A comparative study of perception and practices regarding menstrual hygiene among adolescent girls in urban and rural areas of Jodhpur district, Rajasthan

Demographic and socio-economic correlates of knowledge of the ovulatory cycle among tribal women in India: Evidence from the nationally representative survey (NFHS-5)

BACKGROUND

The knowledge of ovulatory cycle (KOC) is the basis for natural family planning methods. The absence of knowledge is a notable issue since the ovulatory cycle plays a crucial role in reproductive health and empowers women to make informed decisions that influence their lives. This study examines the knowledge of the ovulatory cycle among reproductive tribal women in India and its demographic and socio-economic determinants.

METHODS

The data were derived from the National Family Health Survey conducted in 2019-2021. The effective sample size for the present study was 1,01,914 tribal women aged 15-49 years in India. Descriptive statistics along with bivariate analysis were conducted to find the preliminary results. Additionally, multivariable binary logistic regressions were conducted to determine the likelihood of KOC among tribal women across different characteristics. We conducted statistical analysis in STATA 17.0 (StataCorp) and used ArcGIS 10.8.2 for spatial mapping.

RESULTS

Out of 1,01,914 tribal women, 78.8 per cent lack correct knowledge of the ovulatory cycle. Notably, Education level significantly influences KOC, with secondary education showing higher odds of KOC (AOR: 1.24, 95% CI:1.006-1.528) compared to no education. Christian women exhibit lower odds of having KOC (AOR: 0.749, 95% CI:0.564-0.996) compared to Hindu women. Husband/partner's education level shows a strong association, with higher-educated partners correlating with higher odds of KOC (AOR: 2.501, 95% CI: 1.807-3.461) for higher education. Knowledge of any contraceptive method and current contraceptive use type are strongly associated with KOC. Additionally, rural residence negatively influences KOC (AOR: 1.545, 95% CI: 1.236-1.932), while exposure to mass media has a positive effect (AOR: 1.152, 95% CI: 0.975-1.362) albeit modest.

CONCLUSION

The study highlights the need for targeted educational and awareness programs to improve KOC among tribal women in India. By addressing factors such as education, religious influences, and place of residence, we can empower these women to make informed decisions about their reproductive health, ultimately enhancing their overall well-being and quality of life. This knowledge is not only a foundation for natural family planning but also a key driver of women's agency and autonomy in shaping their lives.

Knowledge, Attitude, Perception and Practices towards Disposal of Sanitary Napkins among Young Females: A Cross-Sectional Study

Background

Almost 70% of women residing in urban areas and 48% of women in rural areas use sanitary napkins in India. According to menstrual health alliance India (MHAI), single sanitary pad will take about 500-800 years to decompose as the plastic used in manufacturing is nonbiodegradable and causes severe noxious effects contributing to global warming through the production of planet warming fuels which eventually have severe impact on environment sustainability. Hence, the study was undertaken to contribute the evidence for the "Clean and Green India".

Aim

To know the perception and practice of disposal of sanitary napkins among young college-going females in India.

Materials and Methods

A cross-sectional study was conducted throughout the country employing a self-administered questionnaire using a survey link sent through social media. Data collected were analyzed and interpreted using SPSS version 20.0.

Result

The study population comprised 484 young college girls with a mean age of 20.92 ± 1.86 years and 96.9% of them are using sanitary napkins as menstrual absorbent aids. The most common method employed for the disposal of sanitary napkins was dumping them in the bin (87.4%). About 63.2% of them had no knowledge about sanitary napkin-burning machines. Around 92% think that improper disposal of sanitary napkins can cause health problems.

Conclusion

The findings from the study revealed that a significant number of women were practicing noneco-friendly disposal methods and menstrual hygiene aids which are a bane to the ecosystem. Study warrants the education and training of females to achieve a green and clean sustainable India.

A Review on Initiatives for Promoting Better Menstrual Hygiene Practices and Management in India

Management of hygiene during menstruation is severely affected by the continued existence of several societal, cultural, and religious restrictions on menstruation and menstruation practices. Since they are frequently unprepared and unaware of their periods, especially in rural regions of the country, girls face a variety of hurdles and problems at home, in school, and at work. We observed from examining the studies that managing menstrual hygiene is affected by a lack of personal sanitation and inadequate, erroneous, or partial understanding of menstruation. Women either possess zero or minimal knowledge about genital infections, which are caused by poor personal hygiene during menstruation. Women in rural areas frequently lack access to sanitary items and have inadequate understanding of their sorts and applications, or cannot afford the high cost of such products. Females in rural areas must use washable cotton pads because of this, which they must use repeatedly. The requirements and desires of teenage girls and women continue to be disregarded, despite substantial developments in the water and sanitation industries. Menstrual products are disposed of in domestic garbage and public facilities when women are outside, while they are flushed down toilets at home without considering the risk of choking. Because of this, there should be a need to inform and educate individuals about the health risks and environmental problems connected to them. Reduced trash may be achieved by using modern techniques like incineration. Therefore, the importance of using natural or reusable sanitary products should be emphasized.

Socio-cultural factors associated with knowledge, attitudes and menstrual hygiene practices among Junior High School adolescent girls in the Kpando district of Ghana: A mixed method study

BACKGROUND

Good menstrual hygiene practice is critical to the health of adolescent girls and women. In Ghanaian public schools, the School Health Education Program which includes menstrual health education has been instituted to equip adolescents with knowledge on menstruation and its related good hygiene practices. However, in most communities, menstruation is scarcely discussed openly due to mostly negative social and religious beliefs about menstruation. In this study, we examined socio-cultural factors associated with knowledge, attitudes and menstrual hygiene practices among Junior High School adolescent girls in the Kpando Municipality of Ghana.

MATERIALS AND METHODS

A mixed method approach was employed with 480 respondents. A survey was conducted among 390 adolescent girls using interviewer-administered questionnaires to collect data on knowledge of menstruation and menstrual hygiene practices. Focus Group Discussions (FGDs) using a discussion guide were conducted among 90 respondents in groups of 9 members. The FGD was used to collect data on socio-cultural beliefs and practices regarding menstruation. Descriptive and inferential statistics and content analysis were used to analyze the quantitative and qualitative data respectively.

RESULTS

Most (80%) of the study participants had good knowledge of menstruation. Also, most (82%) of the participants practiced good menstrual hygiene. Attending a public (AOR = 0.24, 95% CI = 0.12-0.48, p<0.001) and rural (AOR = 0.40, 95% CI = 0.21-0.75, p<0.01) school was significantly associated with reduced odds of practicing good menstrual hygiene. Good knowledge of menstruation was associated with increased odds of good hygiene practices (AOR = 4.31, 95% CI = 2.39-7.90, p<0.001). Qualitative results showed that teachers provided adolescents with more detailed biological information on menstruation than key informants (family members) did at menarche. However, both teachers and family members spoke positively of menstruation to adolescent girls. Social and religious beliefs indicate that menstruation is evil and unclean. Such beliefs influenced community members' attitudes towards adolescent girls and led to practices such as isolating menstruating girls and limiting their ability to interact and participate in certain community and religious activities.

CONCLUSION

Despite the prominence of negative social and religious beliefs about menstruation, good menstrual hygiene practice was high among study participants. Knowledge of menstruation; place of residents; and type of school were the major factors associated with good menstrual hygiene practice. It is therefore, necessary to intensify the School Health Education Program in both rural and urban public and intensively involve private schools as well to ensure equal access to accurate information on menstruation and good menstrual hygiene practices among adolescent girls.

Psychosocial Problems of Adolescent Girls during Menstruation

AIM

To study the psychosocial problems of adolescent girls during menstruation.

METHODS

Cross-sectional study was conducted in Chennai. Descriptive research design was used. Sample size: Sixty students were selected randomly by the teacher from Bhoodhur Govt high school, Sholavaram, Chennai and referred to researcher for the study purpose. Inclusion criteria: Adolescent girls who were aged 13-16 years and attained menarche.

RESULTS

Majority (71.7%) of adolescent girls belong to the age group of 14 - 15 years, 68% were in ninth standard. Nearly half of the respondents were using pads (45%) and clothes (42%) as absorbent, majority (65%) preferred to discuss about their menstrual problems with mother, 28% with friends about menarche, 7% do not discuss with anyone. Most of them (58%) as faced physical problems during menstruation such as pre-menstrual syndrome (55%), menorrhagia (12%), sleep disturbance (12%), body pain (68%), head ache (45%), leg pain (55%).Majority (67%) had psychological problems such as change in the mood (70%) irritability, (78%) restlessness, (63%) unstable mood, (58%) feeling stressed). One-third had faced psychosocial problems in terms of unaware of menarche before the onset (65%), 10% do not have privacy to change sanitary pad and do not know how to use pad, 32% faced restrictions during menarche.

CONCLUSION

Mental health education of adolescent girls is essential to deal with psychosocial problems related to menstruation.

Knowledge on Menstruation and Practice of Menstrual Hygiene Management Among School Adolescent Girls in Central Ethiopia: A Cross-Sectional Study

BACKGROUND

Menstruation is a natural event that is a physiological and psychological milestone in women's reproductive life. But Menstrual Hygiene Management (MHM) continues to be a monthly challenge for adolescent girls in low-income countries, including Ethiopia harming their school attendance, health, and daily life. Therefore, this study aimed to determine the practice of MHM and associated factors in central Ethiopia.

METHODS

School-based cross-sectional study was employed among preparatory and high schools in Holeta Town from May 01 to 20, 2019. A systematic random sampling method was used to select study subjects. Data were collected through a self-administered questionnaire and analyzed using SPSS version 23. Both bivariate and multivariable logistic regression were carried out to identify associated factors.

RESULTS

From a total of 403 respondents, 72.5% of school adolescents had good overall knowledge about menstruation and only 34.7% had adequate MHM practice. The study identified adolescents from urban residence (AOR=2.62, 95% CI: 1.53-4.48), got information about menstruation from mothers (AOR=2.17, 95% CI: 1.18-3.96) and teachers (AOR=5.09, 95% CI: 2.67-9.67), school toilets with inside lock (AOR=2.82, 95% CI: 1.67-4.76), not missing school during menstruation (AOR=4.2, 95% CI: 1.55-11.41), experienced menstrual-related problems (AOR=2.63, 95% CI: 1.49-4.64), experienced any whitish or gray discharge per-vagina (AOR=2.84, 95% CI: 1.66-4.85) and having good overall knowledge about menstruation (AOR=1.94, 95% CI: 1.07-3.52) were significantly associated with adequate MHM practice.

CONCLUSION

The study revealed three-fourth of adolescents had good overall knowledge and two-third of them had inadequate MHM practice. Rural residence, source of information on menstruation, school toilets with inside lock, experiencing menstrual-related problems, and overall knowledge were associated with adequate MHM practice. Therefore, working on enhancing the awareness of adolescent girls on menstruation and MHM practice and making school environments conducive to safe MHM practice were recommended.

Menstrual Morbidities, Menstrual Hygiene, Cultural Practices during Menstruation, and WASH Practices at Schools in Adolescent Girls of North Karnataka, India: A Cross-Sectional Prospective Study

BACKGROUND

Issues of menstrual morbidities, menstrual hygiene, and cultural practices are rarely discussed by adolescents. The burden of menstruation and cultural practices which the adolescent girls have to face has been less quantified. This study aims to assess the issues related to menstruation in school girls.

METHOD

A cross-sectional prospective study was conducted on 1016 school-going adolescent girls in January 2020. A questionnaire in English and in Kannada was distributed to girls of class 8-12 of ages between 10 and 19 years.

RESULTS

70.5% of the girls attained menarche by 12 to 14.9 years, 37.2% of the girls had their periods every 28-34 days, and 12.2% of the girls said they have heavy periods. 61.95% of the girls had dysmenorrheal, and 9.7% of the girls said that they required medications for the pain. 70.7% of the girls were using commercial sanitary napkins, 12.7% were using cloth, and 15.3% were using both. 55.5% of the girls who were using cloth as an absorbent were not drying the cloth in sunlight. 57.1% of the girls were washing their genitals more than 2 times a day. 93.8% were having bath during menses and 87.2% were using soap along with water. 37.7% of the girls disposed their pads by burning them, 50.8% of then disposed them in the dust bin, and 4.9% of them buried them. 8.6% of the girls said that they remained completely absent from school during periods. 17.85% said that they remained absent for a day. 53.4% of the respondents said that they have difficulty in concentrating at school. 76.1% said that they had adequate water and sanitation facilities at school. 22.3% said that there was adequate facility to change their pads at school. 73.2% said that they could get a spare pad at school. 43.3% of the girls said they avoided cultural functions during their periods, and 38.5% said that they avoided religious ceremonies and practices during their periods. 8.7% of the girls were made to sit outside the house during their periods. The girls from rural areas had poorer hygienic habits, in comparison to the urban girls. Cultural restrictions such as sitting outside the house during menstruation and restricting play were more in the rural girls than the urban girls.

CONCLUSION

Menstrual morbidities, menstrual hygiene management, and cultural beliefs all play a role in school absenteeism in adolescent girls. Improvement of facilities at school and conducting awareness programs can help adolescent girls to attend schools.

Menstrual Hygiene Preparedness Among Schools in India: A Systematic Review and Meta-Analysis of System-and Policy-Level Actions

With increasing girl's enrolment in schools, school preparedness to ensure a menstrual friendly environment is crucial. The study aimed to conduct a systematic review regarding the existing evidence on menstrual hygiene management (MHM) across schools in India. It further aimed to highlight the actions that have been taken by the government to improve the MHM situation in India. We conducted the systematic literature search using PubMed, EMBASE, and Web of Science for searching the peer-reviewed articles and Google Scholar for anecdotal reports published from inception until 30 October 2019. Of 1125 publications retrieved through the search, 183 papers were included in this review, using a priori created data-extraction form. Meta-analysis was used to estimate the pooled prevalence (PP) of MHM practices in schools. Less than half of the girls were aware of menstruation before menarche (PP 0.45, 0.39 to 0.51, I2= 100.0%, n = 122). Teachers were a less common source of information about menstruation to girls (PP 0.07, 0.05 to 0.08, I2 = 100.0%, n = 86). Separate toilets for girls were present in around half of the schools (PP 0.56, 0.42 to 0.75, I2 100.0%, n = 11). MHM in schools should be strengthened with convergence between various departments for explicit implementation of guidelines.