Exclusive use of hygienic menstrual absorbents among rural adolescent women in India: A geospatial analysis

Abstract

ObjectivesPoor menstrual hygiene can contribute significantly to female morbidity, yet the use of hygienic absorbents during menstruation is considerably low among rural adolescent women. This study examines the spatial patterns of hygienic absorbent use during menstruation among rural adolescent women to identify the districts of India where it is significantly clustered. Further, it examines the factors responsible for the spatial disparity in the exclusive use of hygienic absorbents. MethodsWe applied Global Moran's I to estimate the degree of spatial heterogeneity. In addition, we ran Cluster and Outlier Analysis (Anselin Local Moran's I) to locate clusters and outliers in the exclusive use of hygienic absorbents across the districts. Ordinary least squares, spatial lag, and spatial error models were used to identify the determinants of exclusive use of hygienic absorbents. ResultsThe Global Moran's I value for the outcome variable was 0.51, indicating a positive spatial autocorrelation in the exclusive use of hygienic absorbents. Central Indian districts had statistically significant cold spots, whereas statistically significant hot spots were discovered in south Indian districts. Our study identified that women's education, religion, social group, household wealth, mass media exposure, and women's employment status were significant determinants of the exclusive use of hygienic absorbents across Indian districts. ConclusionThere is a substantial spatial disparity in the exclusive use of hygienic absorbents among rural adolescent women in India. The use of hygienic absorbents by rural adolescent women could be encouraged through mass media campaigns, rural healthcare personnel, and free or subsidized delivery of hygienic absorbents in the identified cold spots.