Abstract
The study aimed to deepen our understanding of the menstrual hygiene management (MHM) of adolescents and the influence of menstruation on school absenteeism. We employed a school-based cross-sectional design in five Junior High Schools combining both quantitative and qualitative data collection methods. A questionnaire was used to collect quantitative data from 250 schoolgirls, and key informant interviews were conducted with a teacher in each of the five schools. We performed logistic regression analysis to provide crude and adjusted effect estimates and 95% confidence intervals. About fifty percent of the girls were engaged in good MHM, and approximately forty percent of them reported menstrual-related school absenteeism. We did not find evidence (p = 0.858) of association between MHM and menstrual-related school absenteeism. However, after controlling for the effect of other factors, we found evidence that the age of the schoolgirls, their father's occupation, and the receipt of allowance for menstrual care products were associated with MHM. When compared to those aged 17 to 19, those aged 10 to 13 years had 0.72 (95% CI 0.21, 2.44) decreased odds of poor MHM while those aged 14 to 16 had almost 3-fold increased odds (95% CI 1.49, 4.55) of poor MHM. The adolescents whose fathers were farmers had 0.42 (95% CI 0.21, 0.82) decreased odds of poor MHM while those whose fathers were unemployed had 0.24 (95% CI 0.10, 0.61) decreased odds of poor MHM. We found that girls who did not receive regular allowance for menstrual care products had nearly 2-fold increased odds (95% CI 1.06, 3.09) of poor MHM compared to those who received allowance for menstrual care products. Menstrual pain (82.2%), fear of staining clothing (70.3%), fear of being teased (70.3%), nonavailability of sanitary pad (63.4%), and lack of private place to manage period at school (60.4%) were the common reasons cited for menstrual-related school absenteeism.
Highlights
Menstruation is a natural part of the reproductive cycle during which blood is lost through the vagina [1]
After controlling for the effect of other factors, there remained evidence that the age of the schoolgirls, their father’s occupation, and receipt of allowance for menstrual care products were associated with their menstrual hygiene management
Our findings showed that most of the girls who were engaged in good hygiene practices received allowance from parents for menstrual care products, and girls who did not receive regular allowance for sanitary products were nearly 2 times more likely to engage in poor menstrual hygiene management compared to those who received allowance for sanitary products, which is consistent with similar studies in Ethiopia [19] and India [20]
Summary
Menstruation is a natural part of the reproductive cycle during which blood is lost through the vagina [1]. Hygiene during the period of menstruation is fundamental to the dignity and well-being of women and girls and an issue that every girl has to deal with once she enters adolescence around the age of 12 and until she reaches menopause [4, 5]. Menstrual hygiene products such as tampons, sanitary pads, menstrual cups, cloths, paper material, or plant material are used by women and girls to absorb menstrual blood and to maintain personal hygiene during the period of menstruation [6].
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