has cases of sexually transmitted infections which are quite high and have increased every year.in year 2010 as many as 2,567 cases. (Fatimah, 2013).
In Sidoarjo district, the coverage of early detection of uterine cancer using the IVA method found positive IVA in mothers aged 30-50 years, found 230 people, most of whom were found at the Wonoayu Health Center, as many as 76 people.at the health center Jabon as many as 38 people andat the health center Krian found a positive IVA incidence rate of 8 people (Sidoarjo Health Office. 2018).
Ignorance of women of childbearing age about vaginal discharge or reproductive health will have a big impact on women his health Alone. Which of these ignorance will result in behaviors that are not in accordance with what they 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).
Meanwhile, according to Bahari (2012), several ways to deal with leucorrhoea include: wearing clothes made from synthetic materials that are not tight, do not use dirty toilets because of the possibility of bacteria that can contaminate the female organs, change your underwear regularly, especially if you sweat, reduce consumption of sweet foods because it will increase the sugar level in urine and become a place for bacteria to grow, reduce the use of vaginal cleansers because it will kill normal microorganisms in the vagina, change pads regularly during menstruation, avoid changing partners, reduce tiring physical activities, and avoid using tissues which is too often. Efforts to improve health services for women of childbearing age at the Krian Sidoarjo Health Center in the future are to improve service quality, carry out promotions and motivation women of childbearing age about the importance of iva examination. This research was conducted to increase knowledge related to personal hygiene. Leucorrhoea can be prevented through a healthy lifestyle such as cleaning the vagina after defecating with a front to back motion, drying the vagina with a single-wipe tissue, and not sitting on the toilet because vaginal discharge can be transmitted through toilet lip (Suwanti, 2016).
The results of the study May 7 2020 -May 20 2020 knowledge of Women Of Childbearing Age about personal hygiene in the health center area that of the 98 respondents studied, the majority had less knowledge as many as 37 people. Respondents who experienced vaginal discharge were 55 people. The results of cross tabulation of respondents' knowledge were lacking about personal hygiene with pathological vaginal discharge as many as 28 people. Statistical Test Results Obtained a sig(2-tailed) value of 0.001 which indicates the value is smaller than 0.05 so that the p value <α (0.05) then H1 is accepted. From the problems above, the researcher is interested in conducting research entitled analysis of knowledge of young people aged 15-49 years about personal hygiene and the incidence of vaginal discharge in the 2020 Krian Health Center area, Sidoarjo. Total 98 100 The research design used incorrelational research namely research methods to determine the relationship of two or more variables. The approach used in this research iscross sectional. The population in this study were women of childbearing age aged 15-49 years in the Krian Sidoarjo Health Center area. The samples used in this study were women of childbearing age who hadstratified in Krian Health Center Sidoarjo as many as 98 respondents the puskesmas area is divided into 12 villages and 3village among them: Sedengan Mijen, Sidomulyo, East Eggplant, West Eggplant, Kraton, Tarik, Junwangi, Kemasan, Krian, Tambak, Kemerakan Pond, Controversy, Tropodo, Jatikalang and Oranges limestone with area of 16,096 km2 with different numbers of water bodies, in order to get the same number of samples and opportunities. Sampling technique in this study using the method stratified random sampling. At the time of research this research was carried out on May 7 -May 20 2020. Meanwhile, to collect data the researchers used a questionnaire instrument/measuring instrument containing closed questions (Closed Ended Question) which had been made by the previous researcher (Annisa Nurhayati). Data analysis techniques were used to test the "Relationship of Knowledge of 15-49 year olds about personal hygiene with the incidence of whiteness" by using statistical test Who Square to determine the relationship between the independent and dependent variables with a confidence level of α = 0.05. In the calculation

RESULTS
This chapter will describe the results of research on knowledge about personal hygiene with vaginal discharge. Data were 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, it will be discussed about Women of childbearing age knowledge about personal hygiene, the incidence of vaginal discharge and cross-tabulation of Women of childbearing age knowledge about personal hygiene and vaginal discharge. Based on table 3. It shows that most of the women of childbearing age with less knowledge experience pathological leucorrhoea as many as 28 people (28.57%) and a small portion with good knowledge experience pathological leucorrhoea as many as 9 people (9.18%) and sufficient knowledge experience pathological leucorrhoea15 people (15.30%) Based on good knowledge of physiological vaginal discharge, 20 people (20.4%) had sufficient knowledge of physiological vaginal discharge, 15 people (15.30%) and less knowledge of physiological vaginal discharge, 9 people (9.18%).

Respondents Knowledge About personal hygiene
Independent research results Based on the table. 1. Shows that most of the respondents have less knowledge as many as 37 people (37.8%) enough 32 people (32.7%) people, good 29 people (29.6%) Someone who does not have knowledge does not have a foundation in acting, because the behavior based on knowledge is more lasting than behavior that is not based on knowledge. Increased knowledge can be done by increasing education, training, health education, and information through mass and electronic media. Health education This is done by spreading messages and instilling the belief that mothers are not only aware, know, and understand, but are also willing and able to carry out recommendations related to health (Machfoedz, et al. 2012). Many Factors Whichcan affect personal one's hygiene like body image, knowledge, culture, socio economic, and women's habits fertile age it self. In this study, the researcher only discussed more specifically regarding the knowledge of performing personal hygiene resulting from the respondents' answers to the personal hygiene questionnaire. Other factors such as socio economics and knowledge, the researcher only explained in general from the characteristics of the respondents based on their age of education and employment. Personal hygiene is self-care carried out to maintain health, both physically and psychosocially. The factors that influence knowledge can be seen from the age of the respondents, most of whom are >20 years that is as much 41 people (41.8%), women of childbearing age education most of the junior high school that is as much 45 people (45.9%) ,and most women of childbearing age don't work as many as 68 people (69.4%) . The respondent's knowledge is lacking here, it can be seen from the very young age of the respondent, this is because lack information obtained by respondents and the lack of willingness to consult with health workers. Counseling is a means of women of childbearing age to get information about personal hygiene. Counseling is usually done in the neighborhood where Women of childbearing age lives, in hospital or the health center where they check personal hygiene complaints it should have been done by health workers, so that women of childbearing age can apply personal hygiene. With the development of technology, women of childbearing age can add to their insights about personal hygiene itself through the internet so that women of childbearing age know and if at any time experience a complaint they can immediately ask for medical help so that it can be handled as soon as possible. Knowledge of personal hygiene itself, if applied, can reduce the number of maternal deaths due to cervical cancer. If the knowledge possessed by Women of childbearing age is not applied in the right manner, it will affect diseases of the female organs.

Incidence of Leucorrhoea in Women of Reproductive Age in the Region Krian Health Center Sidoarjo
Based on the table. 2 shows that most of the 54 people (55.1%) with vaginal discharge at the Krian Sidoarjo Health Center experienced pathological vaginal discharge. The researchers assumed that the vaginal discharge rate in the Krian Health Center area was caused by the low knowledge of WOMEN OF CHILDBEARING AGE about leucorrhoea, they did not know the signs and symptoms of leucorrhoea, they considered vaginal dischargea trivial matter that did not need to be examined. 2012). Excess of the hormone Progesterone can cause vaginal discharge, Leucorrhoea that comes out of the vagina is caused by the hormone Progesterone which is changing vaginal flora and pH, so that yeast easily grows in the vagina and causes vaginal discharge (Winkjosastro, 2005). Unhygienic behavior such as washing dirty water, underwear not absorbing sweat, using poor sanitary napkins is one of the factors causing vaginal discharge (Ayuningsih, Teviningrum and Krisnawati, 2010).
The characteristics of leucorrhoea, especially pathological leucorrhoea, are thick white like milk, greenish, smell rancid, itchy and reddish, this is in line with Nur Fadilah's research, the number of respondents with less knowledge is53 respondents with a percentage of 82.8%. This is different from research. Annisa who shows good knowledge of 60 people and bad knowledge of 60 people, namely 50%.
The researcher assumed that the high vaginal discharge in the Krian Health Center area was caused by the low knowledge of vaginal discharge about vaginal discharge. It was found that many respondents answered incorrectly about using underwear made of good cotton to absorb sweat, what water is good for washing the vagina with the bad habit of washing the vagina as long as washing without notice technique The correct one is washing from front to back, using feminine hygiene tools every day consider that's good even though it can kill the good bacteria that can keep the vagina moist, and the habit of letting it get wet after a chapter or tub without drying it with a tissue while sometimes the tissue used contains fragrance. DOI: https://doi.org/10.30994/sjik.v12i1.1045ISSN: 2252; 2614-350X (online) Vol.12 No.1 May 2023 Page. 57-63 Tabulation Cross Knowledge has been about personal hygiene with vaginal discharge of Krian Health Center Sidoarjo area Based on table 3, it shows that most of the knowledge of Women of childbearing age is lacking with the incidence of pathological leucorrhoea as many as 28 people (28.57%). have experienced vaginal discharge at least once in their life and 45% of them usually experience vaginal discharge two or more times. The results of research conducted by Nanlessy, in August 2013 in high school were not in line with this study which stated 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 %.

STRADA : Jurnal Ilmiah Kesehatan
The results of the research were cross-tabulation between poor knowledge and the incidence of pathological vaginal discharge as many as 28 respondents (28%) knowledge. Enough with pathological vaginal discharge as many as 17 had good knowledge 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 are well informed but also experienced by respondents who are less knowledgeable. fatigue factor activity Excessive use causes underpants to become damp, causing conditions that are uncomfortable for the wearer and very conducive to the growth of fungi. It is best if after urinating or defecating, clean them with running water and dry them with an unscented tissue. As for Yang factor Influence Whiteness Caused by vaginal infection by mushrooms, candida albicans by bad hygiene drug use-drugs, and stress, there is a cause of vaginal discharge because of the personal hygiene less like often use the WC dirty, activityvery tiring, do not immediately change pads or underwear because of tiring activities.
Based on the results of Women of childbearing age knowledge analysis about personal hygiene with the incidence of vaginal discharge obtained a significant value (p value) of 0.001 (<0.05) and the conclusion obtained is H0 rejectedH1 Accepted. Meaning interpretation of analysis this is no relation knowledge women of childbearing age about personal hygiene with the incidence of vaginal discharge in the Krian health center area Sidoarjo This is in accordance with research conducted by the midwifery polyclinic at A. Yani Metro Hospital on female students SMA Muhamadyah I Metro in 2008, who said that the results of statistical tests prove that there is a relationship between personal hygiene and the occurrence of vaginal dischargewith a value of ρ = 0.033. (Tanjungkarang Department of Health Health Polytechnic, Uploaded 5 September 2014).
Vaginal dischargeter devided into two Categories vaginal discharge fisiologis (normal) dan vaginal discharge patologis (abnormal), Vaginal discharge fisiologis consists above fluid which is sometimes in the form of mucus which contains lots of epithelium with leukocytes, whereas pathological fluor albus contains lots of leukocytes (Subagariang, 2010). According to the theory put forward by Dr. Prikti B, SpOG, leucorrhoea is caused by women of childbearing age not taking proper care of their female organs, namely, washing the wrong way, using antiseptic solutions, using tight pants and panty liners. And according to him, one of the factors for the occurrence of leucorrhoea is poor hygiene due to increased vaginal humidity so that pathogenic bacteria that cause infections easily spread in the reproductive organs.

CONCLUSION
From the results of this study can concluded that of the 98 respondents studied, the majority of Women of childbearing age knowledge about personal hygiene had less knowledge as many as 37 people (37.8%). The results of cross-tabulation of respondents' knowledge were lacking about personal hygiene with pathological vaginal discharges many as 28 people (28.57%). The results of this study indicate that there is a relationship between Women Of Childbearing Age regarding personal hygiene and the incidence of vaginal discharge.