Menstrual hygiene management practices among rural females: findings from a rural health demographic environmental surveillance system (HDESS) cohort in Odisha, Eastern India

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

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...

BackgroundAdolescent girls should practice good menstrual hygiene to enhance their health and educational attainment. However, socio-cultural restrictions and limited water, sanitation, and hygiene in school environments continued to make it difficult for in school adolescent females to practice good menstrual hygiene management. So, the main aim of this study was to assess menstrual hygiene management practice and its associated factors among in-school adolescent girls in the secondary schools of Gimbi town, western Ethiopia.MethodsA school-based cross-sectional study was conducted among 378 adolescent girls in Gimbi town secondary schools. The study participants were selected by using stratified random sampling techniques. Pretested self-administered Afan Oromo questionnaire with sociodemographic characteristics, information and knowledge about menstruation, and practice of menstrual hygiene management, as well as observational checklist to assess school environment were used to collect the data. Data were cleaned, coded, and entered into Epi-info version 7.2.0.4 and exported to SPSS version 25 for statistical analysis. Multivariable logistic regression analysis was used to identify factors associated with the practice of menstrual hygiene management and P-values less than 0.05 was used to declare statistical significance.ResultsOut of 378 respondents, 163 (43.1%) (38–48) of adolescent girls had good menstrual hygiene management practice. Being urban resident (AOR = 3.48, (95% C.I:1.99–6.08), having mother with secondary level of education (AOR = 2.71, 95%CI: 1.15,6.42), having mother with educational level of college and above (AOR = 3.30, 95%CI1.28,8.50), having discussion about menstruation with parents (AOR = 2.42,95%CI:1.45,4.04), and having knowledge about menstruation (AOR = 2.94, 95% CI: 1.69–5.13) were factors associated with good menstrual hygiene management practice.ConclusionIn this study, good menstrual hygiene management practice is low among in school adolescent girls. Place of residence, maternal educational level, discussion about menstrual issue with parent, and having knowledge about menstruation were factors associated with good menstrual management practice. Stakeholders should give appropriate awareness and health education related to menstrual hygiene for adolescent girls at all levels.

Background: This study aimed to assess the association between menstrual hygiene management (MHM) practices and symptoms of lower reproductive tract infections (LRTIs) among women aged 15–49 who use either sanitary pads or cloth, attending selected family health centers in Karachi. Methodology: An analytical cross-sectional study was conducted from October 2022 to June 2023, involving 487 women aged 15–49. Data on sociodemographic, MHM practices, and LRTI symptoms were collected using a structured questionnaire. Nonrandom, purposive sampling was used to recruit participants from 12 family health centers in Karachi. Results: The majority of participants (75.4%) were aged 25–49 years, with 51.0% using cloth and 49.0% using sanitary pads. Overall, 49.9% reported using appropriate MHM materials, including sanitary pads. Sanitary pad users were 0.644 times less likely to report LRTI symptoms (95% CI: 0.447–0.929; p = 0.018). Additionally, those who changed pads or cloth after more than eight hours were 2.008 times more likely to develop LRTI symptoms (95% CI: 1.335–3.005). Other factors such as prolonged menstrual blood flow, frequency of material change, bathing practices, and use of underwear during menstruation were associated with LRTIs. Conclusion: The study underscores that 49.9% of participants reported using appropriate MHM materials, with sanitary pad use being protective against LRTIs. The findings emphasize the role of hygiene practices, including material type, change frequency, bathing, and underwear use, in mitigating LRTIs among women of reproductive age.

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.

BackgroundAdolescent girls' right to achieve menstrual health and hygiene management (MHHM) healthfully is yet to be realized. One reason is the lack of practical guidance on the procurement, use, and disposal of menstrual products. This study defined interpersonal practical guidance (IPG) as face-to-face communication and mediated practical guidance (MPG) as social and behavior change communication (SBCC) intervention-driven communications through print and media materials. We examine the impact of these two delivery mechanisms of practical guidance on adolescent MHHM knowledge, attitudes, and practices (KAP) following an SBCC intervention in India.ObjectivesTo understand how IPG and SBCC-driven MPG independently influence adolescent girls’ KAP on the procurement, use, and disposal of menstrual products and whether those who receive both IPG and MPG have better KAP related to the procurement, use, and disposal of menstrual cloth or sanitary pads than those who receive only one form of practical guidance or none at all.MethodsAdolescent girls' questionnaire responses from GARIMA's case-comparison evaluation were analyzed using Stata/SE 17 (n = 2,384). Girls were matched on sociodemographic and socioeconomic variables. χ2 analysis examined relationships between sociodemographic, practical guidance, and KAP variables. Multivariate logistic regression assessed associations between practical guidance and KAP variables.ResultsThere are significant associations between adolescent girls' KAP depending on whether they received IPG, SBCC-driven MPG, or both. IPG and MPG delivered together has greater odds of predicting correct menstrual management KAP than when delivered separately. These effects were most notable for adolescent girls' knowledge and practices related to using and disposing of menstrual hygiene products.ConclusionThere is urgent need to create positive, sustainable changes to address menstrual health and hygiene management. This study introduces an innovative approach that utilizes interpersonal and mediated communication as mechanisms to deliver practical guidance on menstrual management. Future interventions should implement and evaluate to better understand the role of practical guidance in ensuring all women and girls are prepared to confidently manage their menstrual health.

<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.

BackgroundIn low- and middle-income countries (LMICs), women often use inappropriate materials to manage menstruation, which can threaten their health. Improper practices can also have critical downstream consequences beyond physiologic health, including restricting adolescent girls’ access to academic pursuits.MethodsWe used cross-sectional data collected through a structured questionnaire from the menstruating adolescents and young women 15-23 years of age living in rural Pakistan (n = 25 305). We aimed to describe menstrual hygiene management (MHM) practices and generate a predictive model of the socioeconomic and demographic factors related to the use of MHM materials. Beliefs and barriers around MHM were also summarized. The outcome variable included: those who practiced appropriate and inappropriate MHM practices. Logistic regression was used to generate the predictive model, with results presented as odds ratios (OR) and 95% confidence interval (CI).ResultsInappropriate MHM practices were reported by 75% (n = 19 006) of participants. The majority 61.9% (n = 15 667) reported using old cloths, 12.6% (n = 3191) used nothing, and 0.5% (n = 136) used old cloth with a sanitary pad. One-fourth of participants reported appropriate MHM material use, including 16.2% (n = 4087) sanitary pads, 8.6% (n = 2167) new cloth, and a few reported using sanitary pads with new cloth 0.2% (n = 45). Inappropriate MHM practices were more common in lowest wealth quintile (OR = 4.41; 95% CI = 2.77-7.01, P < 0.0001), followed by those with no education (OR = 3.9; 95% CI = 3.36-4.52, P < 0.0001).ConclusionsThe study indicates the need for multi-sectoral efforts to introduce MHM-specific and MHM-sensitive interventions to improve MHM practices, ranging from the availability of low-cost MHM materials to the inclusion of MHM education in school curriculums and within the community platforms.

Background: A two-generation study on menstrual health and hygiene practices among daughters and their mothers is limited. In this study, the primary objective was to compare menstrual health practices, period poverty and menstrual hygiene practices between female college students and their mothers. Methods: A community-based cross-sectional study was conducted among 500 female college students (mean age 19 years) and their mothers (n=500, mean age 41 years) in the Thoothukudi district. Five colleges were selected from the twenty colleges in the district using simple random sampling. From the list of students from the selected colleges, female students were selected using computer-generated random numbers and the mothers of all the selected students were included in the study. Information on menstrual health, period poverty and menstrual hygiene was collected using a pre-tested structured interview schedule. Results: Among daughters, 80.4% speak about menstrual pain more than mothers 44% (p&lt;0.001). Of the daughters, 46.2% and 19.8% of the mothers had information about menstruation before menarche (p&lt;0.001). Among daughters 63% and among mothers 30.2% are embarrassed about buying period products (p&lt;0.001). Sanitary pad use among daughters was 93.2% compared to 69.9% among mothers (p=0.001). Using cloth as their menstrual product was reported by 21.8% of daughters and 50.4% of mothers (p=0.001). Conclusions: During menstruation, daughters reported better hygiene practices than their mothers. However, some of the daughters still use clothes as menstrual material, which needs improvement.

Background: Menstrual Hygiene Management is the management of hygiene and health when women experience menstruation. UNICEF research results state that 46% of young women in Indonesia change sanitary napkins less than 2 times a day, whereas in theory changing sanitary napkins is at least 3-4 hours a day. Use for more than 8 hours causes genital irritation and itching which will have an impact on health. The purpose of this study was to determine the practice of menstrual hygiene management in high schools in Magelang.Methods: This research was conducted in 5 public high schools in Magelang. This research method is a mixed methods design. explanatory The research was conducted by collecting quantitative data then qualitative data. The study population was all high school students in Magelang City with a total of 267 respondents.Results: The results showed that there was a relationship between the peer support variable (p-value 0,000), the role of the teacher (p-value 0.002), and facilities (p-value 0.003) with menstrual health management practicesConclusion: conclusions and implications for midwifery and nursing practiceAll sections in The peer support variable (p value 0.001) had the most influence on menstrual hygiene management. It is hoped that midwives can contribute in providing health education on Menstrual Hygiene Management (MKM) in cross-sectoral collaboration with the Education Office

India has the highest proportion of adolescents and the highest adolescent pregnancy and childbirth rate in the tribal segment of the population. Very few studies have focused on the use of sanitary pad and quality of health care as menstrual hygiene practices.The data was collected among ‘Bharia’ women who identified as one of the particularly vulnerable tribal groups (PVTGs) in Madhya Pradesh. Towards comparing the use, source, and components of menstrual hygiene practices among adolescents and adult mothers, the sample included adolescent (10-19 years) and adult women 20-49 years of age. The relevant information was collected by trained female investigator with designed questionnaire from the respondents.Findings revealed that only 22.7% women are using sanitary pad during menstruation period in the studied tribe. It was seen the use of this absorbent (sanitary pad) for menstrual hygiene among the adolescents were found significantly higher (37.5%) than that of adult women (14.3%), whereas, the use of old cotton was found significantly higher (78.6%) among adult women. Awareness on menstrual hygiene about 50% adolescents and 64% adult women believed it is a curse of God. About 25% adolescents and 21.4% adult women believed menstruation is a natural process.The tribe has underprivileged menstrual hygiene practices owing to low awareness, illiteracy, and poverty. The special IEC education campaign with suitable strategy can be forced to optimum hygiene practices.

The issue of menstrual health has gained significant traction in recent years as a fundamental aspect of public health, with significant relevance in low- and middle-income countries (LMIC) [1]. Research, practice, and policy addressing menstrual hygiene management (MHM) engages a growing number of actors, including researchers, practitioners, donors, policy makers, social entrepreneurs, national governments, advocates, and civil society. Globally, these actors work to address the social, environmental, and political factors that reinforce menstruation-related challenges experienced by girls and women in varying contexts. To date, the largest body of evidence in the space collectively referred to here as menstrual health and hygiene (MHH) originates from descriptive qualitative and quantitative studies among girls in school, exploring the barriers they face with the onset of menstruation [2,3]. These challenges often reflect the insufficient education and guidance girls receive prior to their first menstrual period (menarche) from their families, communities or the education system. Other barriers are tied to the on-going stigma and taboos relating to menstruation that reinforce the need for secrecy and silence on menstrual management and enforce behavioral restrictions around (1) sleeping arrangements, (2) engaging in prayers or household chores, and (3) school participation. Additionally, inadequate access to clean and safe toilets with water, lacking disposal mechanisms for used menstrual materials, and inadequate menstrual products and related supplies, such as underwear, leave girls with limited agency to manage their menstrual periods [3]. In recent years, additional evidence has emerged from pilot intervention trials conducted with schoolgirls that have assessed the impact of the delivery of menstrual products and information on sexual and reproductive health outcomes, and educational performance [4,5]. There is an urgent need to rigorously assess the impact of the many MHH interventions currently being deployed in numerous LMIC. Another emerging area is humanitarian contexts, with researchers and practitioners focusing on the MHH needs of the over 30 million internally displaced and refugee girls and women around the world, and how to more effectively deliver holistic MHH solutions in such contexts [6]. Additional MHH learnings are needed in countries and contexts where the menstruation-related challenges facing girls have not yet been explored, and although some studies have included the MHH needs of out of school girls [7] and girls with disabilities [8], these are areas in need of additional exploration.

ABSTRACTBACKGROUND: Menstrual hygiene management (MHM) practice varies greatly from country to country, and within the countries. Ethiopia has adopted youth friendly reproductive health and sexual health services to improve the health of young people including adolescents. Credible evidence on MHM practice at community level after adoption of youth friendly service is limited.OBJECTIVE: The aim of the study was to assess MHM practice among adolescent girls in urban and rural areas.METHODS: A community based comparative cross-sectional study design was employed in urban and rural kebeles of Bahir Dar city administration. Multi-stage stratified random sampling technique was used to select the study participants. Data were entered in to SPSS version 16. Descriptive statistics were used to describe data. Multivariable logistic regression analysis was used to identify the predictors of good menstrual hygiene practice.RESULTS: Safe MHM practice was 24.5% and did not show significant variation between urban and rural adolescent girls. However, significantly higher numbers of adolescent girls in the urban area used sanitary pads than the rural adolescent girls. Being older, attending formal education and educational status of participants’ mother were factors associated with safe MHM practice.KEYWORDS: menstrual, hygiene, practice, adolescent, girls, Ethiopia(Ethiopian Journal of Reproductive Health; 2018; 10; 4: 10-20)

Period Poverty in Public Schools: A Neglected Issue in Adolescent Health

Menstrual hygiene and sanitation practices embodies the importance of menstrual hygiene and sanitation for the health and well-being of individuals who menstruate. Inadequate menstrual hygiene management can lead to health issues, social stigma, and absenteeism from work or school. The objective of this study is to examine the menstrual hygiene and sanitation practices to the help of supportive requirements of campus level girls students. Using quantitative and descriptive methods, the study surveyed 340 out of 2,294 bachelor-level female students at Surkhet Multiple Campus, selected through sample random sampling. Closed ended questionnaire was the tool of this study. The findings emphasize that menstrual hygiene and sanitation practices, along with supportive requirements, are crucial for enhancing menstrual health and overall well-being. When the symptoms of menstruation appear, the majority of respondents (91%) carry a menstrual pad, indicating that they are aware of their menstrual management and also (88%) claimed that both reusable cloth pad and sanitary pad is used for their menstrual hygiene management.