Menstrual Hygiene Management Research Articles

Tuloni Biya and its impact on menstrual health: A qualitative exploration of the menstrual experiences of adolescent girls in Assam

AbstractMotivationThe status of menstrual health (MH) and hygiene management is very low in India due to a widespread culture of silence and secrecy regarding menstruation but, among the Hindu community in the north‐east state of Assam, the celebration of Tuloni Biya is a significant cultural event that openly celebrates a girl's menarche.PurposeAssuming that this cultural event is indicative of the openness of society towards menstruation, this study explores the cultural celebration of menarche and its various lesser‐known details. It aims to find out the role of this celebration of menarche on adolescent girls' MH preparedness.Methods and approachA qualitative approach is used. In‐depth interviews were conducted with well‐informed community members to gather information on the historical background of this cultural event; interviews with some adolescent girls from the community to learn about their experiences of menstrual management and the impact of Tuloni Biya.FindingsThe main purpose of celebrating Tuloni Biya among the Assamese Hindu community is to announce when a girl reaches puberty because the celebration of the power of fertility gives girls and women the social status of being fertile, which the community regards as worthy of respect. Notwithstanding the lack of silence and secrecy about menstruation, the social taboo and stigma still remain. Assam continues to perform poorly in relation to MH, and the cultural celebration of menarche in Assam does not appear to have any significantly positive impact in this regard.Policy implicationsTuloni Biya could be used as a development tool for bringing constructive changes in MH preparedness in the community, for instance, by celebrating Tuloni Biya (cultural customs and rituals) and the celebration of menstruation (MH education and literacy); through knowledge‐sharing sessions by teachers on the occasion of Tuloni Biya; arranging the gifts of kits for MH management from the Health Ministry of Assam on the occasion of Tuloni Biya; training of mothers by the public health system in how to use the opportunity of Tuloni Biya to equip their daughters with adequate information and guidance on MH.

Behaviors and practices of incarcerated women towards menstrual hygiene in a large urban prison in Uganda: a phenomenological qualitative study

BackgroundDeplorable and unconducive conditions in prisons present serious challenges to menstrual hygiene management. However, little is known about menstrual hygiene among incarcerated women in Uganda. Our study explored the behaviors and practices of incarcerated women regarding menstrual hygiene management in a large government prison in Uganda. In addition, we explored the barriers to menstrual hygiene management in this population.MethodsIn this phenomenological qualitative study, we conducted in-depth interviews with incarcerated women aged 20–49 years and key informant interviews with female prison officers (wardresses) at Luzira Prison in Kampala, Uganda. The data were analyzed using content analysis and the findings were presented using themes/sub-themes along with participant quotes.ResultsWe interviewed 15 incarcerated women aged 20–49 years (mean age, 29.5 ± 8.7 years) and five key informants aged 30–50 years (mean, 42.6 ± 4.9) about menstrual hygiene behaviors and practices, including barriers to menstrual hygiene. Five sub-themes emerged concerning behaviors and practices of menstrual hygiene among incarcerated women. Findings reveal the behaviors and practices of menstrual hygiene management were characterized by infrequent change of menstrual pads, lack of privacy during menstrual hygiene practices, use of poor-quality menstrual hygiene materials, and improper disposal of used sanitary products. However, bathing with soap and water during menstruation was frequent and non-restricted. Three sub-themes emerged as barriers to menstrual hygiene practices, largely at the institutional level, and they included unhygienic sanitary facilities, unreliable access to clean water, and insufficient sanitary products.ConclusionsBehaviors and practices of incarcerated women fall short of desired standards and they face several barriers to practicing menstrual hygiene. The prison authorities should provide sufficient sanitary products like pads, and knickers including soap, construct more sanitary facilities, educate about the safe disposal of used sanitary products, and provide sufficient clean water to promote good menstrual hygiene management among incarcerated women.

(054) Appropriate Solutions to Reusable Sanitary Products in Uganda

Abstract Introduction Menstrual hygiene management (MHM) is an under-recognized topic in low resource, rural environments such as Uganda due to cultural taboos, access, lack of education, and sanitation issues. Poor MHM practices have been linked to higher absenteeism rates for young girls at school and greater stress and anxiety surrounding changing the menstrual products. This issue is prevalent in Uganda, where high rates of vaginal infections appear to be linked to poor MHM. Objectives This study aimed to create and test prototypes of menstrual products using locally available Ugandan materials. Products aimed to be comfortable, easy to wash, and easy to replicate for local Ugandan women. Methods This study is a multi-phase project consisting of three phases. Prototype development. After conducting a thorough literature review of 35 articles on reusable products already available and the success of their implementation in our population of interest, three prototypes were created using locally available Ugandan materials. The materials included Ankara fabric, gauze, cotton, and snaps; due to the accessibility and affordability. Testing of prototypes with college students. Students will receive a menstrual hygiene kit of materials to test during their next menstrual cycle. Participants will reveal their experiences with the product during a focus group discussion. The purpose of this phase is to test the product and get feedback for improvement before sending the items to Uganda, where women will be trained in creating, marketing, and distributing the product after a similar product testing locally. Assessing attitudes and experiences of reusable menstrual products. Due to the impact of the current pandemic and limitations on assessing local Ugandan women, this phase will use college students to provide some baseline information before adapting the tool for the Ugandan community. An anonymous survey will be distributed online to college students that focuses closely on participants' general knowledge surrounding menstruation, personal perceptions regarding menstrual hygiene management, and their various experiences with reusable menstrual products. Results Results of this first phase included the design and testing of three prototypes. The first was a period underwear. The underwear and reusable pad inserts were both constructed out of the traditional Ankara fabric. The absorbent material used within this design was a combination of gauze and cotton. The second included a holder and reusable pad inserts. In this design, the holder mimics many disposable pads' shape, with the wings that wrap around and snap underneath the underwear. The third was an all-in-one product. This design had half circle wings that fold underneath the underwear and snap to hold the pad in place. The circular design provides privacy and discreteness when hanging outside on a wash line. Conclusions Reusable menstrual products have proven effective at improving young girls' lives, reducing infection rates, and contributing to a woman's self- esteem. The prototypes created and tested will be sent to women in Uganda to be recreated and distributed. Through the training and education of correct use of the product, we hope to decrease vaginal infection rates as women learn the importance of maintaining MHM and gain better access to discrete products. Disclosure No.

Modern, Empowered, but Stigmatized: Analyzing the Construction of Menstrual Cups as Feminist Technologies

Menstrual products have long shaped how women manage their menstruating bodies and how menstruation is socially constructed. Historically, these products have simultaneously promoted messages of shame—menstruation is dirty and requires concealment—and modernity or have linked their use to overcoming the constraints of menstruation to become modern and liberated. In this article, which analyzes the websites of companies that produce menstrual cups (an insertable, reusable menstrual technology), I identify a new use of this “modern” discourse that emphasizes the interrelationship between “modern women” and female empowerment. Notions of modernity are connected to depictions of menstrual cups as modern technologies that invoke modern ideologies and promote living a modern lifestyle—all conceptions of modernity that seek to empower women in their menstrual health and wider lives. Although these intertwined discourses of modernity and empowerment reflect those of feminist menstrual activists, menstrual stigmas often remain embedded within these messages. Analyzing the persistent intermixing of these contrasting discourses allows for expanding the theories of feminist technologies to consider how technologies may benefit, empower, and destabilize patriarchal systems in subtle and diverse ways.

The Financial Cost of Managing Menstrual Hygiene in Schools in the Health District of Bla in Mali

Introduction: Many women and girls face financial challenges in meeting their menstrual hygiene management needs. The main objective of this study is to estimate the financial cost of menstrual hygiene management among school-going girls. Methodology: This is a prospective study carried out in a semi-urban school environment at the Public High School in the health district of Bla in 2020. Results: This study was conducted among 125 high school girls with no income. The average age was 18 years old. Parents lived in rural areas with no fixed monthly income in 52% of cases. Multipurpose pieces of cloth were the protective material used in 67% of cases. The girls explained this choice in 100% of cases by the high cost of single pads and tampons. The average monthly cost of menstrual hygiene management was 0, 56 $ or 6, 67 $ per year with extremes of 0, 16 and 2, 45 $ per month. This amount was used to buy either single-use pads or soap for body care and multiple-use pads. This financial cost was covered at 92% by female support (mother, aunt, sister); male support (father, spouse) accounted for only 8%. Conclusion: This study made it possible to estimate the average annual financial cost of menstrual hygiene management among young school girls in Bla. These findings call for further studies to better understand the financial implications of menstrual hygiene management in low-resource settings.

Self-Care Practices and Knowledge on Menstrual Hygiene Management among Adolescent girls

Menstrual hygiene management (MHM) is an essential aspect of hygiene for women and adolescent girls between menarche and menopause. The menstruation cycle is treated as something dirty, impure, and contaminated. Girls and women are alienated from society as well as their friends and families during this time of the month. They are forced into harmful social restrictions and have to face the human condition and humiliation. The objective of the study was to measure the knowledge and self-care practices of adolescents on menstrual hygiene. A mixed method of qualitative and quantitative study designed to access the knowledge attitude and self-care practices, social cultural practices food taboos during menstrual hygiene among 459 adolescent girls of urban area in the Government Schools of Kathmandu Valley from 23, August 2019 to May 29, 2020. Semi-structured open-ended questionnaires along with a Likert scale and in-depth interviews were done among selected 92 students based on scoring of the Likert scale, focusing on socio-cultural practices, food beliefs and practices, and feelings and emotions during menstruation. The interview was accompanied by concurrent note-taking in the Nepali language which was later translated to English. The code book was generated and thematic data analysis was conducted. The result showed that 19.72% of students need improvement in attitude towards menstruation. Menstruation is taken as a secretive and indiscriminate management practice. During menstruation, 83.09 % of students used old and used cloths as absorbent, and 46.5 % disposed of their used pads by throwing them with other waste. Change of pad depending upon their bleeding was practiced by 54.9% of the student. More than half of the students i.e. 60.6% students don’t take a bath every day during their periods. Even though all adolescents have facilities of the toilet but they are still facing the problem of water which, is a great obstacle for them to maintain their menstrual hygiene. Sociocultural rituals of the menstrual cycle are hampering the self-esteem of the girl's student, for which there is a needto focus on interventional study and MHM programs that suitably address the problems of adolescent girls.

Menstrual hygiene management and associated factors among adolescent school girls in gursum district, Eastern Ethiopia: Institution-based a cross-sectional study

BackgroundIn 2017 WHO reported that due to a lack of menstrual hygiene management (MHM) facilities, high costs, and ignorance, 2.3 billion girls and women worldwide do not manage their menstruation properly. This leads to the use of other options, such as old clothes or other unhygienic materials, which may make them a risk group for infections and other health consequences. Despite the significant role of appropriate menstrual hygiene practices, it is still a missed opportunity to address the hygienic practice of menstruation among girls in many low-and middle-income countries, including Ethiopia.ObjectivePrimarily, this study was aimed at investigating menstrual hygiene management (MHM) practice and determinant factors among young adolescent school girls in eastern Ethiopia, Gursum District 2021.MethodAn institutional-based cross-sectional survey was conducted among adolescent school girls in Gursum, Eastern Ethiopia, in 2021. 577 girls participated in this study and a multi-stage sampling procedure was employed so as to select a fair and representative sample of female students who experienced menarche. After controlling for confounding variables, binary logistic regression was fitted to identify factors affecting MHM among adolescent girls.ResultThis study revealed that 58.41% of adolescent school girls practice unsafe MHM practices. It was also reported that 193(33.45%) of the girls use reusable sanitary pads. Of those, 182(31.5%) of them keep the pads in hidden places as it is a shame to be seen Seventy-six (13.17%) of the respondents had experienced vaginal infections during menarche. Having knowledge about menstruation prior to experiencing menstruation [AOR 0.28 CI: (0.1476132, 0.5613692)], being over 15 years old [AOR 1.56, CI: (1.020577, 2.387646)], living in rural areas [AOR 1.23 CI: (1.1563013, 1.3562546)], and having infection around their vagina during menarche [AOR 4.6 CI: (2.633405, 8. 273,883)] were significant determinants of MHM practice.ConclusionThe majority of the adolescent girls who participated in this study practice unsafe MHM practices. Results suggest that school health education focusing on improving the hygienic practices of adolescent girls during menstruation should be provided.

Building a business case for workplace menstrual hygiene management programs: a social cost–benefit analysis

Abstract Inadequate menstrual health and hygiene (MHH) pose a great challenge for working women, affecting their productivity, job satisfaction, attendance, and advancement, and also have implications for their employers. Yet there has been little research to quantify the impacts of poor MHH conditions or to consider the value add of workplace MHH programs. As part of USAID's Water Sanitation and Hygiene Partnerships for Learning and Sustainability project, we conducted a social cost–benefit analysis (CBA) of the Menstrual Hygiene Management (MHM) in the Workplace Action Research, a 10-month intervention in private sector enterprises in Nepal and Kenya. The intervention aimed to determine if providing adequate MHM in the workplace contributes to women's economic empowerment, including improved business and social outcomes. This CBA of a workplace MHM intervention – the first of its kind – found a positive return for investing in workplace MHM programs. The average benefit–cost ratio in the base-case across factories in a 10-month intervention was 1.4, which increased to 2.3 when projected over 24 months. These early results of a pilot CBA on MHM in the workplace should serve as a call for greater attention by governments and businesses to the needs of menstruating women.

Does distribution of menstrual products through community-based, peer-led sexual and reproductive health services increase use of appropriate menstrual products? Findings from the Yathu Yathu trial

BackgroundGlobally, millions of adolescent girls and young women (AGYW) who menstruate have limited access to appropriate and comfortable products to manage their menstruation. Yathu Yathu was a cluster randomised trial (CRT) that estimated the impact of community-based, peer-led sexual and reproductive health (SRH) services on knowledge of HIV status among adolescents and young people aged 15–24 (AYP). Among the services offered through Yathu Yathu were free disposable pads and menstrual cups. This study aimed to investigate whether the availability of free menstrual products through Yathu Yathu increased AGYW’s use of an appropriate menstrual product at their last menstruation and explored the characteristics of AGYW who accessed menstrual products through Yathu Yathu.MethodsYathu Yathu was conducted between 2019 and 2021 in 20 zones across two urban communities of Lusaka, Zambia. Zones were randomly allocated to the intervention or standard-of-care arm. In intervention zones, a community-based hub, staffed by peers, was established to provide SRH services. In 2019, a census was conducted in all zones; all consenting AYP aged 15–24 were given a Yathu Yathu Prevention Points Card, which allowed AYP to accrue points for accessing services at the hub and health facility (intervention arm), or the health facility only (control arm). Points could be exchanged for rewards, thus acting as an incentive in both arms. We conducted a cross-sectional survey in 2021 to estimate the impact of Yathu Yathu on the primary outcome (knowledge of HIV status) and secondary outcomes. Sampling was stratified by sex and age group; we analysed data from AGYW only to estimate the impact of Yathu Yathu on use of an appropriate menstrual product (disposable or reusable pad, cup, tampon) at last menstruation. We analysed data at zone-level using a two-stage process recommended for CRTs with < 15 clusters/arm.ResultsAmong 985 AGYW participating in the survey who had experienced menarche, the most commonly used products were disposable pads (88.8%; n = 875/985). At their last menstruation, 93.3% (n = 459/492) of AGYW in the intervention arm used an appropriate menstrual product compared to 85.7% (n = 420/490) in the control arm (adjPR = 1.09 95%CI 1.02, 1.17; p = 0.02). There was no evidence for interaction by age (p = 0.20), but use of appropriate products was higher among adolescents in the intervention arm relative to control (95.5% vs 84.5%, adjPR = 1.14 95%CI 1.04, 1.25; p = 0.006) with no evidence for a difference among young women (91.1% vs 87.0%, adjPR = 1.06 95%CI 0.96, 1.16, p = 0.22).ConclusionsDelivering community-based peer-led SRH services increased the use of appropriate menstrual products among adolescent girls aged 15–19 at the start of the Yathu Yathu study. With less economic independence, the free provision of appropriate menstrual products is critical for adolescent girls to access materials that allow them to effectively manage their menstruation.

Using human-centered design to co-design dedicated menstrual health spaces with people who menstruate in Bidi Bidi refugee settlement, Uganda: Learnings for further adaptation and scale in humanitarian settings

BackgroundMany people who menstruate in low- and middle-income countries struggle to manage their menstruation safely, hygienically, and with dignity. This is exacerbated in humanitarian settings with limited access to menstrual products and safe, private spaces for changing, washing, and disposing of menstrual products. To address these challenges, Youth Development Labs (YLabs) used a human-centered design approach to co-design the Cocoon Mini, a safe, physical structure for managing menstruation in the Bidi Bidi Refugee Settlement in Uganda.MethodsThe study comprised five phases, including background research, design research, rough prototyping, live prototyping, and a pilot study. A total of 340 people, including people who menstruate, male community members, and community stakeholders, participated in interviews, focus groups, and co-design sessions. Solution prototypes were created, evaluated, and iterated upon in each successive project phase. The final intervention design, the Cocoon Mini, was evaluated qualitatively for feasibility and acceptability during a three-month pilot using structured interviews with 109 people who menstruate utilizing Cocoon Mini structures, 64 other community members, and 20 Cocoon Mini supervisors.ResultsResults showed widespread desirability and acceptability of the Cocoon Mini among people who menstruate and other community members. Overall, 95% (104/109) of people who menstruate stated the space had made menstrual health management easier, primarily by providing designated waste bins, solar lights, and additional water sources. The Cocoon Mini provided an increased sense of physical and psychological safety in knowing where to privately manage menstruation. Furthermore, the Cocoon Mini demonstrated that an intervention could be run and maintained sustainably at the household level in humanitarian contexts, without continued external stakeholder intervention. Each Cocoon Mini structure costs approximately $360 USD to build and maintain and serves 15–20 people who menstruate, leading to a cost per person of $18-$24. Furthermore, attaching an incinerator to the structure for easier and quicker disposal of waste bin contents (compared to transporting full waste bins elsewhere) costs $2110 USD.ConclusionsPeople who menstruate lack access to safe, private spaces for menstrual health and product disposal in humanitarian settings. The Cocoon Mini provides a solution for the safe and effective management of menstruation. Customizing and scaling up dedicated menstrual health spaces should be considered a high-priority intervention in humanitarian settings.

A Baseline Report on the status of Menstrual Health and Hygiene Management and its impact on girls' participation in school leadership processes in Uganda.

A Baseline Report on the status of Menstrual Health and Hygiene Management and its impact on girls' participation in school leadership processes in Uganda.

Menstrual Hygiene Issues And Reproductive Tract Infections In Flood Affected Victims.

Menstruation, a physiological phenomenon, is still considered a stigmatized subject in 3rd world countries like Pakistan, leading to incorrect and incomplete knowledge, resulting in unhealthy practices (1). In lower socioeconomic classes, menstrual hygiene management(MHM) can be unhygienic and inconvenient for women (2). According to research in Karachi, at menarche, only 28.4 per cent of the general population had an idea of menses and proper placement of absorbent (1). Another study found a statistically significant association between reproductive morbidity and unhygienic menstrual practices (3). Unhygienic practices lead women to Reproductive tract infections, and many women have Pelvic inflammatory disease (PID). According to research, 76.7 per cent of women who came to health clinics had Reproductive tract infections (RTIs), and 14.7 per cent had PID (4). Reproductive tact infections is also a significant reason for secondary infertility (5). In rural areas, women do not have access to and knowledge about sanitary products (6). Recently, floods have inundated one-third of Pakistan. As a result, 33 million people were displaced, and 660,000 people live in relief camps (7), of which 8 million women are of reproductive age. Along with all other issues, women are facing problems regarding menstrual hygiene. Some women in Baluchistan were reported to be using tree leaves instead of pads (7). According to a study by AKU, women in Dadu (an area affected by flood from 2019-2021) were not using sanitary products, instead repeatedly changing out of and washing their stained clothes(7) During the evacuation from flood-affected areas, menstrual products have been unavailable for extended use of soiled products or bloodstained clothing (8). These unhygienic practices will cause Reproductive tract infections in these women, which may complicate PID or even secondary infertility. Paying attention to this problem is the need of the hour. Destigmatizing menstruation, educating women and ensuring the availability of low-cost menstrual hygiene products should be prioritized. These interventions will lead to decreased number of urogenital infections. Along with providing MHM products, women should be educated about proper disposal &amp; waste management. Incineration could be used for this. Plastic pads will cause more water pollution in the flood-affected areas, and cloth towels need to be washed with clean water, which is unavailable in those areas. So natural sanitary products from bamboo fibre, banana fibre or sea sponges can be used (4). Women should be educated about stitching pads from cheap absorbent clothes available locally. ---Continue

Menstrual Hygiene Problems and Challenges Faced by Adolescent Females in Rural Areas: A Narrative Review.

Menstruation is a vital sign of reproductive health and development. Menstrual hygiene practices are consequently a significant public health issue. However, menstrual practices are still tainted by taboos and other sociocultural constraints, which adversely affect health since adolescent females in rural areas are unaware of the scientific facts regarding menstrual hygiene practices. The Indian government has recognized the significance of menstrual hygiene and developed and implemented several programs and schemes for menstrual hygiene management (MHM). But due to a lack of, little, or inaccurate knowledge and cultural practices and socio-economic status, adolescent females face many obstacles and suffer from health issues. A comprehensive literature and datasearch was done using key databases such as PubMed and Google Scholarand other sources such as the Ministry of Health and Family Welfare (MoHFW), the United Nations International Children's Emergency Fund (UNICEF), the World Health Organization (WHO), and Google to identify the relevant articles and reviewed publications using full-text search. A total of 40 articles out of 1,461 were selected for review after the screening and elimination of repeated articles. The objective of this literature review is to assess the awareness and knowledge of the importance of menstruation, the understanding of safe menstruation practices, the significance of properly disposing of menstrual products, and the knowledge of how to guard against reproductive system infection and its consequences and also to identify the problems and challenges faced by adolescent females during their menstrual hygiene practices or management. The core of many health issues is misinformation, myths, erroneous beliefs, lack of awareness, and incomplete or incorrect knowledge about menstruation. Therefore, it is essential to teach adolescent females about hygienic behavior and safe menstrual practices.

Engaging boys in menstrual hygiene management (MHM) interventions in Bangladeshi schools: A pilot study to assess acceptability and feasibility

Engaging boys in menstrual hygiene management (MHM) interventions in Bangladeshi schools: A pilot study to assess acceptability and feasibility

Menstrual Hygiene Management (MHM): A Scheme for Improving Women Welfare

The Ministry of Health and Family Welfare implements the Scheme for Promotion of Menstrual Hygiene among adolescent girls in the age group of 10-19 years since 2011. The scheme is supported by the National Health Mission through State Programme Implementation Plan (PIP) route based on the proposals received from the States / UTs. The major objectives of the scheme are to increase awareness among adolescent girls on menstrual hygiene; to increase access to and use of high-quality sanitary napkins by adolescent girls and to ensure safe disposal of sanitary napkins in an environment friendly manner. Under the scheme, a pack of sanitary napkins are provided to adolescent girls by the Accredited Social Health Activist (ASHA) at subsidized rate of Rs. 6 per pack. In addition, Ministry of Drinking Water and Sanitation under Swachh Bharat Abhiyan has developed National Guidelines on Menstrual Hygiene Management (MHM) for creating awareness on Menstrual Hygiene Management (MHM) in rural areas as part of its overall interventions related to behaviour change on sanitation hygiene aspect. Further, to ensure access to sanitary napkins and good quality medicines at affordable price, Department of Pharmaceuticals under Ministry of Chemicals and Fertilizers implements the Pradhan Mantri BharatiyaJanausadhiPariyojna (PMBJP), an important step in ensuring the health security for women. Under the project, over 8700 JanaushidhiKendras have been set up across the country that provides Oxo-biodegradable sanitary napkins named Suvidha at Rs. 1/- per pad only.

Production-sharing of critical resources with dynamic demand under pandemic situation: The COVID-19 pandemic

The COVID-19 virus’s high transmissibility has resulted in the virus’s rapid spread throughout the world, which has brought several repercussions, ranging from a lack of sanitary and medical products to the collapse of medical systems. Hence, governments attempt to re-plan the production of medical products and reallocate limited health resources to combat the pandemic. This paper addresses a multi-period production-inventory-sharing problem (PISP) to overcome such a circumstance, considering two consumable and reusable products. We introduce a new formulation to decide on production, inventory, delivery, and sharing quantities. The sharing will depend on net supply balance, allowable demand overload, unmet demand, and the reuse cycle of reusable products. Undeniably, the dynamic demand for products during pandemic situations must be reflected effectively in addressing the multi-period PISP. A bespoke compartmental susceptible-exposed-infectious-hospitalized-recovered-susceptible (SEIHRS) epidemiological model with a control policy is proposed, which also accounts for the influence of people’s behavioral response as a result of the knowledge of adequate precautions. An accelerated Benders decomposition-based algorithm with tailored valid inequalities is offered to solve the model. Finally, we consider a realistic case study – the COVID-19 pandemic in France – to examine the computational proficiency of the decomposition method. The computational results reveal that the proposed decomposition method coupled with effective valid inequalities can solve large-sized test problems in a reasonable computational time and 9.88 times faster than the commercial Gurobi solver. Moreover, the sharing mechanism reduces the total cost of the system and the unmet demand on the average up to 32.98% and 20.96%, respectively.

Assessment of menstrual hygiene management knowledge, practice, and associated factors among girls in Boset District, Ethiopia: a school-based cross-sectional study

BackgroundAdolescent girls, particularly in lower socioeconomic settings, lack adequate knowledge of menstrual hygiene management and have subpar hygiene habits. Likewise, the factors related to it have not been well addressed, and schoolgirls are facing a range of challenges. To develop effective intervention approaches, a context-specific assessment of menstrual hygiene practices is useful. Thus, this study aimed to assess menstrual hygiene management knowledge, practice, and associated factors among girls in the Boset district, Ethiopia.MethodsA school-based cross-sectional study was conducted at Boset district secondary schools among 629 randomly selected girls using the multi-stage sampling technique. Data were collected using a self-administered, structured questionnaire. The collected data were entered into Epi-info version 7 and analyzed by Statistical Package for Social Science (SPSS) version 26. Binary logistic regression analysis was used to model the association between dependent and independent variables. An adjusted odds ratio and 95% confidence interval were used to measure the strength of the association, and a p-value < 0.05 was used to declare statistical significance.ResultOf the total study participants, 51.2% (95% CI: 46.6–55.8%) had an appropriate practice of menstrual hygiene and 57.9% (95% CI: 53.3–62.5%) had good knowledge status on menstrual hygiene management. Being an urban resident (AOR = 1.84, 95% CI: 1.20–2.80), having a mother with a secondary and above educational level (AOR = 3.4, 95% CI: 2.07–5.57), earning regular pocket money (AOR = 2.19, 95% CI: 1.45–3.313), and discussing menstrual issues with parents and friends (AOR = 3.65, 95% CI: 2.327–5.727) were associated with good practice of menstrual hygiene.ConclusionIn this study, nearly half of the school girls had good practice and knowledge of menstrual hygiene management. Educating mothers and promoting discussion about menstrual hygiene management issues, especially in rural areas, should be priority actions.

Determinants of Menstrual Hygiene Among Adolescent School Girls in Indonesia.

The aim of this study was to determine the prevalence of menstrual hygiene management (MHM) and its associated factors among adolescent girls in Tangerang District, Indonesia. This study was a cross-sectional study of 409 female students aged 12-15 years old from 3 junior high schools selected using multistage sampling. The data were collected through a self-reported questionnaire both online and offline that was administered from April to May 2022. Bivariate and multivariable analysis using binary logistic regression were performed to determine the factors and predictors between sociodemographic characteristics, menstruation variables, knowledge, attitude, enabling environment, and the practice on MHM. Our study revealed a prevalence of good MHM practices among 52.3% of students, as well as moderate knowledge (48.9%) and neutral attitudes (70.4%). With regard to water, sanitation, and hygiene (WASH) facilities at school, most girls reported access to hand washing soap, a hook, a mirror, and a covered bin, but at home, the least available facilities were a mirror and a covered bin. Significant predictors of healthy MHM practices were having reached grade 8 (AOR = 1.80, 95% CI = 1.10-2.95), having ever received information about menstruation at school (AOR = 1.95, 95% CI = 1.19-3.18), having a positive attitude (AOR = 4.21, 95% CI = 1.78-9.96), having access to a private home toilet (AOR = 2.71, 95% CI = 1.36-5.42), and having a home toilet with a covered bin (AOR = 2.15, 95% CI = 1.38-3.37). The girls in this study showed a high prevalence of good MHM practices, but access to WASH facilities at school and at home was still a challenge. Positive attitude was the most significant factor associated with good MHM among female students. Therefore, we suggest establishing menstruation-focused education related to attitudes, particularly sociocultural norms, myths, and misconceptions and WASH facilities provided at home.

Project period: Improving period product provision in a large inner city hospital

BackgroundBMA guidance recommends all hospitals provide suitable, comfortable and convenient period products. In 2018, none of Scotland’s health boards had policies on sanitary product provision.AimEstablish current provision at Glasgow Royal...

Menstrual Hygiene Management Practices and Associated Factors among Primary Second Cycle Female Students in Boset District of East Shoa Zone, Oromia, Ethiopia

<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.