Health behavior and hygiene practices among islamic boarding school students in Indonesia: A qualitative study

Islamic boarding schools in Indonesia are essential for religious and character education, yet health behavior and hygiene practices (HBHP) among students remain limited, leading to preventable illnesses. This study aimed to explore HBHP in boarding schools, identify supporting and inhibiting factors, and examine the role of community health centers (CHCs) in promoting student health.

A qualitative design with thematic analysis was applied. Nineteen informants were purposively selected, including students, teachers, administrators, caretakers, CHC health promotion officers, and a health department representative. Data were collected through in-depth interviews and participatory observation and then analyzed using Braun and Clarke's framework with NVivo 12 Plus.

Five themes emerged: (1) daily hygiene constraints and common health disorders such as skin, digestive, and respiratory problems; (2) psychosocial and academic impacts of illness, including homesickness, reduced concentration, and disrupted religious activities; (3) factors shaping health behavior, including institutional rules, role models, peer influence, and personal habits; (4) the interface between CHCs and boarding schools through counseling, screening, and health programs, constrained by limited resources; and (5) strategies to overcome barriers, such as schedule adjustments, simplified access, and interprogram collaboration.

The findings highlight that student health in boarding schools is influenced by individual routines, institutional policies, and health system support. Strengthening school rules, teacher role modeling, and consistent CHC involvement are critical to improving HBHP. This study contributes qualitative evidence for culturally grounded health promotion models in Indonesian boarding schools.