A study on the relationship of sociocultural characteristics, menstrual hygiene practices and gynaecological problems among adolescent girls in Eastern India

The association between menstrual hygiene, workplace sanitation practices and self-reported urogenital symptoms in a cross-sectional survey of women working in Mukono District, Uganda

BACKGROUND

Women worldwide experience challenges managing their periods. Menstrual and genital hygiene behaviours have been linked to negative health outcomes, including urogenital symptoms and confirmed infections. However, evidence testing this association has been limited and mixed. This study aimed to (1) describe the menstrual care practices and prevalence of self-reported urogenital symptoms among working women in Mukono District, Uganda, and (2) test the associations between menstrual and genital care practices, and urogenital symptoms.

METHODOLOGY

We undertook a cross-sectional survey of women aged 18-45 working in markets, schools, and healthcare facilities in Mukono District, with 499 participants who had menstruated in the past two months included in this analysis. We developed an aggregated measure of menstrual material cleanliness, incorporating material type and laundering practices. Associations with urogenital symptoms were tested using the aggregated material cleanliness measure alongside the frequency of changing materials, handwashing before menstrual tasks, and sanitation practices.

RESULTS

Among our sample, 41% experienced urogenital symptoms in the past month. Compared to women exclusively using disposable pads, using appropriately cleaned or non-reused improvised materials (PR = 1.33, 95%CI 1.04-1.71), or inadequately cleaned materials (improvised or commercially produced reusable pads) (PR = 1.84, 95%CI 1.46-3.42) was associated with an increased prevalence of self-reported urogenital symptoms in the last month. There was no difference between those using disposable pads and those using clean reusable pads (PR = 0.98; 95%CI 0.66-1.57). Infrequent handwashing before changing materials (PR 1.18, 95%CI: 0.96-1.47), and delaying urination at work (PR = 1.37, 95%CI: 1.08-1.73) were associated with an increased prevalence of self-reported symptoms.

CONCLUSION

Prevalence of self-reported urogenital symptoms was associated with the type and cleanliness of menstrual material used as well as infrequent handwashing and urinary restriction. There is a need for interventions to enable women to maintain cleanliness of their menstrual materials and meet their menstruation, urination and hand washing needs at home and work.

Knowledge and peer support for increase Menstrual Hygiene Management (MHM) in adolescents

Introduction: During the transitional period of reproductive function development, adolescents require special attention, one of which is menstrual hygiene management (MHM). Teenagers dealing with menstruation have little information and understanding due to the taboo assumption of being more comfortable communicating with peers. Therefore, this study aims to explain the relationship between knowledge and peer support with MHM in adolescent girls. Design and Methods: This study adopted a correlational descriptive design with a cross-sectional approach and 122 students in apublic Junior High School in East Java were selected using proportional simple random sampling. Furthermore, the questionnaire was adopted as the study instrument to measure the variables of knowledge level, peer support, and MHM. Data were then analyzed using Spearman Rho Test with a significance level of p<0.005. Results: The results showed that there is a significant relationship between the level of knowledge (p = 0.000 r = 0.619 and peer support (p = 0.000 r = 0.534) with MHM in adolescent girls. Conclusions: Adolescent girls with adequate knowledge and peer support have better MHM. Therefore, information and education about MHM are recommended for adolescents.  

What explains the rural-urban gap in the use of hygienic methods of menstrual protection among Youth in the East Indian state of Bihar?

Background:

Menstrual hygiene management has become a globally recognized public health issue. As evidenced by the National Family Health Survey-4 (NFHS-4), among the states in India, Bihar accounts for the lowest use of hygienic methods of menstrual protection among youth. Further, the use in rural areas of Bihar is substantially lower than in urban areas.

Objectives:

Therefore, using NFHS-4 data, this study endeavors to explore the socioeconomic and demographic factors in explaining the rural-urban gap in the use of hygienic methods of menstrual protection among youth in Bihar.

Methodology:

A logistic regression model is used to identify the socioeconomic and demographic determinants of the use of hygienic methods, and Fairlie's decomposition technique is employed to compute the rural-urban difference in the use, and then to decompose these differentials into their separate underlying factors.

Results:

Findings from logistic regression analysis reveal that women's education, household wealth, media exposure, use of toilet facility, and awareness of sexually transmitted infections (STIs) are the significant determinants influencing the use of hygienic methods of menstrual protection. Results from decomposition analysis indicate that while use of improved toilet facility and mass media exposure among youth reduce the rural-urban gap, the unequal distribution of women's educational qualification, wealth index, marital status, and awareness of STIs has tended to widen the gap.

Conclusion:

The findings suggest promotion of menstrual hygiene practices, enhancement of menstrual hygiene knowledge, opportunities for women's education, better sanitation practices, exposure of mass media, and economic incentives among youth in rural Bihar.

Factors associated with gynaecological morbidities and treatment-seeking behaviour among adolescent girls residing in Bihar and Uttar Pradesh, India

BACKGROUND

Gynaecological morbidities are more common than reproductive and contraceptive morbidities and constitute a substantial proportion of disease burden in women. This study aimed to examine the prevalence and factors associated with gynaecological morbidities and the treatment-seeking behaviour among adolescent girls residing in Bihar and Uttar Pradesh, India.

METHODOLOGY

The study utilized data from the Understanding the Lives of Adolescents and Young Adults (UDAYA) survey with a sample size of 14,625 adolescents girls aged 10-19 years. We defined gynaecological morbidity in dichotomous form, created from five questions on different morbidities. Further, the treatment-seeking behaviour was assessed for reported gynaecological morbidities three months prior to the survey. Univariate and bivariate analysis was used to perform analysis to carve out the preliminary results. Additionally, the study employed the heckprobit selection model, a two-equation model, to identify the determinants of outcome variables.

RESULTS

Overall, about one-fourth (23.6%) of the adolescent girls reported suffering from gynaecological morbidities, and only one-third of them went for treatment. Non-Scheduled Caste/Scheduled Tribe (Non-SC/ST) adolescents were significantly less likely to have gynaecological morbidities (β: -0.12; CI: -0.18, -0.06) compared to SC/ST counterparts; however, they were more likely to go for the treatment (β: 0.09; CI: 0.00, 0.19). The adolescents who had 8-9 (β: 0.17; CI: 0.05, 0.29) or ten and above years of education (β: 0.21; CI: 0.09, 0.34) had a higher likelihood of going for the treatment than adolescents with no education. Moreover, adolescents who belonged to rural areas were less likely to go for the treatment of gynaecological morbidities (β: -0.09; CI: -0.17, -0.01) than urban counterparts.

CONCLUSION

Multi-pronged interventions are the need of the hour to raise awareness about the healthcare-seeking behaviour for gynaecological morbidities, especially in rural areas. Adolescent girls shall be prioritized as they may lack the knowledge for gynaecological morbidities, and such morbidities may go unnoticed for years. Mobile clinics may be used to disseminate appropriate knowledge among adolescents and screen asymptomatic adolescents for any possible gynaecological morbidity.

Menstrual Hygiene Practices of Adolescent Girls in Rural Maharashtra

Menstrual practices of adolescent girls in rural parts of India are greatly influenced by taboos and socio-cultural beliefs. In this study, the menstrual hygiene practices and beliefs of 122 adolescent girls between the ages of 13 and 19 years from rural Maharashtra were evaluated by personal interview and questionnaires. None of the girls had the right scientific knowledge about menstruation and were isolated during menstruation. They used cloth or home-made sanitary pads and were at risk of infections. There is a dire need for knowledge dissemination among school children and their families, increased awareness of menstrual hygiene and access to the requisite sanitary products in rural areas.

Puberty and menstruation knowledge among young adolescents in low- and middle-income countries: a scoping review

Objectives

This study presents a scoping review of evidence relating to knowledge and experiences of puberty and menstruation among females aged 10–14 years in low- and middle-income countries.

Methods

Forty-four items from 12 countries were identified from a systematic scoping review and screening of 8083 items. Included studies were quality assessed.

Results

A majority (40/44) of studies used school-based samples, and fifteen studies reported on interventions. Girls had inadequate knowledge about menstruation; menarche as a trigger for girls learning about menstruation was common. Adolescents struggled with menstrual hygiene. Negative emotions were associated with menarche and menstrual management. A minority of studies dealt explicitly with puberty. Most girls obtained information about menstruation and/or puberty from their mothers, although mothers were not necessarily girls’ preferred source for learning about these topics.

Conclusions

Young adolescent girls are under-prepared for puberty and menstruation. Predominantly school-based studies mean we know little about young out-of-school adolescents. The evidence base lags behind the rise in interest from practitioners as well as the development (and evaluation) of puberty and/or menstruation interventions.

Electronic supplementary material

The online version of this article (10.1007/s00038-019-01209-0) contains supplementary material, which is available to authorized users.

Association between unhygienic menstrual management practices and prevalence of lower reproductive tract infections: a hospital-based cross-sectional study in Odisha, India

Background

The extent to which reproductive tract infections (RTIs) are associated with poor menstrual hygiene management (MHM) practices has not been extensively studied. We aimed to determine whether poor menstrual hygiene practices were associated with three common infections of the lower reproductive tract; Bacterial vaginosis (BV), Candida, and Trichomonas vaginalis (TV).

Methods

Non-pregnant women of reproductive age (18–45 years) and attending one of two hospitals in Odisha, India, between April 2015 and February 2016 were recruited for the study. A standardized questionnaire was used to collect information on: MHM practices, clinical symptoms for the three infections, and socio-economic and demographic information. Specimens from posterior vaginal fornix were collected using swabs for diagnosis of BV, Candida and TV infection.

Results

A total of 558 women were recruited for the study of whom 62.4% were diagnosed with at least one of the three tested infections and 52% presented with one or more RTI symptoms. BV was the most prevalent infection (41%), followed by Candida infection (34%) and TV infection (5.6%). After adjustment for potentially confounding factors, women diagnosed with Candida infection were more likely to use reusable absorbent material (aPRR = 1.54, 95%CI 1.2–2.0) and practice lower frequency of personal washing (aPRR = 1.34, 95%CI 1.07–1.7). Women with BV were more likely to practice personal washing less frequently (aPRR = 1.25, 95%CI 1.0–1.5), change absorbent material outside a toilet facility (aPRR = 1.21, 95%CI 1.0–1.48) whilst a higher frequency of absorbent material changing was protective (aPRR = 0.56, 95%CI 0.4–0.75). No studied factors were found to be associated with TV infection. In addition, among women reusing absorbent material, Candida but not BV or TV - infection was more frequent who dried their pads inside their houses and who stored the cloth hidden in the toilet compartment.

Conclusion

The results of our study add to growing number of studies which demonstrate a strong and consistent association between poor menstrual hygiene practices and higher prevalence of lower RTIs.

Electronic supplementary material

The online version of this article (10.1186/s12879-018-3384-2) contains supplementary material, which is available to authorized users.