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 = 565) and their household sanitation in nine slums of Pune city. Excellent reliability (α = 0.9) was obtained for four variables, two observations obtained good (α = 0.8), two scored acceptable (α = 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.

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