1
|
Njee RM, Imeda CP, Ali SM, Mushi AK, Mbata DD, Kapala AW, Makundi EA, Nyigo VA, Majura AM, Akyoo WO, Mbatia YJ, Baraka GT, Msovela JM, Ngadaya ES, Senkoro MF, Malebo HM. Menstrual health and hygiene knowledge among post menarche adolescent school girls in urban and rural Tanzania. PLoS One 2024; 19:e0284072. [PMID: 38466719 PMCID: PMC10927101 DOI: 10.1371/journal.pone.0284072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/23/2023] [Indexed: 03/13/2024] Open
Abstract
Adolescent girls' capacity to lead healthy lives and perform well in school has been hampered by their lack of awareness about menstruation and the requirements for its hygienic management. Lack of enabling infrastructure, improper menstrual supplies, and limited socioeconomic support for good menstrual health and cleanliness are characteristics of schools in Africa South of the Sahara. We evaluated school-age girls' knowledge of menstrual hygiene and identified bottlenecks that could affect policy and programming for menstrual health and hygiene. A school-based cross-sectional study involved 8,012 adolescent school girls in the age group of 11-18 years (mean age = 14.9 years). The study evaluated students' knowledge of menstrual health and hygiene (MHH) from the viewpoints of schools and communities using a combination of qualitative and quantitative approaches. Data was collected using self-administered surveys, focus group discussions, in-depth interviews, and site observations. Girls' older age (AOR = 1.62, P 0.001), having a female guardian (AOR = 1.39: P = 001), and having a parent in a formal job (AOR = 1.03: P 0.023) were positively associated with Menstrual health and Hygiene Knowledge. MHH knowledge levels varied significantly between girls attending government (53.3) and non-government schools (50.5%, P = 0.0001), although they were comparable for girls attending rural and urban schools. Only 21% of the study's schools had at least one instructor who had received training in MHH instruction for students. We have established that the majority of adolescent girls in schools have inadequate knowledge on menstrual health and hygiene, and that school teachers lack the skills to prepare and support young adolescents as they transition into puberty. Concerted actions aimed at building supportive policy are paramount, for school-aged teenagers to learn about and reap the long-term advantages of good menstrual health practices.
Collapse
Affiliation(s)
- Robert M. Njee
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| | - Calister P. Imeda
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| | - Said M. Ali
- Public Health Laboratory Ivo de Carneri (PHL-IdC), Wawi, Chake, Pemba, Tanzania
| | - Adiel K. Mushi
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| | - Doris D. Mbata
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| | | | | | - Vitus A. Nyigo
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| | | | - Winfrida O. Akyoo
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Yolanda J. Mbatia
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| | | | - Judith M. Msovela
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| | - Ester S. Ngadaya
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| | - Mbazi F. Senkoro
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| | - Hamisi M. Malebo
- National Institute for Medical Research (NIMR), Dar es Salam, Tanzania
| |
Collapse
|
2
|
Sari YM, Novriyanti N. Menstrual Health Problems of Women Indigenous Peoples around Protected Forest Area in Sumatra, Indonesia, and Plants' Usefulness to Treat It. JOURNAL OF MOTHER AND CHILD 2023; 27:1-9. [PMID: 37303200 PMCID: PMC10258455 DOI: 10.34763/jmotherandchild.20222601.d-22-00064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/30/2022] [Indexed: 06/13/2023]
Abstract
BACKGROUND Some cultures have a favorable view of menstruation, consider it sacred, and respect the female body, so some local wisdom and the practice of using plant species are also attached to it. Moreover, menstruation is an integral part of reproductive health for women as mothers of a nation. However, the management of menstrual problems included in the United Nations Sustainable Development Goals (gender justice) goals in several indigenous communities around the forest has not received attention. OBJECTIVE This study aims to explain the situation of menstrual management, predict indications of reproductive problems, and record the practice of using plants to overcome these problems in indigenous tribal communities around the forest. MATERIAL AND METHODS A total of 15 youths of the Orang Rimba, one of the marginal indigenous people in Jambi Province, Sumatra Island, Indonesia, were the subjects of measurement of all variables using anthropometric measurement procedures. The 15 girls were also interviewed regarding menstrual problems, personal hygiene management, and using plant species to overcome them. Meanwhile, ten adults became respondents to the complementary primary data. RESULTS No plant species were explicitly used to treat menstrual problems. Four species are used by the Orang Rimba concerning labor management (pre- and postpartum). CONCLUSION There are no significant reproductive problems despite the incidence of dysmenorrhea. However, aspects of nutrition and personal hygiene, including during menstruation, still need special attention, especially considering that the typology of Orang Rimba varies according to their Tumenggung and the characteristics of their forest habitat; It is challenging to measure their health as a group. This condition may also apply to other communities around the forest due to their limited reproductive health knowledge.
Collapse
Affiliation(s)
- Yesi Mustika Sari
- Universitas Adiwangsa Jambi. Jl.Sersan Muslim No.RT 24, The Hok, Kec. Jambi Sel., Kota Jambi, Jambi, Indonesia
| | - N. Novriyanti
- Forestry Department, Faculty of Agriculture, Universitas Lampung. Jl.Prof. Dr. Soemantri Brojonegoro No.1 Gedong Meneng, Rajabasa, Lampung, Indonesia 361361
- KKI Warsi, Jl.Inu Kertapati No. 12 Pematang Sulur, Telanaipura, Kota Jambi, Indonesia
| |
Collapse
|
3
|
Robinson HJ, Barrington DJ. Drivers of menstrual material disposal and washing practices: A systematic review. PLoS One 2021; 16:e0260472. [PMID: 34860828 PMCID: PMC8641861 DOI: 10.1371/journal.pone.0260472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 11/10/2021] [Indexed: 11/26/2022] Open
Abstract
Background Disposal and washing facilities and services for menstrual materials are often designed based upon technical specifications rather than an in-depth understanding of what drives peoples’ choices of practices. Objectives and data sources This systematic review identified and summarised the main behavioural drivers pertaining to the choice of disposal and washing practices of menstrual materials through the thematic content analysis and study appraisal of 82 publications (80 studies) on menstrual health and hygiene published since 1999, reporting the outcomes of primary research across 26 countries. Results Disposal and washing behaviours are primarily driven by the physical state of sanitation facilities; however, this is intrinsically linked to taboos surrounding and knowledge of menstruation. Implications Using reasons given for disposal and washing practices by menstruators or those who know them well, or inferred by authors of the reviewed studies, we identify the key considerations needed to design facilities and services which best suit the desired behaviours of both planners and those who menstruate. Inclusivity The term menstruators is used throughout to encompass all those mentioned in the studies reviewed (girls and women); although no studies explicitly stated including non-binary or transgender participants, this review uses inclusive language that represents the spectrum of genders that may experience menstruation. Registration The review protocol is registered on PROSPERO: 42019140029.
Collapse
Affiliation(s)
| | - Dani Jennifer Barrington
- University of Leeds, Leeds, West Yorkshire, United Kingdom
- The University of Western Australia, Crawley, Western Australia, Australia
| |
Collapse
|
4
|
Lv C, Turel O, He Q. The Onset of Menstruation and Social Networking Site Use in Adolescent Girls: The Mediating Role of Body Mass Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199942. [PMID: 34639244 PMCID: PMC8508476 DOI: 10.3390/ijerph18199942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 01/23/2023]
Abstract
Evidence suggests that girls spend much time on social networking sites (SNS), often more than boys do. It has been proposed that this may have to do with sex-based differences in the need and approaches for socialization. We posit that adolescent girls are also unique in that they are developing physiologically and start menstruating. Based on prior research, we hypothesize that the onset of menstruation can drive physiological changes (increased body mass index (BMI)), which together with common behavioral-psychological (social and emotional) responses to menstruation can contribute to an increase in SNS use. We therefore aim to test whether BMI partially mediates the relationship between menstruation and SNS use in adolescent girls. Results based on a large nationally representative sample in the United Kingdom suggest that the age of menarche was negatively associated with daily hours of SNS use, and that BMI elevation partially mediated this association. These results extend the negative effects of the early onset of menstruation and imply that BMI control strategies may help to reduce the use of SNS in girls who experience menarche at an earlier age.
Collapse
Affiliation(s)
- Chenyu Lv
- Faculty of Psychology, Southwest University, Chongqing 400715, China;
| | - Ofir Turel
- Faculty of Engineering and Information Technology, University of Melbourne, Parkville, Victoria 3053, Australia;
| | - Qinghua He
- Faculty of Psychology, Southwest University, Chongqing 400715, China;
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing 400715, China
- Chongqing Collaborative Innovation Center for Brain Science, Chongqing 400715, China
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Beijing Normal University, Chongqing 400715, China
- Correspondence:
| |
Collapse
|
5
|
Fennie T, Moletsane M, Padmanabhanunni A. Adolescents' experiences of menarche and menstruation in disadvantaged schools in South Africa: a qualitative exploration. HEALTH EDUCATION 2021. [DOI: 10.1108/he-12-2020-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study explores how menstruation is perceived, experienced and navigated by school-going adolescent girls living in low-to-middle income settings in South Africa. Existing research from developing countries suggest that the onset of menstruation has implications for school attendance and academic performance. There is evidence that menstrual cycle–related symptoms (primarily physical) lead to difficulties in, or interference with, and disengagement from school, social relations, and physical activities (van Iersel et al., 2016; Steiner et al., 2011; Kiesner and Pastore, 2010; Taras, 2005). The onset of menstruation can be shame-inducing and has been associated with anxiety and confusion. Few studies have been conducted on menstruation in countries with a history of sectarian violence and characterised by substantial socio-economic disparities and high levels of gender-based violence. Understanding the experiences of girls in these contexts is important in generating contextually-grounded knowledge and appropriate interventions.Design/methodology/approachA qualitative, exploratory, descriptive and contextual research design was used to collect data from 48 adolescent girls aged 13–16 year-old. A total of six focus group discussions (FGDs) were conducted using a semi-structured questionnaire among a purposive sampling method. Data collected were transcribed verbatim and thematically analysed. Written parental consent was obtained for participants under 18 years old.FindingsThe findings illustrated complex psychological experiences in response to menarche and menstruation. Experiences of shame in relation to menstruation were aggravated by unsupportive responses from school teachers. Challenges such as scarcity of sanitary products were experienced as creating a barrier for girls' school attendance.Research limitations/implicationsExisting research from developing countries suggests that the onset of menstruation has implications for school attendance and academic performance. The research data includes the views of adolescent learners and their negative reactions and positive experiences towards menstruation within the school environment.Practical implicationsGiven the comparative paucity of research emerging from developing countries in sub-Saharan Africa, this paper addresses an important gap in the literature by providing contextually-nuanced information about the menstrual experiences of adolescent girls. The study can further provide information for efforts made by the Department of Education and Department of Health regarding the impact of menstruation on adolescent girls' school attendance.Social implicationsThis study provides important insights regarding the experiences of South African school girls in relation to menstruation. Although dominant feelings of shame, confusion and disgust may surround menstruation, the study also highlighted potential positive experiences associated with menstruation. Teachers and school administrators need to be oriented towards the needs of adolescent girls if issues regarding poor school attendance are to be addressed.Originality/valueTo reduce absenteeism in schools and ensure learners are provided with improved allocation of sanitary products in schools, there is a need for the advocacy regarding sexuality education and resources to promote the psychological health of adolescent girls.
Collapse
|
6
|
Sychareun V, Chaleunvong K, Essink DR, Phommavongsa P, Durham J. Menstruation practice among school and out-of-school adolescent girls, Lao PDR. Glob Health Action 2020; 13:1785170. [PMID: 32741349 PMCID: PMC7480650 DOI: 10.1080/16549716.2020.1785170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The transition from childhood to adolescence is a critical transitional period for girls, and as they experience these changes, having knowledge of, and being able to practice, good menstruation hygiene management is crucial. The objective of this study was to understand in and out of school adolescents' menstrual hygiene management practice, sources of information and attitudes towards menstruation. METHODS A cross sectional, descriptive study was conducted between November 2018 and May 2019. The sampling included adolescent girls aged 11-19 years in higher secondary schools in Khammouane and Champassak provinces and out-of-school adolescent girls. Out of the total number of 433 participants enrolled in the study, only 343 girls had reached menarche and were included in the study. Factors associated with menstruation hygiene management practice were examined with bivariate and multivariate analyses. RESULTS Out of 343 subjects who had reached menarche, 44% reported good menstrual hygiene management practice. Over half of the participants, however, were unable to access the tools of good menstruation hygiene management practice, including having somewhere to dispose of used sanitary pads in private. Being older (16-19 years) (AOR:2.4; 95%CI 1.4 to 3.9), and having primary education (AOR 0.4; 95%CI 0.2 to 0.9) were associated with good practice as was fathers' level of education (AOR 2.1; 95%CI 1.0 to 4.1) and mother-girl discussion about menstruation (AOR 2.2; 95%CI 1.0 to 5.0). No significant differences were found between in- and out-of-school adolescents. CONCLUSIONS In this study, not all participants were able to practice optimal menstruation hygiene management. This is important as good menstrual hygiene management is associated with better health and being able to participate fully in education and work. Further education is needed, but it is also important to ensure that all adolescent girls have access to the necessary tools for effective menstruation hygiene management.
Collapse
Affiliation(s)
- Vanphanom Sychareun
- Faculty of Public Health, University of Health Sciences , Vientiane, Lao PDR
| | - Kongmany Chaleunvong
- Institute of Research and Education Development, University of Health Sciences , Vientiane, Lao PDR
| | - Dirk R Essink
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit , Amsterdam, Netherlands
| | | | - Joanne Durham
- School of Public Health and Social Work, Queensland University of Technology , Brisbane, Australia
| |
Collapse
|
7
|
Michael J, Iqbal Q, Haider S, Khalid A, Haque N, Ishaq R, Saleem F, Hassali MA, Bashaar M. Knowledge and practice of adolescent females about menstruation and menstruation hygiene visiting a public healthcare institute of Quetta, Pakistan. BMC WOMENS HEALTH 2020; 20:4. [PMID: 31906921 PMCID: PMC6945726 DOI: 10.1186/s12905-019-0874-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 12/27/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND The current study is aimed to assess menstruation-related knowledge and practices of adolescent females visiting a public health care institute of Quetta city, Pakistan. METHODS A questionnaire-based cross-sectional survey was conducted. Nine hundred and twenty three female adolescents attending general out-patient departments of Mohtarma Shaheed Benazir Bhutto Hospital Quetta, Balochistan, was approached for data collection. Based on the objectives of the study, descriptive analysis was conducted and SPSS v. 21.0 was used for the data analysis. RESULTS Demographic characteristics revealed that the mean age of the respondents was 15 years. Mothers' (67%) were the main source of menstruation-related information. Majority (77.7%) of our respondents never had a class or session regarding menstruation-related education in their schools. About (44%) knew that menstruation is a physiological phenomenon while 60.2% knew that menstrual blood comes from the vagina. Nearly 40% of our study respondents missed their schools because of menarche. The use of absorbent material was frequent (90%) among the adolescent females and (68.7%) used commercially available sanitary napkins/pads. Although majority of the respondents (58.2%) were not taking baths during menstruation, 80.5% do cleaned their genitalia with water during menstruation. CONCLUSION Female adolescents of our study had certain misconception regarding menstruation because of poor access to health-related education. Education can be provided at healthcare facilities, residential area as well as religious centers. Adolescent reproductive health should be included in the school curriculum; this will influence general reproductive health of females.
Collapse
Affiliation(s)
- Judy Michael
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Qaiser Iqbal
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Sajjad Haider
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | | | - Naheed Haque
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Rabia Ishaq
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Fahad Saleem
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | | | - Mohammad Bashaar
- SMART Afghan International Trainings & Consultancy, Kabul, Afghanistan.
| |
Collapse
|
8
|
Borjigen A, Huang C, Liu M, Lu J, Peng H, Sapkota C, Sheng J. Status and Factors of Menstrual Knowledge, Attitudes, Behaviors and Their Correlation with Psychological Stress in Adolescent Girls. J Pediatr Adolesc Gynecol 2019; 32:584-589. [PMID: 31445139 DOI: 10.1016/j.jpag.2019.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/01/2019] [Accepted: 08/15/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Adolescent girls perceive menstruation as a negative experience, which can affect adolescents' physical and mental health. The aims of this study were to describe the menstrual knowledge, attitudes, and behaviors of adolescent girls in China and to examine their association with psychological stress. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A cross-sectional study was conducted among 1349 adolescent girls aged 11-14 years in Changsha, China. Participants anonymously completed questionnaires that assessed sociodemographic characteristics, menstrual knowledge and attitudes, dysmenorrhea self-care behaviors, and perceived stress. One-way analysis of variance and Pearson r correlation and multiple linear regression analyses were conducted to examine the differences and associations among variables. RESULTS The mean age of menarche was 11.70 (±0.82) years. A total of 1053/1349 (78.1%) of girls had a knowledge of menstruation before menarche and their mothers were the main source 931/1349 (69.0%) of their knowledge. More than half (53.4%) of adolescent girls experienced different degrees of dysmenorrhea. The mother's education, family monthly income, family type, and the girls' age, grade, menstrual status, age at menarche, sanitary napkin change frequency, menstrual restrictions, and dysmenorrhea influenced menstrual knowledge, attitudes, and practice. Psychological stress was affected by age, grade, age at menarche, sanitary napkin change frequency, menstrual restrictions, dysmenorrhea, and menstrual knowledge, attitudes, and practices. CONCLUSION Psychological stress management during menstruation should be a focus of health education programs for adolescent girls. During adolescence, health care providers should not only pay attention to the physical changes of adolescence girls, but also provide stress management skills to help them cope with menstrual-related concerns.
Collapse
Affiliation(s)
| | - Chi Huang
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Mengxiang Liu
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Jing Lu
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Huiting Peng
- Xiang Ya Nursing School, Central South University, Changsha, China
| | | | - Jiangming Sheng
- The Second Xiang Ya Hospital, Central South University, Changsha, China.
| |
Collapse
|
9
|
Lawal AM, Idemudia ES, Balogun SK. Menstrual attitude dimensions, Anxiety and Body Esteem in adolescent girls. PSYCHOL HEALTH MED 2019; 25:418-425. [PMID: 31284734 DOI: 10.1080/13548506.2019.1640885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
One of the horrifying experiences that adolescent girls endure is menstruation. Understanding how some individual-related factors affect menstrual attitudes has substantial implications for coping with difficulties that come with it. We tested the direct and interactive effect of anxiety and body esteem dimensions (attribution, weight & appearance) on dimensions of menstrual attitudes (debilitating, bothersome, natural, prediction & denial) among adolescent girls in Ibadan, Nigeria. This is a cross- sectional survey of 276 secondary schools girls aged 12-19 years (M= 14.89, SD= 1.46). Multivariate Analysis of Variance results revealed adolescent girls with lower anxiety reported positive menstrual attitude by anticipating the onset of menstruation. Body esteem-appearance directly influenced both debilitating and bothersome dimensions of menstrual attitude; suggesting girls with higher body esteem for appearance positively accept menstrual experience as weakening and inconvenient. Interactively, anxiety and appearance dimension of body esteem influenced prediction dimension; likewise anxiety, weight and attribution dimensions of body esteem. It is concluded that body esteem and less anxiety are important for adolescent girls' positive menstrual attitudinal change. Thus, reduced apprehension and high self-respect for body appearance and weight are recommended for accepting menstruation as a normal bodily function occurrence during a woman's reproductive lifespan.
Collapse
Affiliation(s)
- Abiodun Musbau Lawal
- Department of Psychology, Faculty of Social Sciences, Federal University Oye-Ekiti, Oye-Ekiti, Nigeria
| | - Erhabor Sunday Idemudia
- Research Unit, Faculty of Humanities, North-West University, Mafikeng Campus, Mafikeng, South Africa
| | | |
Collapse
|
10
|
Duby Z, Katz A, Musara P, Nabukeera J, Zimba CC, Woeber K, Palanee-Phillips T, van der Straten A. "The state of mind tells me it's dirty": menstrual shame amongst women using a vaginal ring in Sub Saharan Africa. Women Health 2019; 60:72-86. [PMID: 31043134 DOI: 10.1080/03630242.2019.1607803] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Socio-cultural beliefs and practices surrounding menses influence women's sexual and reproductive health behaviors and decision-making. We analyzed menstrual experiences within the context of the MTN-020/ASPIRE clinical trial during which women were asked to use a monthly vaginal ring for HIV prevention. The qualitative component of the trial was conducted during February 2013-June 2015, included interviews and focus group discussions with 214 women aged 18-42, in Malawi, Zimbabwe, Uganda, and South Africa. Emotions of shame, embarrassment and disgust relating to menses emerged. Menstruation was referred to using euphemistic terms or language about dirtiness. Women were uncomfortable touching their own menstrual blood when removing vaginal rings and felt embarrassed about study staff seeing blood on returned rings. Despite reassurances, women felt ashamed performing study procedures while menstruating, leading to missed study visits. Women's aversion to menstrual blood was linked to narratives about avoiding sex during menses and beliefs about its potential harms. Women associated men's disgust pertaining to menstrual blood with men's willingness to use condoms for sex only during menses, highlighting another way through which socio-cultural beliefs and practices around menstruation affect HIV protective behaviours. These findings provide novel insight into menstrual shame among women in these four countries.
Collapse
Affiliation(s)
- Zoe Duby
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Rondebosch South Africa
| | - Ariana Katz
- Women's Global Health Imperative, RTI International, San Francisco, California, USA
| | - Petina Musara
- University of Zimbabwe College of Health Sciences-Clinical Trials Unit (UZCHS-CTRC), Harare, Zimbabwe
| | - Josephine Nabukeera
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | | | - Kubashni Woeber
- HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa
| | | | | |
Collapse
|
11
|
Fagbamigbe A, Obiyan M, Fawole O. Parametric survival analysis of menarche onset timing among Nigerian girls. Heliyon 2018; 4:e01105. [PMID: 30603722 PMCID: PMC6310774 DOI: 10.1016/j.heliyon.2018.e01105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/22/2018] [Accepted: 12/24/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study was a response to the dearth of information on the timing of menarche in low-income countries, and the need to update knowledge on the condition. It thereby enables the provision of adequate support to young girls during menarche. The study determined the timing and range of onset of menarche and identified the factors influencing the timing. METHODS We used data on girls' sexual and reproductive processes from a nationally representative population survey of girls aged 15-24 years in Nigeria. Descriptive statistics, and survival analysis techniques were used for data analysis at p = 0·05. FINDING A quarter of the respondents (26%) had commenced menstruation by age 12. Almost all, (90%) had experienced menstruation by age 17. Girls aged 20-24 years reported later menarche (time ratio 1·066, 95% CI: 1·045-1·087) compared to those aged 15-19 years. An increase of respondents age by one year resulted in 0·8% delay in onset timing. Significant differences were also found in the zone of residence among the sampled population. Compared with girls from the South East, the timing of menstruation was generally delayed among the girls from South-South by 5%, North Central by 9%, South West by 10%, North East by 16% and 17% among girls from the North West. INTERPRETATION There was a wide range in menarcheal age in Nigerian girls with a peak at 13-14 years and the possibility of a secular trend in the timing of onset. Early family life education is recommended.
Collapse
Affiliation(s)
- A.F. Fagbamigbe
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria
- Centre for AIDS Research, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - M.O. Obiyan
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile Ife, Nigeria
| | - O.I. Fawole
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria
| |
Collapse
|