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Menstruation and menstrual hygiene amongst adolescent school girls in Kano, Northwestern Nigeria

Authors:
  • Bayero University and Aminu Kano Teaching Hospital, Nigeria

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This study examined the knowledge and practices of adolescent school girls in Kano, Nigeria around menstruation and menstrual hygiene. Data was collected quantitatively and analyzed using Epi info version 3.2.05. The mean age of the students was 14.4 +/- 1.2 years; majority was in their mid adolescence. The students attained menarche at 12.9 +/- 0.8 years. Majority had fair knowledge of menstruation, although deficient in specific knowledge areas. Most of them used sanitary pads as absorbent during their last menses; changed menstrual dressings about 1-5 times per day; and three-quarter increased the frequency of bathing. Institutionalizing sexuality education in Nigerian schools; developing and disseminating sensitive adolescent reproductive health massages targeted at both parents and their adolescent children; and improving access of the adolescents to youth friendly services are veritable means of meeting the adolescent reproductive health needs in Nigeria.
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African Journal of Reproductive Health Sept. 2010 (Regular Issue); 14(3): 201
ORIGINAL RESEARCH ARTICLE
Menstruation and Menstrual Hygiene amongst Adolescent
School Girls in Kano, Northwestern Nigeria
Lawan UM1*, Nafisa Wali Yusuf2, Aisha Bala Musa3
1Department of Community Medicine, Bayero University Kano (B.U.K) & Aminu Kano Teaching Hospital (AKTH), Kano
State; 2Department of Physiology, Bayero University, Kano (B.U.K), Kano State; 3Department of Obstetrics and
Gynaecology, Aminu Kano Teaching Hospital (A.K.T.H), Kano State
*For Correspondence: Muhammad Lawan Umar. E-mail: drlawanumarus@yahoo.com.
Abstract
This study examined the knowledge and practices of adolescent school girls in Kano, Nigeria around menstruation and
menstrual hygiene. Data was collected quantitatively and analyzed using Epi info version 3.2.05. The mean age of the
students was 14.4 ± 1.2 years; majority was in their mid adolescence. The students attained menarche at 12.9 ± 0.8
years. Majority had fair knowledge of menstruation, although deficient in specific knowledge areas. Most of them used
sanitary pads as absorbent during their last menses; changed menstrual dressings about 1-5 times per day; and three-
quarter increased the frequency of bathing. Institutionalizing sexuality education in Nigerian schools; developing and
disseminating sensitive adolescent reproductive health massages targeted at both parents and their adolescent children;
and improving access of the adolescents to youth friendly services are veritable means of meeting the adolescent
reproductive health needs in Nigeria (Afr. J. Reprod. Health 2010; 14[3]: 201-207).
Résumé
Mensuration et l’hygiène menstruelle chez les étudiantes adolescentes à Kano, au nord du Nigéria. Cette étude a
examiné la connaissance et les pratiques des étudiantes adolescentes à Kano, au Nigéria à l’égard de la menstruation
et l’hygiène menstruelle. Des données ont été recueillies quantitativement et ont été analysées à l’aide de la version info
Epi 3, 2,05. L’âge moyen des étudiantes était 14±1,2 ans. La majorité étaient dans la mi-adolescence. Les étudiantes
ont subi la première apparition des règles à l’âge de 12,9±0,8 ans. La majorité avaient une connaissance considérable
de la menstruation, quoique insuffisante, dans les domaines des connaissances spécifiques. La plupart des étudiantes
se servaient des serviettes hygiéniques comme des absorbants pendant leurs dernières menstruations; elles
changeaient les pansement menstruels à peu près 1-5 fois par jour; et trois quarts ont augmenté la fréquence des
besoins. L’institutionnalisation de l’éducation sexuelles dans les écoles nigérianes, le développement et la diffusion des
messages sensibles de santé de la reproduction chez les adolescentes qui visent à la fois les parents et leurs enfants
adolescentes et l’amélioration de l’accès aux services qui favorisent les jeunes gens par les adolescentes sont de vrais
moyens pour satisfaire les besoins de santé de la reproduction chez les adolescents au Nigéria (Afr. J. Reprod. Health
2010; 14[3]:201-207).
Key words: Menstruation; menstrual hygiene; adolescents; school girls.
Introduction
Adolescents are a large and growing segment of the
world’s population. More than half of the world’s po-
pulation is below the age of 25, and one in every
two young people in the world is adolescent1. Du-
ring adolescence, young people develop their adult
identity, move toward physical and psychological
maturity. Physiologically, the hypothalamus produ-
ces growth hormone and gonadotropins which initia-
tes pubertal changes2. Menstruation, the periodic
vaginal bleeding that occurs with the shedding of
the uterine mucosa is one of the signs of puberty,
and occurs one or two years following appearance
of secondary sexual characteristics3. Once establi-
shed, every mature female menstruates on the ave-
rage 3-5 days (minimum 2 days, maximum 7 days)
each month until menopause4. A woman’s period
may not be the same every month and it may not be
the same as that of other women. Periods can be
light, moderate or heavy and the length of the period
also varies5. If poorly managed, menstrual period
may be accompanied by discomfort, reproductive
tract infection, smelling and embarrassment among
others6.
Menstrual hygiene deals with the special health
care needs and requirements of women during
monthly menstruation or menstrual cycle7. These
African Journal of Reproductive Health Sept. 2010 (Regular Issue); 14(3): 202
areas of special concern include choice of the best
“period protection” or feminine hygiene products;
how often and when to change the feminine hygiene
products; bathing care of the vulva and vagina as
well as the supposed benefits of vaginal douching at
the end of each menstrual period7. Provisions for
good menstrual hygiene include home-made reme-
dies like pieces of cotton cloth which are either
placed on a woman’s undergarment or on a home-
made belt that wraps around the waist. These cloths
can be washed, dried and used again7,8. Available
commercial products for women’s hygiene during
menstruation include pads, tampons and cups8.
Although adolescence is a healthy period of life,
many adolescents are often less informed, less ex-
perienced, and less comfortable accessing repro-
ductive health information and services than adults1.
In many parts of the developing countries, a culture
of silence surrounds the topic of menstruation and
related issues9,10; as a result many young girls lack
appropriate and sufficient information regarding
menstrual hygiene. This may result in incorrect and
unhealthy behaviour during their menstrual period.
Also, many mothers lack correct information and
skills to communicate about menstrual hygiene
which they pass on to their children, leading to false
attitudes, beliefs and practices in this regard1. Re-
cent discuss on the introduction of sexuality educa-
tion into secondary schools in Nigeria generated a
lot of tension amongst parents and religious scho-
lars particularly in northern parts of the country.
Learning about hygiene during menstruation is
a vital aspect of health education for adolescent
girls as patterns that are developed in adolescence
are likely to persist into adult life. It was against this
background that this study was planned to evaluate
adolescent secondary school girls’ knowledge of
menstruation and menstrual hygiene, as well as
their practices of menstrual hygiene. It was envisa-
ged that findings from the study will be a pointer to
some adolescence reproductive health needs in
northern Nigeria, and will also provide foundation for
policy makers and programme managers to make
rational decision on improving adolescence repro-
ductive health in Nigeria.
Methodology
A cross-sectional design was used to study a sam-
ple of 400 adolescent female secondary school stu-
dents (10-19 years old) estimated using an appro-
priate sample size formula for descriptive studies11.
The field work was conducted in October and No-
vember 2009. The students were selected using the
multistage sampling technique: A list of all secon-
dary schools within the eight metropolitan LGAs of
Kano State was compiled and was stratified into
mixed public school; mixed private school; girls only
public schools and girls only private schools; and a
school was randomly chosen from each of the four
categories using simple random sampling. This re-
sulted in the selection of Samadi International Sch-
ool (Mixed private); Maryam Abatcha Girls’ Secon-
dary School (Girls only public); Maitama Sule Girls
Academy (Girls only public) and Federal Govern-
ment College (FGC) Kano (Mixed public). Systema-
tic sampling method was used at the next stage to
select 100 eligible students from each of the selec-
ted schools. This was achieved using a sampling
interval (S.I) of 3, 9, 2 and 5 for Samadi, Maryam
Abatcha, Maitama Sule and FGC respectively. The
sampling intervals were obtained by dividing the
number of eligible students in each school by the
required sample (100). This was used for the res-
pective schools to recruit subjects until the required
sample was completed. Permission and ethical
clearance for the study were obtained from Ministry
of Education Kano State and the Institutional Re-
view Board of Aminu Kano Teaching Hospital res-
pectively; and informed consent was sought and
obtained from the students before the interviews.
Data on the students’ knowledge of menstruation
and menstrual hygiene and their practices of men-
strual hygiene was collected using pretested self
administered questionnaires. Generated data were
entered into the computer system and analyzed
using Epi-info 3.2.05 computer statistical software.
Quantitative data were summarized using mean and
standard deviation, whereas qualitative data were
summarized using percentages and frequencies.
The students’ knowledge and practices were
scored using a scoring system adopted from a past
study12. Each correct response under knowledge
attracted one point, whereas any wrong or don’t
know answer attracted no mark. In scoring the stud-
ents’ practices of menstrual hygiene however, stud-
ents that used sanitary pad during their last mens-
truation (adjudged best product for adolescents)
were scored two (2) points whereas those that used
any other sanitary method were scored one (1)
point. Correct responses for the other questions un-
der practice attracted one (1) point each and the
wrong answers attracted no mark. This gave a total
score of six (6) points for practice and 15 points for
knowledge. Respondents that scored 0-4 points un-
der knowledge were adjudged as having poor know-
ledge; whereas those that scored 5-8 and 9-12 were
adjudged as having fair and good knowledge res-
pectively. Similarly those students that scored 4-6
points and 0-3 points under practice were adjudged
as having good and poor practices respectively.
Results
All the 400 school girls that were approached to
participate in the study responded positively giving a
response rate of 100%.
African Journal of Reproductive Health Sept. 2010 (Regular Issue); 14(3): 203
Table 1. Socio-demographic characteristics of
respondents.
Characteristics
Frequency (n =
400)
Percent
(%)
Age group
10 13
14 15
17 19
Ethnicity
Hausa
Fulani
Yoruba
Igbo
Others
Religion
Islam
Christianity
Marital status
Married
Single
78
262
60
293
86
10
2
9
392
8
8
392
19.5
65.5
15.0
73.2
21.5
2.5
0.5
2.3
98.0
2.0
2.0
98.0
* Others include Kanuri; Idoma; Igbira.
Fig 1: Respondents' first source of information
on menstruation and menstrual hygiene
35.3
20.0
21.5
14.3
9.0
Parents
Friends
Sisters
Teachers/matrons
Others
Source
%
Figure 1. Respondents’ first source of information on
menstruation and menstrual hygience. *Others = elec-
tronic media; books.
Respondents’ personal data
Respondents’ personal data are summarized in
Table 1. Their mean age was 14.4 ± 1.2 years. The
majority (65.5%) were in their mid adolescence.
Three hundred and seventy one (92.7%) students
had attained menarche. The students attained me-
narche between 11 to 15 years of age. Their mean
age at menarche was 12.9 ± 0.8 years. The stud-
ents were mostly of Hausa and Fulani tribes
(94.8%); Muslims (98.0%) and were never married
(98.0%).
Respondents’ knowledge of menstruation and
menstrual hygiene
When the students were asked questions to elicit
their knowledge of menstruation and menstrual hy-
giene, it was observed that most of them (97.0%)
were aware that mature women experience monthly
/cyclical flow of blood (menstruation), and knew that
girls attain menarche around the ages of 11 to 16
years (77.8%). Few (6.5%) of the girls correctly
knew that menstruation is normal when it occurs in
early adolescence; and about half of the subjects
(58.8%) knew that the duration of a normal menses
is 2 to 7 days. Similarly, majority (87.0%) of the
school girls have heard of menstrual cycle, but only
one-third (33.8%) knew that a menstrual cycle ex-
tends from the first day of a period to the beginning
of the next period; and only 2.5% of the subjects
knew correctly that normal menstrual cycles vary
between 21 to 35 days. However, the majority
(94.0%) reported that menstrual cycles last exactly
30 days. Although more than half of the subjects
(56.5%) knew that a woman can conceive when she
mates at a certain period in her menstrual cycle,
none of them knew that the fertile period spans for
about nine (9) days around the middle of the men-
strual cycle. However, most of the respondents
(94.0%) knew that sanitary products are available
for menstrual protection (Table 2). Almost all
(86.5%) the school girls knew correctly that sanitary
pad is the best sanitary absorbent recommended for
adolescents. Also, about half of the students
(57.0%) knew that poor hygiene predisposes to
infection; and that personal hygiene has a place in
the prevention of menstrual pain (57.0%). Table 2
captures the parameters used in assessing the
knowledge of respondents and the proportion of
positive responses. The mean score of the school
girls knowledge of menstruation and menstrual hy-
giene was 8.0 ± 2.1, with the majority 350 (87.5%)
having fair knowledge of the subject. Detailed grad-
ing of the respondents’ knowledge of menstruation
and menstrual hygiene is depicted in Table 3. The
respondents’ knowledge was significantly associa-
ted with the age group of the respondents (2 =
19.96, p<0.05) but not with the type of school they
attended or their religion as shown in Table 4).
The distribution of respondents by their first
source of information on menstruation and mens-
trual hygiene is also illustrated in Figure 1. The ma-
jority, 136 (35.3%) first heard of menstruation and/or
menstrual hygiene from their parents. Few subjects
however (14.3%) learnt about the topic from the
school teachers and matrons. The remaining had
their first contact with the information through fri-
ends (either in school or at home), sisters; or
through other relatives.
Respondents’ practices regarding menstrual
hygiene
Three hundred and fourty eight (93.8%) of the sch-
ool girls that have commenced menstruation used
African Journal of Reproductive Health Sept. 2010 (Regular Issue); 14(3): 204
Table 2. Parameters used for assessing respondents’ knowledge of menstruation and menstrual hygiene.
Parameter
Positive response
(Frequency)
Percentage
(%)
Aware that mature women experience monthly/ cyclical flow of blood
(menstruation)
Knew correctly that menstruation in early adolescence is normal
Aware of expected age range for starting menstruation
Aware of the duration for a normal period
Have heard of menstrual cycle
Knew correct description of menstrual cycle
Knew duration of a normal menstrual cycle
Knew sanitary products exits for menstrual protection
Awareness of sanitary products used for menstrual protection
Sanitary pad
Reusable cloth
Tampons
Aware of the best sanitary product for adolescent
Aware that poor hygiene predispose to infection
Knew that personal hygiene has a place in prevention of menstrual pain
Aware of age of normal cessation of menstruation
-
388
26
311
235
348
135
10
376
347
13
6
346
228
228
141
-
97.0
6.5
77.8
58.8
87.0
33.8
2.5
94.0
86.8
3.3
1.5
86.5
57.0
57.0
35.3
Table 3. Knowledge and practice grading on
menstruation and menstrual hygiene.
Grading
Frequency
Percentage
(%)
Knowledge (n = 400)
Good (9-12 points)
Fair (5-8 points)
Poor (0-4 points)
Practice (n = 371)
Good (4-6 points)
Bad (0-3)
16
350
34
329
42
4.0
87.5
8.5
88.7
11.3
sanitary pads as absorbent during their last mens-
trual period. The remaining 23 (6.2%) used either
designated pieces of cloth that they washed/ boiled,
dried and re-used; or used any available piece of
cloth that they discarded after use. When the stu-
dents that did not use sanitary pads as absorbent
during their last menses were asked why they opted
for another alternative, 21 (91.3%) claimed it was
expensive and as such they could not afford it while
the remaining 2 (8.7%) claimed that sanitary pad
causes vaginal discharge.
The number of times the students changed any
form of the menstrual protection dressings ranged
from one (1) to five (5) times with a mean of 2.6 ±
0.8. Three hundred and twenty three (87.1%) and
barely more than half (56.5%) of the students chan-
ged the dressings at night and during school hours
respectively. Although 72.5% of the students increa-
sed the number of times they took bath during men-
struation. The parameters used for assessing the
students’ practice of menstrual hygiene are summa-
rized in Table 5. Overall, 329 (88.7%) of the stud-
ents examined had good practice of menstrual
hygiene. The mean practice score of the subjects
was 4.7 ± 1.1. Table 3 also shows the summary of
respondents’ grading on menstrual hygiene. The
students’ practices was also associated with res-
pondents’ age group (2 = 61.85, p<0.05) and their
knowledge of menstruation and menstrual hygiene
(Fisher’s exact p<0.05); but not with the type of sch-
ool they attended or religion (Table 4).
The various methods the students used for dis-
posing used menstrual absorbents include disposal
with domestic wastes (71.2%); burning (24.3%); bu-
rial (4.3%) and flushing in toilet (0.3%).
Discussions
Menstruation is a normal physiology in females.
Poor hygiene during menstruation has been asso-
ciated with serious ill-health ranging from repro-
ductive tract infection, urinary tract infection, bad
odour and many more6. Females are generally exp-
ected to exercise good hygienic practices during
menstruation to prevent themselves from these pro-
blems. However, remaining stable during menstrua-
tion requires that females especially the adole-
scents are prepared psychologically to develop the
associated power and mastery over the physiolo-
gical changes that occur during this period. They
should have sufficient knowledge surrounding men-
struation, menstrual cycle and of menstrual hygiene
even before they attain menarche. In this study
however, majority of the students had fair
African Journal of Reproductive Health Sept. 2010 (Regular Issue); 14(3): 205
Table 4. Factors influencing respondents knowledge and practices regarding menstruation.
Characteristic
Knowledge
A. Knowledge
(n = 400)
Good
(n= 34)
Fair
(n=350)
Poor
(n=16)
Total
Test
p-value
Significance
Type of school
Private
Public
21
13
173
177
6
10
200
200
2 = 2.93
0.231
Not significant
Religion
Islam
Christianity
32
2
346
4
14
2
392
8
2 = invalid
Age group
Early adolescence
Middle adolescence
Late adolescence
6
19
9
63
239
48
9
4
3
78
262
60
2 = 19.96
0.001
Significant
B. Practice (n =371)
Good
(n=329)
Bad
(n=42)
Knowledge
Good/fair
Poor
323
34
4
10
327
44
Fisher’s
exact
0.001
Significant
Type of school
Private
Public
174
155
17
25
191
180
2 = 2.30
0.129
Not significant
Religion
Islam
Christianity
322
7
41
1
363
8
Fisher’s
exact
0.621
Not significant
Age group
Early adolescence
Middle adolescence
Late adolescence
46
233
50
27
9
6
73
242
56
2 = 61.85
0.001
Significant
knowledge of menstruation and menstrual hygiene.
Specifically, majority of the students knew that
mature females normally experience monthly/cycli-
cal flow of blood per vagina, they knew correctly
that age at menarche ranged from 11 to 14 years
and that sanitary pads are used for menstrual
protection. However, almost half of the students did
not know the average duration of the normal
menstrual flow; and about one-third of the school
girls could correctly describe the menstrual cycle or
knew the average duration of the menstrual cycle
(2.5%). Further-more, none of the school children
knew the timing of the fertile period albeit the fact
that more than half of them were aware that a
woman can conceive when she mates at a certain
period in her menstrual cycle. These findings are
similar to those reported in past studies13-16 but
contrary to those of Drak-shayani17 and Abioye-
Kuteyi18 where sufficient knowledge of menstruation
and menstrual hygiene was reported amongst their
study subjects. The similarities in findings of this
study with that of Irinoye13, Adinmas14, Poures-
lami15 and the Abraham16 studies may perhaps be
due to the fact that the studies were conducted
among schooling adolescent who are expected to
have some exposure to this knowledge either
through school/teachers or the print media. This is
clearly indicated by our finding that a significant
proportion of the respondents first learnt about
menstruation and/or menstrual hygiene from tea-
chers or matrons in school and/or from friends in
school. The differences however between our study
findings and those of the other studies17,18 may not
be unconnected with cultural differences since
some cultures encourage parents to discuss freely
with their children on their cognitive development.
This is reflected by the fact that only about one-third
of our respondents first heard of menstruation and/
or menstrual hygiene from their parents or close
relatives. This does not augur well for the future
mothers who are expected to have good practice of
menstrual hygiene and are expected to carry on the
message to their young ones.
Learning about menstrual cycle is important for
adolescents for the purpose of knowing about fertile
periods and of contraception. Collective knowledge
of age at menarche, menstrual cycle and duration of
menstrual flow in adolescents is also useful for
African Journal of Reproductive Health Sept. 2010 (Regular Issue); 14(3): 206
allaying fears and psychological trauma that may
arise from an unexpected appearance of blood per
vagina at menarche. In addition, sufficient know-
ledge of menstruation is expected to empower the
adolescents to delineate between physiologic and
abnormal uterine bleeding. Further more, it is a well
known fact that adolescence is a period of increa-
sed risk-taking and therefore susceptibility to beha-
vioural problems at the time of puberty. This asser-
tion is corroborated by findings of a qualitative sur-
vey from southwestern Nigeria10 that illustrated the
different cognitive development of the girls by the
type of questions they asked during the session.
While the late adolescents focused on coping with
relationships and demands for sex, the early and
middle adolescents focused on their feelings, rela-
tionships, menstruation and breast size. Those in
childhood (7-11 years) appeared totally ignorant
about parts of their body; and myths and miscon-
ceptions were identified in all age groups. This is a
clear indication for the need of sexuality education
amongst the adolescents. While learning about
menstruation and what surrounds it, the girls should
also be exposed to consequences of intimate rela-
tionships with their male counterparts and of contra-
ceptive knowledge to prevent unwanted abortions
and STIs including HIV and AIDS.
Promotion of healthy sexual maturation and
prevention of diseases are among the key reasons
for menstrual hygiene. Our study found that majority
of the school girls used sanitary pads during their
last menstruation. This is similar to reports from El-
Gilany and colleagues from Egypt19 but in contrast
to the Adinmas study where the majority was found
to be using toilet rolls followed by sanitary pads to
catch menstrual blood14. The use of sanitary pad as
absorbents is simple, hygienic and convenient as
the pads come in different sizes that a female can
choose from depending on her menstrual flow. Soi-
led pads are easily discarded and as such saves
the trouble of re-treatment for future use. Although
the use of designated re-useable cloth is hygienic
for adults, it may not be the best product for adole-
scents where the requirements for maintaining its
hygiene in terms of time, effort and resources may
not be assured. Our study however found that few
of the school girls used re-useable pieces of cloth or
any old piece of cloth to catch menstrual blood du-
ring their last menstruation. The main reason given
by these students for using re-useable pieces of
cloth was they could not afford sanitary pads. Other
respondents practices like regular changing of all
forms of menstrual absorbents, changing menstrual
dressings at nights and during school hours; and
increasing frequency of bathing during menstruation
which prevail amongst the majority of our respon-
dents signify good state of menstrual hygiene prac-
tices albeit their insufficient knowledge of the sub-
ject.
In summary, this study observed that the majo-
rity of the school girls examined incidentally had
good practices of menstrual hygiene albeit having
fair knowledge of the subject. In view of the salient
findings of this study therefore, we recommend as
follows:
1. Sexuality education is a formidable strategy
for ensuring healthy sexual maturation and hygiene
amongst school adolescents. The government sho-
uld therefore not relent in its efforts to institutiona-
lize sexuality education in both public and private
secondary schools and in tertiary institutions of
learning in Nigeria.
2. Information is power, and knowledge is well
known to influence attitude over time. The govern-
ment and development partners should therefore
work towards developing and disseminating sensi-
tive programmes targeted at both parents and the
adolescents on the unmet needs of adolescents in-
cluding sexuality education. The electronic and print
media, community organizations and faith-based
organizations are veritable means of disseminating
these messages
3. Parents should be made to acknowledge
the need to support their children at school with
sanitary menstrual absorbents in addition to other
basic hygienic products. The government and/or
schools administrations should on the other compli-
ment these provisions as part of the school health
programmes.
4. Youth friendly services provide good milieu
for the adolescents to interact and learn more about
their health. The government and developing part-
ners should tap from these wealth of experience
and facilitate access to these services for all adole-
scents both in school and at homes.
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... Today, such ideologies still hold sway in many local communities, especially in middle and low-income countries of the world (Kpodo et al, 2020). These social constructs, have been shown to consciously and perhaps subconsciously influence the way and manner a woman conducts herself and views her own body in today's society, even in many developed climes (Lawan et al, 2010). There is also a gamut of myths surrounding menstruation, and these myths have undertones too; dictating or rather influencing her conduct, subconsciously (Kumbeni, et al, 2021). ...
... A study by Lawan et al (2010), in northern Nigeria, Kano revealed the impact of poverty and socioeconomic instability on menstrual health among adolescent girls. Lawan et al (2010) in their qualitative research revealed that over 30% of adolescent girls faced dire challenges in the procurement of quality sanitary, absorbent and disposable menstrual pads, as a result of the rising cost of living, and incessant political instability. ...
... A study by Lawan et al (2010), in northern Nigeria, Kano revealed the impact of poverty and socioeconomic instability on menstrual health among adolescent girls. Lawan et al (2010) in their qualitative research revealed that over 30% of adolescent girls faced dire challenges in the procurement of quality sanitary, absorbent and disposable menstrual pads, as a result of the rising cost of living, and incessant political instability. The numbers in the study rose to 50% exclusively in areas affected by armed conflict. ...
Thesis
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INTRODUCTION : This research work is a scoping review of available evidence relating to the pattern of menstrual health management and hygiene, among adolescent girls aged 10-19 years, in sub -Saharan Africa and Southern Asia. Data from high quality studies done within the past decade (2012-2022), in ten countries which are located in the sub -Saharan and Southern Asian sub continents, were reviewed and analyzed. METHODS: This project is a compounded multi-synthesis of data evidence surrounding the pattern of menstrual health management and hygiene among adolescent girls living in sub- Saharan Africa (SSA) and Southern Asia. By an empirically transparent and systematic approach, relevant literature from Nigeria, Kenya, Tanzania, Ghana, Uganda, Ethiopia, Nepal, India, Bangladesh, and Indonesia, were examined and extracted from six open source public health databases: ScienceDirect, MEDLINE, CINAHL, DFID, ISI, and G00gle sch0lar. This was guided by the PRISMA-ScR framework (Preferred Reporting Items for Systematic reviews and Meta-Analysis Extension for Scoping Reviews), and the Rayyan Systematic Review Research Protocol. Seven thousand Six hundred and Six (7606) studies were identified, 3981 citations were screened, 980 full-text documents were assessed f0r eligibility, and 102 eligible citations were included in the final scoping review data analysis. RESULTS : The scoping review identified the social determinants of menstrual health, and the perception of menstrual management among adolescent girls in the Asian and African sub regions, of the research interest. Of the entire articles reviewed, 86.3% were school based while 13.7% were community based. The mixed methods form of research, the observational, the descriptive cross sectional, the non randomized and randomized controlled trials, consisted nearly half (42.5%) of the entire body of evidence analyzed. Nearly 60% of the data source were systematic reviews and longitudinal intervention studies. Sixty six studies were based in sub Saharan Africa, while thirty six studies were based in Southern Asia. India and Nepal together comprised half of the studies analyzed, within the Southern Asian sub- region, while one third was of Bangladeshi origin. One out of every 6 study analyzed in the Southern Asia sub- region had Indonesian roots. Studies from Kenya and Ethiopia made up 43.9% of eligible studies from the sub Saharan, while 27.3%, were of Ugandan and Tanzanian origins (Table 3.1-2). Studies from Nigeria and Ghana made up the entire percentage of eligible studies from the West African sub-continent, in the ratio 3:2, respectively (Table 3.2-3). There exists a complex pattern of menstrual health management and hygiene among young women, girls, and adolescents living in the middle and low-income countries of sub Saharan Africa and Southern Asia. The study revealed that there are wide healthcare gaps among female adolescents, in sub Saharan Africa and Southern Asia, and this is driven by the social determinants of health, which does vary, based on educational and socioeconomic status. Generally, those financially buoyant have better access to quality menstrual management options, as opposed to those who may not be. This is further complicated by inherent sociocultural barriers. CONCLUSION: Menstrual health management is a public health challenge in middle and low income countries within the Southern Asian and sub- Saharan regions of the world. Due to the prevailing socio- economic inequalities inherent in these countries, many girls can barely afford quality menstrual healthcare. Effective, continuous and well targeted campaigns are necessary to improve the knowledge of menstrual hygiene, and access to quality menstrual healthcare.
... The assessed studies showed a mixed prevalence of girls with a current general knowledge related to menstruation ranging from 51.9%-97.8% 5,12,13,15,[18][19][20][21] ; however, studies that assessed the level of knowledge showed that although most girls know that menstruation is a monthly flow of blood, arriving around the age of 11-16 years, and lasting 2-7 days each month, only one-third of girls knew that a menstrual cycle lasts from one period to the next and only a quarter of girls knew that the length can vary from 30 days 20 . Additionally, Boakye-Yiadom et al., 2018 22 , concluded that 67.5% of adolescent girls had adequate MHM knowledge, defined as scoring five out the eight questions asked correctly. ...
... The most used menstrual product across studies was commercial disposable pads with use ranging from 21%-87% 6,8,10,13,22,27,29 . Other materials included reusable pads used by 6%-54.2% of respondents, old cloth or pieces of mattresses used by 9%-54% of respondents 13,20,22 . The choice of material was influenced primarily by cost, in addition to comfort, safety, fear of stigma, and availability (presence of a shop and distance to travel) 22 . ...
... flushed the product down the toilet (0.3%-16.5%), threw the product in open spaces (47.0%) or buried the product at school or home (4.3-46.6%) 12,20,23,29,30 . These methods can cause problems with a lack of sewage systems and waste management infrastructure to remove the waste safely. ...
... It has also been established that significantly, more number of girls from urban areas use sanitary napkins during menstruation unlike their counterparts in rural areas and that awareness about adolescent health clinic is significantly more among urban girls (Choudhary & Gupta, 2019). Some school girls have good practices of menstrual hygiene albeit having fair knowledge of the subject (Lawan, Nafisa, & Aisha, 2010), probably as a result of the environment where the schools are located and the level of information made available to the students. In a resource limited settings in area around Bangalore city, it was found that the actual knowledge regarding the process of menstruation as well as the Personal hygiene practices of women were found to be unsatisfactory, and that there is avoidance of certain foods and practices during the time of menstruation alongside some cultural factors (Shanbhag, Shilpa, D'Souza, Josephine, Singh & Goud, 2012). ...
... This study therefore sets out to interrogate the exposure and response to menstrual hygiene information among the pre-menopausal women in south east, Nigeria. Lawan, Nafisa, and Aisha (2010) examined the knowledge and practices of adolescent school girls in Kano, Nigeria about menstruation and menstrual hygiene. Data was collected quantitatively and analyzed using Epi info version 3.2.05. ...
Article
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Given the perceived effects of poor menstrual hygiene on women and the society, this work examined the response to menstrual hygiene information among pre-menopausal women in South East, Nigeria. The study examined the response of the women to menstrual hygiene information and the extent to which they comply with such information. The study is anchored on the Uses and Gratifications theory, based on the premise that women who are exposed to menstrual hygiene information may use the messages to satisfy a variety of health needs and gratifications. The study utilized a mixed approach of both the quantitative and qualitative designs involving the Survey and Focus Group Discussion (FGD). The multi stage probability sampling and purposive sampling techniques were used. The study revealed that many of the women (84.2%) were not influenced by menstrual hygiene information received, suggesting that some of the women are already practicing general body hygiene principles including menstrual hygiene. The study also found that many of the women do not perceive the messages on menstrual hygiene as sufficient to bring about a positive behaviour change (84.2%), implying that some cultural and socioeconomic factors influence how they negotiate or accept the information. This work concludes that the attention they give to such information is relatively minimal. The study also concludes that many women do not pay sufficient attention to information on menstrual hygiene, perhaps owing several socio-cultural and environmental variations and these have continued to affect the health of the Nigerian society. The study recommends among others, that mothers and care givers should play an advisory role to female children by teaching them how to safely manage their menstrual cycles and that the women affairs' ministries and establishments in various Federal and State levels should engage in more open advocacy of menstrual hygiene practices and assist women with information and materials on how to manage their menstrual cycles effectively.
... The data collection instrument comprised five elements, which were associated with menstruation hygiene, social support, school environmental characteristics, and sociodemographics. (31). The data collection tool was first developed in English, translated into Amharic, and then back into English to guarantee consistency. ...
... This study was in agreement with one conducted in Addis Ababa [29]. and Nigeria [31]. It's probable that parents' expertise and experience have a beneficial impact on their children's menstrual hygiene habits. ...
Article
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Background Despite being a normal occurrence, menstruation requires hygienic care and is associated with a number of myths and wrongdoings. Menstrual hygiene issues have been linked to major health issues, such as urinary tract and reproductive tract infections. Consequently, the purpose of this study was to evaluate the management of menstrual hygiene and related aspects among teenage students in Debre Markos town, North West, Ethiopia. Methods From March 15 to April 15, 2019, teenage pupils in Debre Markos town participated in a cross-sectional mixed study. An in-depth interview and a self-administered structured questionnaire were used to gather data. Quantitative information was imported into Epi Data and then exported to SPSS for examination. A 95% Confidence Interval of p-value ≤ 0.05 was used to declare significance. The method of thematic content analysis was used to examine the qualitative data. Result This study comprised 531 individuals in total, with a 96.2% response rate. Approximately 260 adolescent females (49%, 95% CI: 39.2, 59.2) had good management practices for menstrual hygiene. Girls whose mothers were private employees (AOR: 0.3, 95% CI: 0.09, 0.99), self-employed (AOR: 0.52, 95% CI: 0.28, 0.98) and housewives (AOR: 0.53, 95% CI: 0.29, 0.98), and parent-adolescent discussions about menstruation (AOR: 1.62, 95% CI: 1.40, 3.34) were significantly associated with good menstrual hygiene management. Adolescence aged 17 years or older (AOR: 2.13, 95% CI: 1.32, 3.44) were found to have good knowledge regarding menstrual hygiene (AOR: 1.59, 95% CI: 1.43, 2.94). The qualitative study found that ignorance, an unfavorable school climate, and cultural and economic factors were the main causes of teenagers’ poor menstrual hygiene. Conclusion Nearly half of adolescent girls had good menstrual hygiene practice. Menstrual hygiene practice was associated with adolescent age, knowledge of menstruation, maternal occupational and discussion with parents. Girls had difficulty to manage menstrual hygiene due to poor knowledge, unsafe school environment, and cultural barriers. Thus, school-based programs aimed at improving knowledge towards menstrual hygiene management are needed.
... Dang districts, Nepal (67.0%), North Western Nigeria (88.7%) (21)(22)(23)(24). This variation might be due to different study setting, and divergence scoring system for measuring the practice level of menstrual hygiene in different studies.The possible explanation for this difference also, might be related to socio economic status variation, as this study group incorporates the rural school adolescent's girls who are constrained from the factors which are affecting menstrual hygienic practice like inaccessible of sanitary material, unaffordability SNK, inconvenient school and home environment etc. ...
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Background Menstrual hygiene management is the practice done by girls or women through; using a clean material, changing a private way body using water with soap,and having disposal facilities. It is insufficiently acknowledged among adolescent school girls in Ethiopia. Therefore, understanding the level of hygiene management practice and identifying determinant factors is a crucial first step to taking appropriate interventions Method An -institution-based cross-sectional study design was employed among 335 urban adolescent girls from March to April 2021.Study participants were selected by using a multistage stratified sampling technique. Aninterviewer-administered structured questionnaire was used for data collection. The data were entered by using EPI INFO version 7.2 and analyzed by using STATA version 14.1 software. Bivariate and multivariable logistic regression analysis with a 95% confidence interval was employed. A P-value< 0.05 was considered as statistically significant and AOR with a 95% confidence interval was considered to show the strength of the association. Result Overall, prevalence of menstrual hygiene practice among adolescents’ girls were 66.0% (95% CI: 60.7, 70.9) among urban school girls. urban residence [AOR= 3.41(95% CI: 1.1, 10.58), media exposure for SNP advertisement [AOR=2.43 (95%CI; 1.08, 5.48)], good menstrual knowledge [AOR=3.68 (95% CI: 1.76, 7.69)], female toilet inside locked [AOR=2.66 (95%CI; 1.1, 6.45)], girls who have private room at home [AOR=3.53(95% CI: 1.46, 8.5)], good water accessibility (AOR=3.35(95% CI:(1.62,6.95), gain information from friends [AOR=3.35(95%CI:1.04,10.77)] were found to be significantly associated with good MHP among overall school adolescent girls, Conclusion Though the overall prevalence of the study was low.it was relatively better among urban school girls. It shows a significant variation between the urban and rural study groups. Therefore,Implementation of girl friendly WASH services in all schools should be applied, health education should be strengthened, WASH facilities constructed at school levels, free discussion with parents and teachers in order to practice safe MHM.
... Various studies have shown that most teenage girls prefer absorbent sanitary napkins, but sanitary napkins are difficult to access due to their high cost. 20,[28][29][30] Regarding the disposal practice of sanitary pads, our study revealed that 37.33% of respondents burnt the pad, while 31.83% threw it in dustbins. ...
... 14,15 Our findings also contrast reports from urban Nigerian settings which indicate a higher rate of commercial disposable pad use. 16,17 The use of commercial disposable products could facilitate convenient and safer menstrual practices. However, cost of these products is a major deterrent. ...
Article
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Background Adolescent girls face numerous challenges which hinder their ability to manage menstruation in a healthy and dignified manner. Objectives To examine the menstrual hygiene practices of adolescent girls schooling in rural Anambra communities. Study design Cross-sectional descriptive study. Method Participants were selected using multistage stratified random sampling technique and interviewed using self-administered semi-structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22.0. Results Mean age of all, pre-menarche and post-menarche girls were 14.7 ± 1.84, 12.8 ± 1.09 and 15.1 ± 1.73 years, respectively. About 46% of the pre-menarche girls had not received any information on menstruation. Common sources of initial menstruation information were mother (87.3%), school (52.2%) and peers (20.0%). Among the 1091 (85.0% (1091/1283)) post-menarche girls, last menstrual period, last menstrual period duration and cycle length could not be recalled by 53.9%, 34.4% and 39.3%, respectively. Majority (98.3%) who could recall last menstrual period had a cycle length of ⩽30 days and the mean duration of menses was 4.4 ± 0.84 days. Disposable sanitary pad was mostly (60%) cited as recommended product, but cloth/rags (40.6%) or tissue paper (32. 3%) were predominantly used. Majority (88.6%) took their bath ⩾twice/day, 50.9% changed sanitary product ⩽twice/day while 72.5% exhibited poor hand washing. Sanitary products were mostly discarded by burning (45.4%). Fifty-one percent could not change in school predominantly due to lack of functional toilets/changing rooms (84.2%) while 72.5% of those who changed did so in bushes or unused spaces. Challenges faced during menstruation include restriction from holy places (38.9%), waist pain (74.9%), blood stains (36.1%) and lack of money to buy pad (27.0%). Factors significantly associated with using commercial pads were age (p = 0.047), class (p = 0.006), mother’s educational status (p < 0.001), social class (p < 0.001), ability to recall last menstrual period date (p = 0.029) or duration (p = 0.001). Conclusion Menstrual hygiene management was unsatisfactory among studied adolescents. Continuous education of adolescent girls on menstrual hygiene management and advocacy for adequate menstrual hygiene management support are imperative.
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Menstruation is a natural biological process closely intertwined with women’s lives. However, various superstitions and stigmas related to menstruation are prevalent, creating multiple health risks for women. This study attempts to understand the changing perceptions of menstrual practices across generations. Specifically, it addresses the knowledge levels of women, rituals, social stigmas and taboos, and the changing sources of socialization regarding menstruation. As the task is exploratory, the study follows the phenomenological tradition of qualitative research. Twenty-five households consisting of three generations of women have been interviewed to gather primary data. Thematic analysis has been used to analyze the primary data. Findings demonstrate that the knowledge levels of the first and second generations of women are primarily similar, as they think that menstruation is a sign that indicates women can have children and that after menstruation a woman’s body matures. On the other hand, the third generation of women knows that menstruation occurs due to bodily hormonal changes. The first and second generations of women mostly used dirty cloths and consumed holy water to reduce pain during menstruation. The third generation of women uses sanitary pads and knows the risks of unhygienic practices during menstruation. Furthermore, different types of misconceptions and stigmas were noticed among first and second-generation women. However, the third generation of women is conscious, explicit, and vocal about menstruation. Lastly, the socialization process regarding menstruation has changed over time. The first and second generations of women mostly learned about menstruation from their mothers, and there was no opportunity to discuss it with male members. But the third generation of women gains knowledge related to menstruation from their mothers, fathers, and media.
Article
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As menstrual hygiene issues have continued to gain prominence across the globe, this work examined the extent of exposure and medium of exposure to menstrual hygiene information among women in south East, Nigeria. This study adopted a mixed research of both quantitative and qualitative designs involving the 'survey', and 'Focus Group Discussion'. Survey was used to determine the women's exposure to menstrual hygiene information. Focus Group discussion helped gain insights into their shared interpretations regarding this exposure. For the survey, multi stage probability sampling technique was employed to sample a total of 663 respondents, with 5% error margin and 99% confidence level, derived from the sample size table worked out by Krejcie and Morgan (1970), while purposive sampling was employed for the FGD. The study was anchored on the health belief model to argue that women in South East, Nigeria who are exposed to menstrual hygiene information have perceived chances of developing favourable or positive behavioural conditions. The study found that menstrual hygiene information is popular among the women in south east Nigeria but these information are still insufficient as lack of Information on Menstrual hygiene could result in Poor Menstrual hygiene which may pose some threats or health risks such as reproductive and urinary tract infections, among others. Although many of them already have some foundational knowledge on how to effectively manage their menstrual hygiene, they hardly wish to openly debate or discuss their menstrual health which they occasionally obtain through interpersonal communication/word of mouth, Internet/New media, and stories on any form of print literature. This work concludes that exposure to menstrual hygiene information among women in south east is widespread but the attention they give to such information is relatively minimal. The study recommends among others, that relevant institutions in Nigeria should provide sufficient educational contents for women in their early years of menstruation. This will help them learn how to manage their menstruation effectively. The study further recommends that the government, relevant agencies and non government organizations as well as individuals can assist by proving the healthy sanitary materials for women especially the poor, and the media should assist in the campaign for menstrual hygiene.
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Intoduction : Objectives : Method : Results : Conclusion : Key words : In the developing country like India, females are facing many menstruation related health problems, which are significant causes of morbidity, hampering daily life. Improper menstrual hygiene practices predispose the females towards many communicable diseases. The knowledge, attitudes and practices regarding menstrual hygiene, which establish at adolescent age, are usually followed by them throughout life and also passed on to the next generation. 1. To detect the menstrual health problems 2. To assess menstrual hygiene practices 3. To assess the restrictions in daily activities considered appropriate by the adolescents. Current cross sectional study was conducted at Kheda district of Gujarat State, India. The sampling was done using multi stage sampling technique. The sample included 400 adolescent girls of 14 to 17 years of age. Considering the dropout rate, 30% sample was constituted by non school going subjects and 70 % by school going subjects. 76(19%) participants had irregularity in menstruation. 103 (25.8%) participants had problem in doing daily activities whereas 112 (28%) participants had problem in doing specific activities like playing, exercise etc. 244 (61%) participants have used cloth while 156 (39%) used sanitary pad during last menstruation. As revealed by the study, the adolescent girls are facing various menstrual health problems like abdominal pain, menorrhagea, polymenorrhoea etc. They are unaware of proper disposal techniques of sanitary pad or other material used as absorbent. Menstrual Problems, Menstrual Hygiene Practices
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This cross-sectional descriptive study was conducted amongst 550 secondary school girls in southeastern Nigeria to determine their perceptions, problems, and practices on menstruation. Majority of the students, (75.6%), were aged 15-17 years. Only 39.3% perceived menstruation to be physiological. Abdominal pain/discomfort, (66.2%), was the commonest medical problem encountered by the respondents, although 45.8% had multiple problems. Medical problems were most commonly discussed with the mother, (47.1%), and least commonly discussed with the teachers, 0.4%. Analgesics, (75.6%), were most commonly used to relieve menstrual pain. Only 10% of respondents used non-pharmacologic remedies. Unsanitary menstrual absorbents were used by 55.7% of the respondents. Menstruation perceptions are poor, and practices often incorrect. A multi-dimensional approach focusing on capacity building of mothers, and teachers on sexuality education skills; using religious organizations as avenues for sexuality education; and effectively using the Mass Media as reproductive health education channels are recommended towards improving adolescents' perceptions and practices on menstruation.
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Menstruation and menstrual practices are still clouded by taboos and socio-cultural restrictions resulting in adolescent girls remaining ignorant of the scientific facts and hygienic health practices, which sometimes result into adverse health outcomes. (i) To elicit the beliefs, conception and source of information regarding menstruation among the study population and (ii) to find out the status of menstrual hygiene among adolescent girls. A descriptive, cross-sectional study was conducted among 160 adolescent girls of a secondary school situated in the field practice area of Rural Health Unit and Training Center, Singur, West Bengal, with the help of a pre-designed and pre-tested questionnaire. Data were analyzed statistically by simple proportions. Out of 160 respondents, 108 (67.5%) girls were aware about menstruation prior to attainment of menarche. Mother was the first informant regarding menstruation in case of 60 (37.5%) girls. One hundred and thirty-eight (86.25%) girls believed it as a physiological process. Seventy-eight (48.75%) girls knew the use of sanitary pad during menstruation. Regarding practices, only 18 (11.25%) girls used sanitary pads during menstruation. For cleaning purpose, 156 (97.5%) girls used both soap and water. Regarding restrictions practiced, 136 (85%) girls practised different restrictions during menstruation. Menstrual hygiene, a very important risk factor for reproductive tract infections, is a vital aspect of health education for adolescent girls. Educational television programmes, trained school nurses/health personnel, motivated school teachers and knowledgeable parents can play a very important role in transmitting the vital message of correct menstrual hygiene to the adolescent girl of today.
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The menstrual knowledge and practices of 352 randomly selected healthy Nigerian schoolgirls were studied. 187 (53.1%) had attained menarche. 40% of subjects were deficient in knowledge about menstruation. Although menstrual knowledge was higher in post-menarcheal girls, 10% of these were totally ignorant about menses and 84% were not psychologically prepared for the first menses. Girls' menstrual knowledge was positively associated with parental education. The major source of menstrual information was the family. Although more than half of the girls menstruated regularly, 66.3%, used insanitary materials as menstrual absorbent. The mean duration of menstrual flow was 4.32 +/- 1.15 days (mean +/- SD) with a range of 3-7 days in 95.2% of the study population. There is an acute need for education and psychological preparation of girls for menstruation well ahead of menarche.
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This study was carried out among 345 pregnant women attending antenatal clinics at two health facilities in Lagos, Nigeria. It was undertaken to determine their knowledge and acceptability of HIV voluntary counselling and testing in pregnancy as a strategy for the prevention of mother-to-child transmission (PMTCT) of HIV. Data were collected on issues relating to mother-to-child transmission of HIV, willingness to go for voluntary counselling and testing, actions to be taken if a pregnant woman was found to be HIV positive including infant feeding options. Majority of the women (89.9%) had good knowledge of the modes of HIV transmission, however, knowledge of specific aspects of PMTCT was poor. Close to half of the women (41.7%) were not aware of the association between breast milk and HIV transmission. Almost all the women (96.1%) were willing to undergo HIV testing in pregnancy particularly if it would assist preventing transmission of HIV to their babies; but only few would undergo the test if the result would be shared with relatives. Many of the women would still prefer breastfeeding even if they were found to be HIV positive. Awareness of anti-retroviral drugs among the study group was very poor. As the country is about to embark on its PMTTCT programme, there is need to increase the level of knowledge, acceptability and adoption of VCT and other PMTCT strategies among potential beneficiaries. Innovative information and education techniques need to be developed to provide HIV positive mothers with knowledge and skills that can enable them to make informed choices about infant feeding options and other forms of care.
Article
Background - The aim of this study was to assess the level of knowledge, attitudes and behavior of female students, aged 15 to 18 years, with regard to dysmenorrhea and menstrual hygiene, in suburban districts of Tehran. Methods - The study applied a descriptive, cross-sectional method, in which 250 students were selected at random using a cluster random sampling method. The data were collected by applying a 44-item questionnaire. The reliability of the questionnaire was checked by Chronbach-Alpha method, which showed a correlation of 90%. Results - Seventy-seven percent of the subjects claimed that they had adequate knowledge of dysmenorrhea. But only 32% of these practiced personal hygiene, such as taking a bath, and used hygienic materials (i.e. sterile pads). About 33% of the subjects, avoided any physical activity or even mild exercise during menstrual period. Over 67% of the girls reported taking palliative medicine for their menstrual pain without consulting a doctor. Fifteen percent of the subjects stated that dysmenorrhea had interfered with their daily life activities and caused them to be absent from school from between 1 to 7 days a month. The prevalence of dysmenorrhea in this study was 71%. Conclusions - The main conclusion derived in this study was the necessity of educating female students about personal hygiene associated with their menstrual period and to adopt a healthy behavior, which includes: appropriate nutrition, exercise and physical activity, personal hygiene, and appropriate use of medications based on a physician's prescription.
Article
The results of a survey of 1377 young Australian women aged 14 to 19 years, conducted to determine their attitudes, state of knowledge and practices with regard to menstruation, are presented. The young women, as a group, lacked sufficient information about menstruation, about the time of ovulation, about menstrual discharge, and about the use of tampons. A high proportion (80%) considered menstruation to be inconvenient or embarrassing. Certain measures aimed at remedial action are suggested.
Article
Menstruation is a phenomenon unique to the females. It is clear from the study findings that majority of the girls were having correct knowledge about menstruation. Regarding the practices, only 10 girls were using boiled, and dried cloth as menstrual absorbent. Though almost all 64 girls received advice regarding menstrual hygiene from different sources, some of their practices were unhygienic. This shows that the mothers of these girls were lacking of right knowledge and the same thing was transferred to their off springs. Before bringing any change in menstrual practices they should be educated about the facts of menstruation and its physiological implications. The girls should be educated about the significance of menstruation and development of secondary sexual characteristics, selection of a sanitary menstrual absorbent and its proper disposal. This can be achieved through educational television programmes, school nurses/Health personnel, compulsory sex education in school curriculum and knowledgeable parents, so that she does not develop psychological upset and the received education would indirectly wipe away the age old wrong ideas and make her to feel free to discuss menstrual matters without any inhibitions.
Article
This paper attempts to understand the experience of menstruation in the socio-cultural context of an urban Indian slum. Observations were gathered as part of a larger study of reproductive tract infections in women in Delhi, using both qualitative and quantitative methods. The qualitative phase consisted of 52 in-depth interviews, three focus groups discussions and five key informant interviews. In the quantitative phase inferences were drawn from 380 respondents. Mean age at menarche was 13.5. Onset of menarche is associated with physical maturity and the ability to marry and reproduce. However, a culture of silence surrounds menarche, an event which took the women interviewed almost by surprise. Most were previously unaware that it would happen and the information they were given was sparse. Menstruation is associated with taboos and restrictions on work, sex, food and bathing, but the taboos observed by most of the women were avoidance of sex and not participating in religious practices; the taboo on not going into the kitchen, which had been observed in rural joint households, was not being observed after migration from rural areas due to lack of social support mechanisms. There is a clear need to provide information to young women on these subjects in ways that are acceptable to their parents, schools and the larger community, and that allow them to raise their own concerns. Education on these subjects should be envisaged as a long-term, continuous process, beginning well before menarche and continuing long after it.
Article
This study investigated students' knowledge of, beliefs, attitude to and practices during menstruation. Data was collected from a sample of 200 students from Ile-Ife using the multi-stage sampling technique. Only 5% of respondents could correctly define menstruation. Materials used to manage menstruation include sanitary pad, pieces of cloths, toilet rolls, cotton wool, tampon and shoulder pad foam. Practices vary on menstruating and non-menstruating days with 11(39.3%) of the 28 practices classified as healthy, 6(21.43%) as potentially harmful and 11(39.3%) as uncertain. Three (21.43%) of the listed 14 beliefs and taboos are potentially health-promoting, 5(35.71%) are potentially not health-promoting while 6(42.86%) are potentially harmless. Menstruation is associated with restrictions in diet and social interaction with 8%, 20.5% and 5% seeing menstruation as abnormal, dirty and a disease respectively. Findings from this study would be helpful in planning educational programmes to correct misinformation and promote healthy practices among women during menstruation.