Menstrual hygiene management practice and its associated factors among in-school adolescent girls in Western Ethiopia

Mapping the Expertise and Understanding of Menarche, Menstrual Hygiene, and Menstrual Health among Adolescent Ladies in Low- and Center-Profit Nations

Most adolescent women face many restrictions, which become much more severe during menstruation. In India, millions of adolescent girls drop out of school every year due to menstruation-related problems and restrictions. Despite extensive research, a paucity of literature was observed on the level of knowledge, attitude, and practices of adolescent girls regarding menstruation. Hence, we proceeded to undertake the present study, to have a deeper understanding of the menstrual hygiene management of adolescents. To describe the menstrual hygiene management among adolescent school girls. (a) To examine the association, if any, between menstrual hygiene management and school absenteeism during menstruation in adolescent school girls. We conducted a school-based cross-sectional analytical study in an urban area in north India. The study population comprised adolescent school girls of all the high schools in the urban area. With a 95% confidence interval, and 5% margin of error, the sample size was calculated to be 369. However, an even larger sample size of 600 was actually studied. The probability proportional to size sampling approach was followed based on the number of adolescent girls in each school class/section. Participants were selected through a stratified proportionate sampling method. Ethical approval was obtained from the ethical committee of the district director of education of the urban area where the study was conducted before the commencement of the study. Confidentiality of the information collected was ensured. The data collected was quantitative in nature, using a pretested self-administered questionnaire consisting of both open-ended and close-ended questions. Data was checked for its completeness, coded, and entered into Microsoft Excel 2021 Spreadsheet. Subsequently, the data was imported into IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. for data analysis. Standard statistical methods were utilized for data analysis. The mean age (standard deviation [SD]) of the study participants was 13.68 (1.29). The mean age (SD) at menarche was 13.29 (0.96). Based on the overall menstrual hygiene management score, 377 (62.83%) of the study participants were engaged in good menstrual hygiene management, while 223 (37.17%) were engaged in poor menstrual hygiene management. The mean score (SD) was 7.80 (±0.43). Compared to those aged 17-19 years, those aged 10-13 years had a 0.36 (95% CI 0.17-0.75) decreased odds of good menstrual hygiene, while those aged 14-16 years had a 0.29 (95% CI 0.14-0.59) decreased odds of good menstrual hygiene. The adjusted odds ratios were 0.32 (95% CI 0.19-0.65) and 0.25 (95% CI 0.12-0.41) respectively. Out of 600 study participants, 229 (38.17%) reported school absenteeism at least once in the last 1 year because of menstruation. The mean (standard deviation) duration of school absenteeism was 2.4 (0.78) days per menstrual cycle. The commonest reason for menstruation-related school absenteeism was pain, wherein 105 (45.85%) study participants reported this reason. In our study, we observed that over two-thirds of the study participants were engaged in good menstrual hygiene practices, while ~40% of them reported menstrual-related school absenteeism. Our study also found evidence that the age of the school girls was associated with their menstrual hygiene management practices. We recommend further research on the impact of menstruation and its management on the academic performance of adolescent school girls. Efforts are also required to develop the capacity of teachers to teach menstrual hygiene education.

Background. Many adolescent girls in developing countries lack appropriate information, means or materials, and access to the right sanitary facilities to manage menstruation. Hence, they adopted unsafe hygienic practices during menstruation that in turn has a negative impact on their dignity, health, and education. Thus, this study aimed to assess the practices of menstrual hygiene management and associated factors among secondary school girls in East Hararghe Zone. Methods. A school-based cross-sectional study was conducted from April to May 2017 among secondary school girls in East Hararghe Zone, Eastern Ethiopia. A total of 672 girls were selected randomly and interviewed using a structured interviewer-administered questionnaire. Logistic regression analysis was employed to identify predictors of good menstrual hygiene management practices. Result. Overall, 58.3% of the girls had good menstrual hygiene management practices. Around two-thirds (66.1%) of them used commercial sanitary pads as absorbents, 56.4% changed sanitary materials more than three times a day, and 68.3% cleaned their external genitalia daily during their menstruation. During multivariate analysis, living in urban areas (AOR = 2.59, 95% CI: 1.77, 3.80), having moderate (AOR = 2.78, 95% CI: 1.64, 5.28) and good knowledge about menstruation (AOR = 3.87, 95% CI: 2.21, 6.77), and mothers’ secondary and above education (AOR = 1.83, 95% CI: 1.01, 3.30) showed a positively significant association with good menstrual hygiene management practices. Conclusion. In this study, the practice of good menstrual hygiene management of secondary schoolgirls was low. Factors independently influencing menstrual hygiene management practices were girls’ place of residence, knowledge status of menstruation and its hygiene management, and mothers’ educational status. This highlights a need for targeted interventions to raise awareness of school girls especially for rural residents and the public in general to improve the knowledge and practices of menstrual hygiene management.

Menstruation is a common and normal experience during the reproductive age of adolescent females and if not well managed might expose the female to menstrual distress. To determine the menstrual hygiene management practices and menstrual distress among adolescent secondary school girls. Six hundred participants randomly drawn participated in the study. A structured questionnaire which had two inventories was used to collect data. The first inventory was a self-developed Menstrual Hygiene Management Practices Questionnaire (MHMPQ) (r = 0.71) and the second one was a modified 11-item Menstrual Distress Scale (MDS) (r = 0.74). Data were analyzed using descriptive and inferential statistics. Results showed that menstrual hygiene management practices of the girls were poor and they were very highly distressed. Statistically significant differences were observed in menstrual hygiene management practices among the girls with regard to age, location of residence and occupation of mother and on menstrual distress in relation to occupation of father (p < 0.05). Significant positive relationship between menstrual hygiene management practices and menstrual distress was observed. The findings accentuate the need for a caring atmosphere for menstrual sanitation both at home and in school.

IntroductionEven though menstruation is a normal biological process, adolescents are facing managing their menstruation when they are at school. It causes girls to miss their class on average three days every month. Studies in some countries showed that the magnitude of menstrual hygiene management problems is higher in rural adolescent girls, but little is known in the Ethiopia context. The objective of this study was to assess and compare menstrual hygiene management practices among rural and urban schoolgirls, Northeast, Ethiopia.MethodsAn institution-based comparative cross-sectional study was employed among 1078 schoolgirls (539 urban and 539 rural) from February to March 2020. The participants were selected using a multi-stage sampling technique. A structured self-administrative questionnaire and observational checklist were used for data collection. Bivariate and multivariable logistic regression analysis with a 95% confidence interval was employed. A P- value less than 0.05 was used to declare statistical significance.ResultsOverall, the magnitude of good menstrual hygiene practice was 52.9% (95%CI: 50.3%-56.5%), which was 65.9% (95% CI: 62.8%-70.7%) among urban and 39.9% (95% CI: 36.2%-44.6%) among rural schoolgirls. Among urban schoolgirls, the odds of good menstrual hygiene management practice was higher for girls aged below 18 years (AOR = 1.58, 95%CI: 1.05–2.39), learned about menstrual hygiene at school (AOR = 1.89, 95%CI: 1.21–2.97), heard about menstrual hygiene before menarche (AOR = 4.98, 95%CI: 2.71–9.13), and discussed menstrual hygiene with parents (AOR = 2.56, 95%CI: 1.25–5.27). Whereas, the odds of good menstrual hygiene management practice was higher among those who were knowledgeable on menstrual hygiene (AOR = 5.47, 95%CI: 3.68–8.12), those who learned about menstrual hygiene at school (AOR = 1.75, 95%CI: 1.13–2.70), and girls who heard about menstrual hygiene before menarche (AOR = 3.34, 95%CI: 1.44–7.76) in rural schoolgirls.ConclusionsThough the overall menstrual hygiene practice was low, it was relatively better among urban schoolgirls. This calls for more effort to solve these problems and achieve sustainable development goals. Therefore, education and awareness creation on menstrual hygiene for schoolgirls, even before menarche at both settings should be strengthened. Encouraging parent-adolescent discussion on menstrual hygiene would have paramount importance, particularly to urban schoolgirls.

The study aimed at examining menstrual hygiene management practices among adolescent girls in public secondary schools in Kibondo District. The study used the mixed research approach with the convergent parallel design. The study was comprised of the sample size of 99 respondents from four out of 17 schools, including ten parents, 12 female teachers, 68 students, 4 matrons, 4 Heads of schools and 1 District Education Officer. Data collection was done through semi-structured interview, focus group discussion and questionnaire. Qualitative data analysis was done through content analysis while quantitative data were analyzed descriptively with the help of the Statistical Package for Social Science (SPSS) version 20 and presented in tables through percentages, and frequencies. The study discovered that there are problems in MHM practices among public secondary schools under investigation. There were shortages of menstrual hygiene management practice facilities such as toilets and private areas to change absorbent pads, disposable mechanisms and water. The study recommended that adolescent girls should be provided with sanitary pads and education. There is need to improve MHM facilities such as water, disposable mechanisms and private rooms for changing absorbent materials for effective management of menstrual periods. Menstrual hygiene management topics should be integrated into the syllabi in order to increase awareness on MHM to adolescent girls. Teachers and health workers should closely provide guidance and health talks to adolescent girls, advising them on how to manage their menstrual-related illness effectively for their good performance in school.

Background: Adolescent girls in developing countries may lack appropriate information, meansor materials, and access to the right sanitary facilities to manage menstruation. Hence, they haveadopted unsafe hygienic practices during menstruation that in turn have a negative impact ontheir health and education. Aim: Thus, this study aimed to assess the pattern and practices ofmenstrual hygiene and its associated factors among secondary school girls in Ogbomoso.Methodology: A school-based cross-sectional study was conducted in February 2022 amongsecondary school girls. A total of 460 girls were selected randomly and interviewed using astructured interviewer-administered questionnaire. Logistic regression analysis was employed toidentify predictors of good menstrual hygiene management practices. Results: Overall, 76.3% ofthe girls had satisfactory menstrual hygiene management practices. (88%) of them usedcommercial sanitary pads as absorbent, 56.4% changed sanitary materials more than three timesa day, 22% of them experienced restrictions and 68.3% cleaned their external genitalia dailyduring their menstruation. 37.1% of the respondents reused the absorbent material and 86.8 usedsoap and water to wash the absorbent material being reused, while 58.9% dried the absorbentmaterials indoors. 51% of the respondents change the absorbent material thrice a day and above70% change in the bathroom. The majority of the respondents disposed of the absorbentmaterial by burning (64.8%) while 27.9% disposed of the materials in the toilet. Conclusion: Inthis study, the practice of proper menstrual hygiene management of secondary schoolgirls wasquite satisfactory when compared with findings in previous studies in the same geographicalarea. The majority of the respondents had mothers with tertiary education and these motherswere mainly responsible for the provision of information about menstruation and its hygienemanagement. Hence, it is important to state that the role of mothers, their level of education andthe information about menstrual hygiene cannot be overemphasized as it pertains to knowledgeof menstruation and the practice of menstrual hygiene.

ObjectivesThe primary objective was to describe Ugandan schoolgirls’ menstrual hygiene management (MHM) practices and estimate the prevalence of inadequate MHM. Second, to assess the relative contribution of aspects of MHM...

<i>Background</i>: In adolescents who experienced menstruation for the first time, menstrual hygiene management is constrained by practical, social, economic, and cultural factors such as the expense of commercial sanitary pads, lack of water and latrine facilities, lack of private rooms for changing sanitary pads, and limited education about the facts of menstrual hygiene. Therefore the Objective of this study is to menstrual hygiene management practices and associated factors among primary second-cycle female students in Boset district of east Shoa zone, Oromia regional state, central Ethiopia from March 28, 2022, to April 28, 2022. Methods: School-based cross-sectional study was conducted by multistage random sampling technique among 629 female students from the Primary second cycle. Data were collected using Self-administered pre-tested and semi-structured questionnaires. The data were coded, checked for completeness, entered into Epi-Info-7, and then exported to SPSS Version 22 for analysis. Bivariate and multivariate logistic regression with Crude and adjusted odds ratios with 95% CI was calculated, and p-values <0.05 was considered to indicate statistical significance. <i>Results</i>: The overall proportion of good menstrual hygiene management practices account for 51.2% (95% CI: 47.4–55.3). This study found that: being urban residence [AOR]: 1.84, 95% CI: (1.20, 2.80)], secondary and above the educational status of mothers [AOR]: 3.399, 95% CI: (2.07,5.57)], receiving pocket money for modes [AOR]: 2.19, 95% CI: (1.45,3.313)], freely discussing menstruation with parents [AOR]: 3.65, 95% CI: (2.327,5.727)], learning in school about menstrual hygiene [AOR]: 3.12, 95% CI: (2.096,4.628)], presence of water supply in school compound [AOR]: 1.71, 95% CI: (1.15,2.53)] and presence of functional toilets and hand washing facilities [AOR]: 1.789, 95% CI: (1.17,2.73] were significant predictors of Menstrual Hygiene Management Practices. Conclusion: In this study, the practice of good menstrual hygiene management among primary second-cycle school girls was low. Factors independently influencing menstrual hygiene management practices were girls’ place of residence, mothers’ educational status, pocket money, discussions with parents, water supplies, functional toilets, and hand washing facilities. Hence students’ parents should give pocket money and freely discuss with their female students and also government and other stakeholders should take action to improve and sustain water supply, functional toilets, and hand washing facilities for schools.

Introductionthe issue of menstrual hygiene is inadequately acknowledged and efforts to address the gaps has been unsatisfactory. Hygienic menstrual practice such as the use of sanitary pads is crucial during menstruation. Lack of sanitation facilities, especially for school girls, makes them vulnerable to emotional and physical challenges during their menstrual days. This study sought to investigate menstrual hygiene management among adolescent girls in junior high schools in rural northern Ghana.Methods: a school-based cross-sectional study design was used. Multistage sampling technique was employed to select 730 school girls who had attained their menarche. Menstrual hygiene management was rated using the Selvi and Ramachandran scale. Bivariate analysis was conducted to compare good and poor menstrual hygiene management. The data were analyzed using STATA version 13.1.Resultsthe prevalence of good menstrual hygiene was 61.4%. Mothers' education and parents' socio-economic status were significantly associated with menstrual hygiene management. Inadequate sanitation facilities was a major challenge to menstrual hygiene management at schools. The use of sanitary pads was significantly associated with school attendance (p-value < 0.0001).Conclusionthe level of menstrual hygiene among in-school adolescent girls in northern Ghana is described as average. Although most of the schools had toilet facilities, they lacked clean water, soap, privacy and dustbins which are necessary for menstrual hygiene management. Interventions should target improving water, sanitation and hygiene facilities in schools as well as supply of pads to girls in rural school.

Background The transition from childhood to adolescence is a critical transitional period for girls, and as they experience these changes, having knowledge of, and being able to practice, good menstruation hygiene management is crucial. The objective of this study was to understand in and out of school adolescents’ menstrual hygiene management practice, sources of information and attitudes towards menstruation. Methods A cross sectional, descriptive study was conducted between November 2018 and May 2019. The sampling included adolescent girls aged 11–19 years in higher secondary schools in Khammouane and Champassak provinces and out-of-school adolescent girls. Out of the total number of 433 participants enrolled in the study, only 343 girls had reached menarche and were included in the study. Factors associated with menstruation hygiene management practice were examined with bivariate and multivariate analyses. Results Out of 343 subjects who had reached menarche, 44% reported good menstrual hygiene management practice. Over half of the participants, however, were unable to access the tools of good menstruation hygiene management practice, including having somewhere to dispose of used sanitary pads in private. Being older (16–19 years) (AOR:2.4; 95%CI 1.4 to 3.9), and having primary education (AOR 0.4; 95%CI 0.2 to 0.9) were associated with good practice as was fathers’ level of education (AOR 2.1; 95%CI 1.0 to 4.1) and mother-girl discussion about menstruation (AOR 2.2; 95%CI 1.0 to 5.0). No significant differences were found between in- and out-of-school adolescents. Conclusions In this study, not all participants were able to practice optimal menstruation hygiene management. This is important as good menstrual hygiene management is associated with better health and being able to participate fully in education and work. Further education is needed, but it is also important to ensure that all adolescent girls have access to the necessary tools for effective menstruation hygiene management.

&#x0D; &#x0D; &#x0D; INTRODUCTION: Adolescence in girls has been recognized as a special period that signifies the transition from girlhood to womanhood. This study was conducted to assess the determinants of menstrual hygiene practices among in-school adolescent girls in private and public secondary schools in Osun State, Nigeria.&#x0D; METHODS: A descriptive, cross-sectional study (comparative) involving 650 in-school secondary students (public and private), were selected via multistage stratified sampling technique, using a self-administered structured questionnaire. Relevant data was collected via a semi-structured questionnaire and analyzed using SPSS 23.0. Appropriate univariate analysis using frequency tables and charts, while bivariate analysis was done using a chi-square table. Multivariate analysis was done using logistics regression.&#x0D; RESULTS: The modal age range was middle adolescence (14-16 years old). There was a statistically significant difference between public and private school respondents in terms of age menarche: More students in private schools (81.8%) had their menarche before the age of 13 compared to those in public schools (73.2%). More respondents in private secondary schools (67.1%) have good menstrual hygiene practices compared to their counterparts (55.4%). Almost all the respondents in public secondary schools and private secondary schools have good management on menstruation Multivariate analysis, more of the respondents in junior classes among public school respondents were approximately two times less likely (1/0.506 = 1.97) to have good hygiene practice compared to their counterparts.&#x0D; CONCLUSION: Based on the findings in this study, it could be concluded that more of the respondents in private secondary schools had good hygiene practices compared to their counterparts. Hence, the need for all stakeholders to intensify efforts to provide accurate and adequate information as well as enable the environment to promote menstrual hygiene practices among in-school adolescent girls.&#x0D; &#x0D; &#x0D;

BackgroundDespite 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.MethodsFrom 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.ResultThis 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.ConclusionNearly 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.

Introduction: Every year, different batches of adolescent girls between the ages of 10-19 years experience menarche often unprepared to manage the menstruation hygienically. In Ghana, most girls enter adolescence when they are in basic schools, which make menstrual hygiene among girls in Junior High Schools very important. This study examined the knowledge, attitudes, and practices of menstrual hygiene management among both premenarcheal and post-menarcheal adolescent students in basic schoolsin the Yendi Municipality in Ghana. Methods: the study was cross sectional and used quantitative research methods. Semi-structured questionnaires were used to collect data from the female adolescent students aged 10-19 years. A total of 412 female adolescents from 9 basic schools in the Yendi Municipality participated in the study. Students were scored for their level of knowledge, attitude and practices of menstrual hygiene management. Results: The study found that although awareness of menstruation was universal, the Likert scores showed that 67.5% had adequate knowledge of menstrual hygiene management. About a tenth (13.6%) of the adolescent female students had a positive attitude towards menstrual hygiene management and a third (31.1%) practised good menstrual hygiene management. Older age and living with both parents were the main predictors of knowledge of menstrual hygiene management (P < 0.05). Similarly, age, staying with both parents, staying with mother only, access to funds and having adequate knowledge of menstruation were the main determinants of good menstrual hygiene management practice among adolescent girls in basic schools in Yendi Municipality (P < 0.05). Conclusions and recommendations: more than half of the respondents have adequate knowledge but their awareness and knowledge did not translate to positive attitude towards good menstrual hygiene management practices due to negative socio-cultural norms and practices among others that tend to stigmatise menstruation.

IntroductionAdolescence is a critical period characterized by significant physical, emotional, cognitive, and social changes, including the monthly occurrence of menstruation of adolescent girls. Despite being an inevitable natural event, most societies consider menstruation and menstrual blood as taboos and impure. Such consideration prevents many adolescent girls from proper health education and information related to menstrual health, which forces them to develop their ways of managing the event. This study attempted to explore the pattern, the urban–rural differences, and the determinants of menstrual hygiene management practices (MHMP) among adolescent girls in the Rajshahi division, Bangladesh.MethodologyUsing a cross-sectional study design with multistage random sampling, we collected data from 586 adolescent girls (aged 14–19 years) from the Rajshahi division of Bangladesh. The MHMP was measured using eight binary items, where the value from zero to five as ‘bad,’ six as ‘fair,’ and seven-eight as ‘good’ practices. Finally, we employed bivariate analysis and multinomial logistic regression analysis.FindingsOnly 37.7% continuously used sanitary pads. Among the cloth users, nearly three-fourths reused cloths, and about 57% used water and soap to wash them. About 49% changed menstrual absorbent, and 44% washed their genitalia three times daily. About 41% used water only to wash genitalia, and 55% buried sanitary materials under the soil. Around 36.9% of the girls practiced bad, 33.4% fair, and 29.7% good menstrual management. We found significant differences in MHMP among adolescent girls between urban and rural areas (32.3% vs. 27.7% good users, p ≤ 0.05). Multinomial logistic regression found that place of residence, age, family size, parental education, and age at first menstruation were the significant determinants of MHMP.ConclusionAlthough there are some cases of sanitary pad use, still menstrual hygiene management is unhealthy in most cases. The continuous supply of sanitary pads at affordable cost, change in existing social norms about menstruation, proper education, information, and services are essential for achieving health-related SDG goals in both rural and urban areas of Bangladesh.