Menstrual health and factors associated with school absence among secondary school girls in Luang Prabang Province, Lao People's Democratic Republic: A cross-sectional study.

Souphalak Inthaphatha,Viengsakhone Louangpradith,Valee Xiong,Leyla Isin Xiong,Nobuyuki Hamajima,Vue Xaitengcha,Alongkone Phengsavanh,Eiko Yamamoto,Ly Ly,Srinivas Goli

doi:10.1371/journal.pone.0261268

Souphalak Inthaphatha, Viengsakhone Louangpradith + Show 8 more

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https://doi.org/10.1371/journal.pone.0261268

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Abstract

In Lao People's Democratic Republic (Lao PDR), information on school sanitation and menstrual health among secondary school girls is limited. This study aimed to explore knowledge and practices surrounding menstrual health and to identify factors associated with school absence due to menstruation among secondary school girls in Lao PDR. The study involved 1,366 girls from grade 9 to grade 12 in six secondary schools in Luang Prabang Province. Data on socio-demographics and menstrual health of the girls and data on school toilets was collected. Logistic regression analysis was performed to identify the factors associated with school absence due to menstruation. The mean age was 15.8 years old. The average age of menarche was 12.9 years old. Of 1,366 girls, 64.6% were shocked or ashamed when they reached menarche and 31.8% had been absent from school due to menstruation in the six months before this study was conducted. Factors associated with school absence due to menstruation were age ≥ 16 years old (AOR = 1.79, 95% CI 1.37-2.34), higher income (AOR = 2.38, 95% CI 1.16-4.87), menstrual anxiety (AOR = 1.55, 95% CI 1.09-2.20), using painkillers (AOR = 4.79, 95% CI 2.96-7.76) and other methods (AOR = 2.82, 95% CI 1.86-4.28) for dysmenorrhea, and disposing used pads in places other than the school's waste bins (AOR = 1.34, 95% CI 1.03-1.75). Living with relatives (AOR = 0.64, 95% CI 0.43-0.95) and schools outside the city (AOR = 0.59, 95% CI 0.38-0.90) were significantly less associated with school absence. Although the association between school toilets and school absence was not examined, the results of this study suggest that school toilets should be gender-separated and equipped with waste bins in the toilet. Furthermore, menstrual education should start at elementary schools and teacher training on menstrual health should be promoted.

Highlights

Menstruation is a natural process of the female reproductive system
This study aimed to explore knowledge and practices surrounding menstrual health and to identify factors associated with school absence due to menstruation among secondary school girls in Luang Prabang Province, which is located in the northern part of Lao People’s Democratic Republic (Lao PDR)
Factors associated with school absence among the girls

Summary

Introduction

Menstruation is a natural process of the female reproductive system Girls express their secondary sex characteristics, both physiology and emotions, and change through the adolescent period [1]. Adolescence is a transition period where girls experience cognitive development and social changes take place [2]. Poor menstrual hygiene management is associated with poor mental health and poor physical health, such as urinary tract infection and bacterial vaginosis [12,13,14,15]. Bacterial vaginosis may cause reproductive tract infections and lead to pelvic inflammatory disease [14, 16], and unhygienic practices during menstruation is reported to be one of risk factors of secondary infertility [16, 17]. Girls drop out of school because they cannot manage their menstrual hygiene when they are at school [19, 20]

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