Menstrual Health Management Research Articles

Technological Advancements in Menstrual Health: The Role of Generative Pre-Trained Transformer and Bees Algorithm

This paper introduces the concept of a smart menstrual cup, incorporating advanced technology to address challenges associated with traditional menstrual health management methods. The proposed method, Hybrid Bidirectional Encoder Generative Transformer based Bees Search (Hybrid BEGT-BS), aims to enhance the longevity and reliability of smart menstrual cups. The Generative Pre-trained Transformer (GPT) is employed to extract key information and determine emotional tones related to menstruation, while the Bidirectional Encoder Representations from Transformer (BERT) classifies menstrual-related data such as cycle tracking, hygiene, and symptoms. Further different validation metrics such as F1-score, specificity, Area Under the Curve-Receiver Operating Characteristic (AUC-ROC), Mean Squared Error (MSE), recall, energy consumption, accuracy, and precision are employed to assess the method's effectiveness. From the comparative results it demonstrates the superior performance of the Hybrid BEGT-BS method in enhancing the performance of smart menstrual cups.

Promoting menstrual health management among women and girls in Mehe (Cameroon) through a pilot testing project: a quasi-experimental study

Promoting menstrual health management among women and girls in Mehe (Cameroon) through a pilot testing project: a quasi-experimental study

“It became a cycle I was not able to break” towards menstrual justice: addressing human rights violation at Indian workplaces

Purpose This paper aims to advance the concept of “menstrual justice” by building on the comprehensive framework developed by Margaret E. Johnson (2019), which integrates legal rights, social justice and intersectional analysis. By applying Johnson’s insights and human rights frameworks to menstrual health management, the study advocates for state interventions to safeguard women labourers from exploitative practices that endanger their reproductive health and to uphold their menstrual rights. Design/methodology/approach A case study methodology is used to scrutinize menstrual injustices experienced by women labourers in precarious employment conditions. Specifically, it examines two cases, the mass hysterectomies in Beed, Maharashtra and the administration of unidentified pharmaceuticals to women in Tamil Nadu factories to mitigate menstrual pain and maximize productivity. Findings The findings reveal severe violations pertaining to menstrual justice, with practices deeply rooted in socioeconomic deprivation and systemic neglect. These issues subject female workers to various forms of gender-based violence that goes beyond physical abuse, raising critical concerns about menstrual justice and human rights violations. Research limitations/implications The study’s findings have limited generalizability due to the specific contexts of the case study. Furthermore, the absence of insights from managers/supervisors, and factory owners limits a comprehensive understanding of the policies and factors leading to neglect of menstrual management practices. Practical implications The findings of the study will prompt the medical industry to initiate research into medications that can effectively alleviate period pain while minimizing harmful side effects. Current treatments often come with significant drawbacks, highlighting the need for safer and more effective alternatives. Addressing this research gap is vital for achieving menstrual equity, as it ensures that individuals suffering from menstrual pain have access to relief that does not jeopardize their overall health. Advancing research in this area will not only enhance the quality of life for menstruators but also contribute to a more equitable and inclusive approach to menstrual health care. Social implications The findings support reframing menstrual friendly labour policies including comprehensive sexual and reproductive health information to everyone, regardless of gender, to reduce misinformation and stigma associated with menstruation at workplaces. Additionally, the study proposes the introduction of reusable menstrual products like menstrual cups to overcome period poverty. Thus, ensuring access to these resources is crucial for enabling informed decision-making, promoting gender equality, addressing health disparities and fostering the development of menstrual-friendly workplace policies. Originality/value This study, by using a case study-based approach, has thoroughly examined the issues and challenges faced by female labourers in fields and factories. It uniquely identifies the inadequacies in menstrual management provisions for female workers in India and advocates for a human rights-based approach to ensure that menstruators can manage their menstrual health safely. Unlike most existing studies, which primarily focus on product usage and the stigma or myths surrounding menstruation, this study advances menstrual justice by calling for labour policy reforms and medical research to lessen menstrual pain without compromising menstruators’ health. These reforms aim to provide working women with adequate rest and necessary provisions during menstruation. Addressing these gaps is essential and has been largely overlooked in global health policies.

Hubungan Pengetahuan dan Sikap Remaja Putri Dengan Manajemen Kesehatan Menstruasi di Posyandu Remaja Wilayah Kerja Kelurahan Baran Timur

Menstrual health management is a way to maintain cleanliness and health when women are menstruating. Poor knowledge and attitudes can lead to poor menstrual health management which can cause disease in women's reproductive organs. The aim of this research was to determine the relationship between knowledge and attitudes of adolescent girls and menstrual health management in the youth posyandu in the working area of ​​Baran Timur subdistrict. This research is a quantitative research with a cross-sectional approach. The population in this study were teenage girls who had menstruated with a total of 87 respondents taken through total sampling. Data collection used a questionnaire and data analysis used the chi-square test. Bivariate analysis results show a p value of 0.016 for the relationship between knowledge and menstrual health management and a p value of 0.029 for the relationship between attitudes and menstrual health management, where this value is less than 0.05 so that Ha is accepted which means there is a relationship between knowledge and attitudes of young women and menstrual health management. It is hoped that knowledge of menstrual health management will be further improved so that attitudes will improve. The author's suggestion for the Ceria Youth Posyandu is to be able to collaborate with the community health center and the East Baran sub-district to be able to provide education regarding Menstrual Health Management not only to young women but also to young men.

Breaking the Cycle: Addressing Period Poverty as a Critical Public Health Challenge and Its Relation to Sustainable Development Goals.

This narrative review comprehensively examines the intricate relationship between period poverty and the Sustainable Development Goals (SDGs), positioning it as a critical public health challenge with far-reaching implications. Through an in-depth analysis of the multifaceted impact of period poverty on public health, including its effects on reproductive health, mental well-being, and economic participation, the paper underscores the urgent need to address this issue within the framework of the SDGs. An overview of existing literature on period poverty, its impact on health and well-being, and its relation to the SDGs was carried out. Different perspectives, interventions, and policy approaches to addressing period poverty were also explored. By illuminating the interplay between period poverty and various SDGs, particularly those related to gender equality, health, education, and economic empowerment, the study emphasizes the imperative of integrating menstrual health and hygiene into global development efforts. Advocating for targeted policies, funding, and advocacy, the manuscript calls for a holistic and inclusive approach to breaking the cycle of period poverty, ultimately contributing to advancing the SDGs and fostering a more equitable and healthier global society. Efforts to eradicate period poverty - providing affordable menstrual products, improving sanitation infrastructure, enhancing education, and implementing supportive policies - lead to significant progress in public health and gender equity. By prioritizing menstrual health management in public health policies, educational programs, and economic strategies, we can ensure that everyone who menstruates can do so with dignity and without limits on their potential.

THE SPARŚA PROJECT: BUILDING A COMPREHENSIVE MENSTRUAL HEALTH MANAGEMENT INTERVENTION IN NEPAL

This article addresses the pervasive silence around menstrual health management (MHM) in Nepal, emphasizing its impact on women's rights. Despite being a natural process, menstruation remains taboo, perpetuating gender discrimination and restricting women's empowerment. This study examines the lack of sufficient menstruation-related targets in international development agendas and focuses on Nepal's cultural norms concerning this issue that affect women's behaviour, health, and social participation. The paper advocates for a comprehensive understanding of women's experiences and preferences to design effective MHM interventions. It explores various strategies, including campaigns against practices like Chhaupadi, presents findings from a field survey and introduces the Sparśa project - a women-led social enterprise offering biodegradable pads to counteract menstrual discrimination across Nepal. The article emphasises the historical neglect of menstrual-related needs, resulting in adverse effects like school absenteeism and social marginalization. It highlights the crucial role of coordinated efforts and fostering knowledge-sharing to implement more impactful and comprehensive interventions in the field of MHM. The research highlights the Sparśa project's potential to transform societal perceptions of menstruation, break the silence, and contribute to women's rights. It offers insights into the challenges faced by Nepali women and provides valuable considerations for global menstrual health initiatives.

Impact of dysmenorrhea on urban school girls in Tanzania: the need for a comprehensive menstrual health management guideline

Impact of dysmenorrhea on urban school girls in Tanzania: the need for a comprehensive menstrual health management guideline

Perceived associations between the menstrual cycle and Attention Deficit Hyperactivity Disorder (ADHD): A qualitative interview study exploring lived experiences

BackgroundThe research gap regarding Attention Deficit Hyperactivity Disorder (ADHD) in people who were assigned female at birth has led to a lack of knowledge and adequate approaches in clinical practice, as well as diagnosis processes. Recent studies report potential associations between reproductive hormones and ADHD, but existing research remains scarce. AimThis study aims to explore the experiences of people who perceive an association between their menstrual cycle and their ADHD symptoms. MethodologyDesign and Method.A qualitative research design with an inductive approach was used. Ten participants were interviewed, using semi-structured, in-depth interviews. The data was transcribed, coded, and analyzed using reflexive thematic analysis according to Braun and Clarke. ResultsFindings show participant’s perceived associations between their ADHD and their menstrual cycle: participants reported experiencing ADHD symptom mor severe during the mid-luteal phase of the menstrual cycle. Other results showed uncertainty around ADHD medication in relation to the cycle and varied experiences with health care encounters as well as heightened challenged around menstrual health management. ConclusionsThis study provides insights to how perceived associations between ADHD and the menstrual cycle might be experienced. This report highlights the need for further research and theory about the potential associations between ADHD and reproductive hormones. The researchers strongly suggested that forthcoming ADHD studies consider times of key hormonal changes, such as puberty and menarche, menopause, hormonal birth control, pregnancy, hormone treatment, and more.

The effectiveness of MESH–TEEN application on the menstrual hygiene management of teenage girls in Medan, Indonesia

The purpose of this research is to identify the effectiveness of the MESH–TEEN application on the knowledge, attitudes and actions of teenagers regarding menstrual hygiene management in the city of Medan, Indonesia. A quasiexperimental study design was used. Total sampling was the method used. A total of 165 respondents took part in this study. Paired t test was used to analyze data. With a P = 0.001 (≤0.05) value for data analysis on teenage knowledge, attitudes, and actions, it can be concluded that there is a significant difference in respondents’ knowledge, attitudes, and actions before and after the intervention. The study has proven that the MESH–TEEN application improves teenage knowledge, attitudes, and actions about menstrual health management. It is suggested that the socialization of the use of this application be continued with other teenage girls to improve the health and welfare of teenage girls during menstruation and their reproductive health system.

Impact of a nurse-led intervention in understanding menstrual health management among adolescent girls attending specific schools in Navi Mumbai, India

Abstract Background: Premenstrual symptoms are prevalent among menstruating individuals, affecting around 75% of those who report some level of discomfort during their cycles. However, approximately 10% of women endure premenstrual syndrome (PMS), marked by symptoms that significantly disrupt daily functioning. PMS remains poorly comprehended and difficult to diagnose. The aim of this study was to assess the efficacy of an intervention and analyze the disparity in knowledge levels between the two groups. Materials and Methods: A genuine experimental design was employed using a pretest and post-test control group approach. A simple random sampling lottery method was used to select 40 adolescent girls for the study and control groups. These girls, aged 12–15 years, were chosen from specific schools in Navi Mumbai, adhering to predetermined inclusion criteria. A structured knowledge questionnaire was administered to both groups. At 1 week post-test, the study group received a nurse-led intervention through a planned teaching program. Data analysis included descriptive and inferential statistics. Results: In the control group, pretest knowledge scores averaged around 57.5%, suggesting a moderate level of knowledge. Conversely, the study group exhibited an average pretest knowledge score of 60%. Examining post-test knowledge scores, it is evident that in the control group, the majority (42.5%) demonstrated average knowledge, while in the study group, 67.5% exhibited excellent knowledge. Paired t test findings indicated a significant influence of the planned teaching program in the study group compared with the control group, with a P value of 0.001 at a significance level. Conclusion: Adolescent girls in the selected schools lacked knowledge about menstrual health management. Consequently, the nurse-led intervention on menstrual health management significantly improved knowledge among the control group of adolescent girls.

IJCM_60A: Menstrual hygiene management practices in tribal areas of Mysore district: A cross-sectional study

Background: Menstrual Health Management is defined as women and adolescent girls using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of menstruation period, using soap and water for washing the body as required and having access to facilities to dispose of menstrual management materials. Since considerable amount of tribal population belong to Mysore district it is important to study the practices among the most vulnerable population. Objectives: 1. To estimate the knowledge on menstrual hygiene among the study population. 2. To measure the impact of socio-demographic and cultural determinants on menstrual hygiene management practices among the study population. Methodology: A community based cross-sectional study on menstruating women residing in tribal areas of Mysuru district was conducted from July to September 2023. Sample size was calculated using single proportion formula and it was estimated to be 130. All menstruating women/girls who were present during the time of visit were included in the study after getting their consent/ ascent. Multistage sampling was adopted to select the study participants. A validated semi-structured questionnaire was used for collection of data. Data was entered in MS Excel and analysed using SPSS v29 trial version. Results: 99% of the study population knew that menstruation is a physiological process and poor menstrual hygiene causes urinary and reproductive tract infections. More than 80% of the study population have access to sanitary napkins for managing their menstrual cycles. Conclusion: Majority of the study participants are aware about menstruation as a physiological process and have access to sanitary napkins for management. But the disposal of sanitary waste and cultural barriers that persists in the society are still existing as a roadblock for improving reproductive health.

Predictors of menstrual health management among the high school adolescent girls

Background: Adolescence (10-19 years) is an essential human developmental stage, during which physical, sexual, psychological, and social development occurs Objectives: To estimate the knowledge and attitude regarding menstruation health as well as its determinants among school going adolescent girls. Methods: A questionnaire based cross-sectional study was conducted among school going adolescent girls. In addition to descriptive analysis, bi-variate analysis was also done to find out the association between various predictors of knowledge and attitudes of the study population. Results: Majority of the adolescent girls preferred mother (75.6%) as a source of information regarding puberty related issue with 86.2% of them using health related sanitary pad as one of the methods for menstrual hygiene. Conclusion: Proper menstrual hygiene practices which could be imparted through appropriate interventions at earlier stages of life can prevent the girls and women from suffering reproductive morbidities.

IoT and Deep Learning Enabled Smart Solutions for Assisting Menstrual Health Management for Rural Women in India: A Review

A global medical issue, primarily raised in underdeveloped nations, is inappropriate Menstrual Hygiene Management (MHM) among teenage girls. Menstrual hygiene is a global concern because there are over 0.6 billion teenage females (about 8% of the population). The Asian and African continents are home to over 80% of these teenagers. Throughout, 355 million girls and women in India have periods. However, MHM causes discomfort and a lack of respect for millions of women all over the country. In alignment with today's technologies like cloud computing, artificial intelligence (AI), and Internet of Things (IoT), the MHM can be handled effectively. A quantitative survey was carried out among 184 random volunteers aged 18-22 to reveal the current status of MHM in India. The result of the survey confirmed that 72.8% of girls encountered stress during their period, 45% of them were unaware of hygiene products to be used while in the menstruation cycle, 65.2% of them used sanitary pads, and 57.6% of them received disrespectful treatments. This work aims to empower women with the MHM by facilitating knowledge on the menstrual cycle and guiding them about safe-to-use products and disposal strategies in home, work, or community places with the help of technological advancements. Further, introduce a simple friendhood discussion forum through an intelligent chatbot like "Sirona, " a chatbot built over Whatsapp that facilitates a complete ecosystem for MHM.

“I Like to Know When My Period’s Coming”: How Menstruators Use Technology to Track, Monitor, and Manage Their Menses

Managing menstruation is a global public health issue. Cultural issues such as period poverty, negative stigmas, and technological advancements are often discussed in the menstrual care space. Technologies, such as mobile apps (e.g., Flo, Glow, iPhone Health) and devices (e.g., menstrual cups, intrauterine devices), have changed how menstruators monitor and manage their menses. Little research exists on how these tools could affect university student menstruators. Virtual focus group discussions (n = 32 across five focus groups) were conducted in February 2021. Eligible participants were student-menstruators attending a large Midwestern University. Thematic analysis techniques were used for data analysis, allowing for a constant comparative approach to contextualization and theme identification. Results demonstrated that participants employed various technologies, including mobile apps, birth control methods, and reusable products, to track, predict, and manage their menstrual experiences effectively. These technologies proved instrumental in tracking symptoms, manipulating the timing of menstruation, facilitating communication with healthcare providers, and alleviating menstrual discomfort. Furthermore, participants emphasized the factors influencing their technology choices, such as menstrual cups’ economic and environmental advantages. These findings have implications for menstrual health programs, public health initiatives, and period policies, emphasizing the importance of integrating technology-driven solutions for menstrual health management. The study showcases the value of incorporating technology into education and awareness campaigns to empower individuals in managing their menstrual health and facilitating informed decisions about contraception and fertility. Furthermore, the research highlights the need for policymakers to support reusable menstrual technologies and destigmatize menstruation, ultimately contributing to gender equality and overall well-being.

Assessment of Knowledge, Attitudes, and Practices Regarding Menstrual Hygiene Management Among Adolescent Schoolgirls (10-19 Years) in the Saurashtra Region, Gujarat.

Background Menstrual health management proves pivotal for the adoption of hygienic practices and the embracement of womanhood from the onset of menarche. Menstrual hygiene is pivotal yet under-addressed among adolescent girls in India. This study aimed to assess the knowledge, attitudes, and practices regarding menstrual hygiene and influencing factors. Methodology A cross-sectional study was conducted among 361 adolescent schoolgirls aged 10-19 years in the Saurashtra region of Gujarat using a pretested questionnaire. Multistage sampling was used. In the first stage, six schools (three rural and three urban) were selected through random sampling. In the second stage, all adolescent girls aged 10-19 years in the selected schools who had attained menarche were invited to participate. Those who provided written assent were included in the study. The data were analyzed with descriptive statistics and logistic regression. A p-value <0.05 was considered significant. Results Knowledge about menstruation was evenly distributed as good (47.65%) and poor (52.35%). Most relied on mothers for information and considered menstruation a normal phenomenon. Attitudes reflected complex cultural perceptions. The use of sanitary pads was high (96.12%), although 39.89% used reused absorbents. Multivariate analysis revealed age 16-19 years (adjusted odds ratio (AOR) = 2.08, 95% confidence interval (CI) = 1.14-3.81), higher parental education, pit latrine usage (AOR = 6.7, 95% CI = 2.97-15.15), and knowledge about menstruation (AOR = 8.21, 95% CI = 4.56-14.78) as positive predictors of good menstrual practices. Conclusions Despite the widespread use of sanitary pads, the persisting knowledge gap and sociocultural influences lead to unhygienic practices. Improving awareness and attitudes through educational interventions among adolescent girls and mothers, in particular, addressing cultural taboos through the engagement of all stakeholders, and improving sanitation infrastructure in schools are imperative.

Socio Economic Determinants and Effective Menstrual Management among Primary School Girls in Rural Schools in Nyatike Sub County

Access to menstrual hygiene products is a major challenge facing women and girls in developing countries, including Kenya. This study is about the socioeconomic determinants of menstrual management among girls in Nyatike Sub County. The study was guided by the following specific objectives: to establish the effects of traditional practices on menstrual management among primary school girls, examine the effects of knowledge and awareness of hygiene on menstrual management, analyze the effects of family income on the menstrual management of girls, and assess the current measures that are in place to enhance menstrual health management of girls in rural primary schools in Nyatike Sub County. A descriptive survey design was used, and cluster sampling coupled with simple random sampling was used to select 689 respondents for the questionnaire, who were mainly primary school girls, head teachers and teachers, and the female heads of households. Descriptive analysis showed that 59.3% of the girls have encountered traditional restrictions during their menstruation. About 74.4% of the respondents believe that knowledge about menstrual hygiene has improved their overall confidence and comfort during menstruation. Additionally, 53.2% of the girls always have access to the menstrual hygiene products they need. However, 46.8% still have difficulties obtaining the necessary products. Consequently, 76.8% of the respondents revealed that their schools are sensitizing students about menstrual health and hygiene. The inferential analysis showed that traditional practices have various effects on menstrual management among primary school girls. In conclusion, there is a positive effect of knowledge and awareness of hygiene on menstrual management among primary school girls. It is also clear that most primary schools have implemented some menstrual health management strategies for girls. The study recommends regular awareness and sensitization programs for students, teachers, parents, and the community to eliminate stigma, myths, and misconceptions around menstruation.

The impact of community-based integrated HIV and sexual and reproductive health services for youth on population-level HIV viral load and sexually transmitted infections in Zimbabwe: protocol for the CHIEDZA cluster-randomised trial.

Youth have poorer HIV-related outcomes when compared to other age-groups. We describe the protocol for a cluster randomised trial (CRT) to evaluate the effectiveness of community-based, integrated HIV and sexual and reproductive health services for youth on HIV outcomes. The CHIEDZA trial is being conducted in three provinces in Zimbabwe, each with eight geographically demarcated areas (clusters) (total 24 clusters) randomised 1:1 to standard of care (existing health services) or to the intervention. The intervention comprises community-based delivery of HIV services including testing, antiretroviral therapy, treatment monitoring and adherence support as well as family planning, syndromic management of sexually transmitted infections (STIs), menstrual health management, condoms and HIV prevention and general health counselling. Youth aged 16-24 years living within intervention clusters are eligible to access CHIEDZA services. A CRT of STI screening (chlamydia, gonorrhoea and trichomoniasis) is nested in two provinces (16 of 24 clusters). The intervention is delivered over a 30-month period by a multidisciplinary team trained and configured to provide high-quality, youth friendly services.Outcomes will be ascertained through a population-based survey of 18-24-year-olds. The primary outcome is HIV viral load <1000 copies/ml in those living with HIV and proportion who test positive for STIs (for the nested trial). A detailed process and cost evaluation of the trial will be conducted. The trial protocol was approved by the Medical Research Council of Zimbabwe, the Biomedical Research and Training Institute Institutional Review Board and the London School of Hygiene & Tropical Medicine Research Ethics Committee. Results will be submitted to open-access peer-reviewed journals, presented at academic meetings and shared with participating communities and with national and international policy-making bodies. https://clinicaltrials.gov/: NCT03719521.

Study protocol for an individually randomized control trial for India's first roleplay-based mobile game for reproductive health for adolescent girls

BackgroundGo Nisha Go™ (GNG), is a mobile game combining behavioural science, human-centric design, game-based learning, and interactive storytelling. The model uses a direct-to-consumer (DTC) approach to deliver information, products, services, interactive learning, and agency-building experiences directly to girls. The game’s five episodes focus on issues of menstrual health management, fertility awareness, consent, contraception, and negotiation for delay of marriage and career. The game’s effectiveness on indicators linked to these issues will be measured using an encouragement design in a randomized controlled trial (RCT).MethodsA two-arm RCT will be conducted in three cities in India: Patna, Jaipur, and Delhi-NCR. The first arm is the treatment (encouragement) arm (n = 975) where the participants will be encouraged to download and play the game, and the second arm (n = 975) where the participants will not receive any nudges/encouragement to play the game. They may or may not have access to the game. After the baseline recruitment, participants will be randomly assigned to these two arms across the three locations. Participants of the treatment/encouragement arm will receive continuous support as part of the encouragement design to adopt, install the game from the Google Play Store at no cost, and play all levels on their Android devices. The encouragement activity will continue for ten weeks, during which participants will receive creative messages via weekly phone calls and WhatsApp messages. We will conduct the follow-up survey with all the participants (n = 1950) from the baseline survey after ten weeks of exposure. We will conduct 60 in-depth qualitative interviews (20 at each location) with a sub-sample of the participants from the encouragement arm to augment the quantitative surveys.DiscussionFollowing pre-testing of survey tools for feasibility of methodologies, we will recruit participants, randomize, collect baseline data, execute the encouragement design, and conduct the follow-up survey with eligible adolescents as written in the study protocol. Our study will add insights for the implementation of an encouragement design in RCTs with adolescent girls in the spectrum of game-based learning on sexual and reproductive health in India. Our study will provide evidence to support the outcome evaluation of the digital mobile game app, GNG. To our knowledge this is the first ever outcome evaluation study for a game-based application, and this study is expected to facilitate scalability of a direct-to-consumer approach to improve adolescent sexual and reproductive health outcomes in India.Trial registration number: ctri.nic.in: CTRI/2023/03/050447.

Sosialisasi Kesehatan Menstruasi Bagi Remaja Perempuan di Panti Asuhan Anak Harapan Kalimantan Timur

Menstruation is a common thing that happens to women, but during menstruation, women feel pain and uncomfortable conditions, especially teenagers who have just experienced menstruation. Lack of knowledge about menstrual cycles and improper handling can affect adolescent female activityTherefore, it is necessary to increase knowledge for adolescent girls related to menstruation and menstrual health management. This community service program is carried out through socialization activities for women, especially adolescents. The target of this program is foster children at the Harapan Children's Orphanage (Panti Sosial Asuhan Anak Harapan/PSAAH). Activities are carried out with preparatory stages in the form of coordination with PSAAH leaders and establishing mutual agreements for program implementation. Stages of preparing learning tools for socialization in the form of modules and pre-test and post-test devices. The stages of implementing activities are in the form of implementing socialization activities. Socialization is carried out using the lecture method for the delivery of material related to menstruation and menstrual health. The result of dedication is the high enthusiasm seen from the activeness of socialization participants. The results of this service activity are beneficial for adolescent girls in PSAAH, namely, women gain knowledge related to menstruation and healthy menstrual management. The results of the service also showed that there was a 95% change in knowledge related to menstruation and menstrual health. This community service program has a positive impact, namely changing the knowledge of foster children, especially adolescent girls in PSAAH East Kalimantan.

Becoming women: period. Perceptions of barriers and facilitators to menstrual hygiene management programs for Pakistani girls.

Discussions on and around menstruation are often considered a cultural taboo in many parts of Pakistan. Mostly, individuals avoid discussing menstruation and lack awareness about its related health and hygiene issues. Sexual health education is entangled in a complex myriad of social and cultural stigmas. Limited knowledge and lack of access to menstrual health management (MHM) resources decrease the self-confidence of girl students and lead to reluctance to seek help or advice. This quantitative study aimed to gain a deeper understanding of the intersectionality of the influences leading to barriers and facilitators of access to the MHM program in a public school in the Hyderabad district and utilize this information to construct a framework for evaluation of the Water, Sanitation, and Hygiene (WASH) in Schools program. This study sampled all girls' elementary and higher secondary schools in the Hyderabad district. Due to the limitations of time and access during the global COVID-19 pandemic, the researchers collected data from more than 100 school leaders and teachers regarding the MHM facilities in their schools through an online self-administered survey. The data were then analyzed in SPSS for frequencies, mean scores, and standard deviation. The results suggest that school leaders and teachers of the Hyderabad district perceive MHM facilities to be significantly low in terms of both resources and policies. Schools worldwide are introducing life skills, hygiene, good health, and wellness subjects. Pakistan needs to change its educational policy for the welfare of women, who comprise a magnanimous 48.54% of its population. Moreover, with the planning and implementation of programs such as WASH in Schools (WinS), the perceptions of barriers and facilitators to MHM facilities in Pakistan must be studied to fight the taboo and raise awareness about the same.