Menstrual Hygiene Management Practices Research Articles

Menstrual cups to reduce bacterial vaginosis and STIs through reduced harmful sexual and menstrual practices among economically vulnerable women: protocol of a single arm trial in western Kenya

BackgroundIn western Kenya, menstrual hygiene management (MHM) is a pervasive problem. Challenges are compounded for economically constrained women who continue to engage in sex during menses and resort to practices such as vaginal insertion of tissue and cotton to maintain dryness during sex. These practices can be harmful to the vaginal microbiome (VMB) and can lead to high rates of sexually transmitted infections (STIs) and HIV. This study will evaluate whether menstrual cups that can be worn during intercourse may be beneficial to the VMB and help prevent Bacterial vaginosis (BV) and STI acquisition among these economically vulnerable women.MethodsIn this single-arm trial among economically vulnerable women in semi-urban western Kenya, we will evaluate the preliminary efficacy of menstrual cups on non-optimal VMB, BV, and STIs, and investigate safety, acceptability, and implementation needs. Through peer referral we aim to recruit 402 menstruating women aged 15–35 who exchange sex for money or basic needs. Women who are pregnant, have delivered in the past six months, or use an intrauterine device (IUD) will not be eligible. Participants will be seen every six months for 24 months and be asked about their sexual and MHM practices, with samples collected to assess BV and VMB. At baseline, 12-, and 24-month visits, additional samples will be collected to measure HIV and STIs (C. trachomatis, N. gonorrhoeae, and T. vaginalis). HSV-2 status will be assessed at baseline. Intervention provision will consist of one reusable disc-shaped menstrual cup per participant and a group-based training within four weeks of the 12-month visit, followed by monthly telephone surveys for the first three months to assess cup use, adverse events, and provide any assistance. Primary analyses of preliminary efficacy will compare probabilities of optimal VMB, BV, and STIs in the pre-intervention period to the post-intervention period. Primary safety analyses will compare occurrence of menstrual toxic shock syndrome and cervicovaginal laceration.DiscussionIf demonstrated safe and effective, this multipurpose reproductive health intervention will offer a dignified solution for the menstrual hygiene needs of women who engage in sex for livelihood and reduce their occurrence of non-optimal VMB, BV, and STIs.Trial registrationClinicaltrials.gov NCT05666778 (28th December, 2022); Pan African Clinical Trials Registry 202,305,912,778,108 (25th May, 2023).

Association between attitude and menstrual hygiene management practices among adolescent girls with disabilities in selected schools in Wajir County, Kenya

Background: Menstruation is the recurrent peeling of the uterine lining that occurs monthly on girls and women of the reproductive age. Many adolescent girls in African countries have poor knowledge regarding menstruation and this is even worse among menstruating girls with disabilities who are faced with a greater challenge as they require private and specific sanitation facilities. The study focused on establishing the association between attitude and menstrual hygiene management practices among adolescent girls with disabilities in selected schools in Wajir County. Methods: A descriptive cross-sectional design was adopted. Census method was used to select respondents where 101 were interviewed. Pretested questionnaires were used to collect data. All necessary research approvals from relevant institutions were obtained as well as consent and assent sought from respondents and guardians where applicable. Data was managed using SPSS version 22.0 software. Results: Most 88.1% of the respondents did not practice menstrual hygiene management. Further results revealed that 98.9% of those who had negative attitude had not practiced menstrual hygiene management. There was a significant statistical association between nature of attitude and practice of MHM (χ2=11.009, p*=0.029). Conclusions: About 9 out of 10 adolescents with disabilities in Wajir County did not practice menstrual hygiene management. The nature of attitude towards menstrual hygiene management was significantly associated with practice. The study recommended provision of free sanitary pads by relevant stakeholders to all girls who are living with disabilities and provision of enough washrooms to address privacy issues.

Eco-Friendliness and Cost-Effectiveness of Reusable Sanitary Pads for Rural Women: A Model for Menstrual Hygiene Management in Low Resource Settings

Background Menstrual Hygiene Management (MHM) is fundamental to women’s health, well-being, and gender equality. The study aimed to assess the cost-effectiveness and acceptability of reusable sanitary pads among rural women in Pakistan, proposing a scalable model for improving MHM practices in low-income countries. Methods A cross-sectional study was conducted using Multi- Stage Cluster sampling to accomplish a sample size of 340 childbearing-age women from the rural areas of Sindh, Pakistan. The data was collected using a standard questionnaire regarding the affordability and accessibility of reusable versus disposable sanitary pads; further information was also gathered from Market surveys for MHM products. The biodegradability of the pads was assessed using a soil burial test. The data was analyzed using SPSS version 27. Results Our research found a significant preference for reusable sanitary pads. The biodegradability tests demonstrated that reusable pads had a superior degradation rate (1.88%) to disposable pads (1.59%) over four months. Economic assessments showed a low utilization of commercial pads (12.5%) due to affordability issues, with 87.5% using reusable cloths. Despite 70% awareness of menstrual hygiene, 48% of women showed interest in creating sanitary solutions, underscoring the feasibility of implementing locally sourced, cost-effective products across similar socio-economic landscapes. Conclusion The present study underscores the universal applicability of affordable, sustainable MHM solutions in rural communities of low-income countries, advocating for broader implementation of such models to address global menstrual hygiene challenges. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1030-1037

Connecting the dots: Exploring the relationship between menstrual hygiene and bacterial vaginosis in eastern India

ABSTRACT Introduction: Menstruation is a normal physiological event that takes place in a rhythmic fashion during the reproductive period of a woman. Menstrual hygiene management (MHM) practices differ and depend on the individual’s socioeconomic status, local traditions and beliefs, and access to water and sanitation resources. Insufficient and incorrect information regarding menstruation and lack of knowledge and awareness leads to poor personal hygienic practices, which further leads to many infections. Bacterial vaginosis, the most common RTI, is characterized by an alteration in the vaginal micro biome with a decline in hydrogen peroxide producing Lactobacillus colonization and an overgrowth of facultative anaerobic bacteria like Gardnerella spp., Mobiluncus spp., etc. Aims: The primary objective of the study was to find out the association of bacterial vaginosis with menstrual hygiene practices. The secondary objective was to determine the prevalence of bacterial vaginosis among patients presenting with vaginal discharge to the outpatient department of a tertiary care hospital. Methods: Women in the reproductive age group 18-45 years having regular menstrual cycles were included in the study. Participants were enquired for sociodemographic data, menstrual hygiene practices and symptoms of abnormal vaginal discharge. High vaginal swab was collected for the symptomatic patients and sent to investigate for presence of bacterial vaginosis. Results and observation: The prevalence of BV was found to be 13% among symptomatic patients presenting with abnormal vaginal discharge. Apart from abnormal discharge, itching and burning sensation was also seen to have a positive association with bacterial vaginosis (p < 0.001). The women who used clothes as absorbent were more prone to develop BV than women using sanitary pad. The other parameters to have positive association with BV were decreased frequency of taking body bath. Unsatisfactory sanitation of latrine was found to be strongly associated with BV after adjusting for confounders. Conclusion: In conclusion, the result of this study provided a strong association between poor MHM practices with BV.

Menstrual hygiene management among reproductive-aged women with disabilities in Bangladesh.

Women with disabilities in low- and middle-income countries face unique challenges in managing menstruation, affecting their health, dignity, and quality of life. This study aimed to explore menstrual hygiene management (MHM) practices among reproductive-aged women with disabilities in Bangladesh and its impact on social participation. We analyzed data from 51,535 women from the 2019 Multiple Indicator Cluster Survey (MICS). The outcome variables were: (i) material used to manage blood flow while menstruating (appropriate, inappropriate), (ii) availability of a private place for washing and changing menstruation rags (yes, no), and (iii) impact on attendance of social activities, school, or work during menstruation (yes, no). Disability status was considered as a major explanatory variable and categorized as no disabilities, moderate disabilities, and severe disabilities. Associations of outcome variables with explanatory variables were determined using a multilevel mixed-effects binary logistic regression model adjusted for individual-level factors, household-level factors, and community-level factors. Among the sample, 2.7% reported severe disability and 19.2% moderate disabilities, with vision-related disabilities (12.2%) being the most prevalent, followed by cognitive (9.5%) and walking disabilities (8.2%). Overall, 4% reported using inappropriate materials for menstrual flow, rising to 8.0% among those with severe disabilities and 5.8% for moderate disabilities. Women with moderate to severe disabilities had 33%-47% lower odds of using appropriate materials and 34%-44% lower odds of having a private place to change at home. Additionally, women with severe disabilities were 1.66 times more likely to report that menstruation impacted their social activities. Women with disabilities in Bangladesh face significant barriers to effective MHM. Addressing these issues requires targeted interventions, including disability-inclusive menstrual health education, improved access to menstrual products and sanitation facilities, and community initiatives to reduce stigma.

WASH services and menstrual hygiene management among reproductive age females in the IDPs camps of Shire town in Tigray region of Ethiopia: a cross- sectional study

Menstruation is a natural cyclic occurrence experienced by reproductive age females in a good health which deemed a proper management, otherwise, it ends with various health complications and impaired quality of life. The aim of this study was to investigate the menstrual hygiene management practice and its determinant factors among reproductive age females living in the IDPs camps of Shire town, Northern Ethiopia. A cross-sectional study was conducted among 633 reproductive age females in Shire town from May to June 2022. Data were entered, cleaned, and analyzed using SPSS version 23. Descriptive analysis and binary and multivariable logistic regression were conducted to obtain the descriptive findings and to investigate the strength of the association respectively. P-value < 0.05 was considered statistically significant. The prevalence of good menstrual hygiene management practice among the reproductive age females was 41.9% (95% CI, 38-45.8%). Menstrual hygiene management practice was significantly (p < 0.05) associated with access to sanitary materials, educational level, availability of continuous water supply and sex-separated latrines. The results of this study demonstrated that more than a half of the reproductive age females did not have good menstrual hygiene management practices. Consequently, it is recommended to work collaboratively to enhance the menstrual hygiene practice, especially in IDPs camps.

Menstrual hygiene management practice and associated factors among high school and preparatory school adolescent students in Debre Markos town, Northwest, Ethiopia: a mixed-method study

BackgroundDespite being a normal occurrence, menstruation requires hygienic care and is associated with a number of myths and wrongdoings. Menstrual hygiene issues have been linked to major health issues, such as urinary tract and reproductive tract infections. Consequently, the purpose of this study was to evaluate the management of menstrual hygiene and related aspects among teenage students in Debre Markos town, North West, Ethiopia.MethodsFrom March 15 to April 15, 2019, teenage pupils in Debre Markos town participated in a cross-sectional mixed study. An in-depth interview and a self-administered structured questionnaire were used to gather data. Quantitative information was imported into Epi Data and then exported to SPSS for examination. A 95% Confidence Interval of p-value ≤ 0.05 was used to declare significance. The method of thematic content analysis was used to examine the qualitative data.ResultThis study comprised 531 individuals in total, with a 96.2% response rate. Approximately 260 adolescent females (49%, 95% CI: 39.2, 59.2) had good management practices for menstrual hygiene. Girls whose mothers were private employees (AOR: 0.3, 95% CI: 0.09, 0.99), self-employed (AOR: 0.52, 95% CI: 0.28, 0.98) and housewives (AOR: 0.53, 95% CI: 0.29, 0.98), and parent-adolescent discussions about menstruation (AOR: 1.62, 95% CI: 1.40, 3.34) were significantly associated with good menstrual hygiene management. Adolescence aged 17 years or older (AOR: 2.13, 95% CI: 1.32, 3.44) were found to have good knowledge regarding menstrual hygiene (AOR: 1.59, 95% CI: 1.43, 2.94). The qualitative study found that ignorance, an unfavorable school climate, and cultural and economic factors were the main causes of teenagers’ poor menstrual hygiene.ConclusionNearly half of adolescent girls had good menstrual hygiene practice. Menstrual hygiene practice was associated with adolescent age, knowledge of menstruation, maternal occupational and discussion with parents. Girls had difficulty to manage menstrual hygiene due to poor knowledge, unsafe school environment, and cultural barriers. Thus, school-based programs aimed at improving knowledge towards menstrual hygiene management are needed.

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.

Menstrual hygiene management and menstrual problems among adolescent girls in an urban area in north India: A cross-sectional study.

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

Menstrual hygiene management and menstrual secrecy among young women in rural Lao PDR: A cross-sectional study.

As a fundamental right, all women should have equal access to menstrual hygiene management (MHM). However, certain sociocultural contexts foster an atmosphere of secrecy surrounding menstruation, which discourages open discussion. The present study seeks to explore the relationship between attitudes on menstrual secrecy and MHM practices among young women in rural areas of the Lao People's Democratic Republic (Lao PDR). In March 2023, a cross-sectional survey using semi-structured self-administered questionnaires was conducted on 80 women (age range, 15-24 years) randomly selected from eight villages in the central part of Lao PDR. Logistic regression analysis was performed to examine the associations between sociodemographic and economic characteristics, MHM practices, social support, and attitudes toward secrecy regarding menstruation. Among the 70 respondents, 68 (97.1%) reported being satisfied with current MHM practices; however, 27 (38.6%) agreed that menstruation should not be discussed with others. Some women lacked access to private spaces for changing pads or washing. The results of the logistic regression analysis indicated that women with higher monthly disposable income were less likely to endorse menstruation secrecy (odds ratio: 0.15, 95% confidence interval: 0.02-0.85). No significant associations were found between MHM practices and attitudes on secrecy. Although no direct association was found between MHM practices and attitudes on menstruation secrecy, some participants remain in unfavorable MHM environments.

A Comparative Study of Menstrual Hygiene Knowledge and Practices among International and Government School going Adolescent Girls in Delhi

Introduction: Menstrual Hygiene Management (MHM) involves using clean absorbents, maintaining body hygiene, and practicing safe disposal methods. This study aimed to compare the knowledge and MHM practices of adolescent school girls from an urban and a slum area in Delhi. Methods: The study included 85 and 168 girls aged 13-18 years from an urban and a slum area school of Delhi respectively. Information was gathered using a pre-designed, pre-tested and structured questionnaire with 12 questions related to the knowledge about menstruation and MHM practices. Results: 92.9% of urban and 85.7% of slum area school girls knew menstruation as a physiological process whereas 3.5% of urban school girls were unaware of the cause of menstruation compared to13.7% of the slum area school girls(p=0.01). All girls identified sanitary pads as their ideal absorbent, and 100% of the participants used them. Satisfactory cleaning practices were 31.8% in urban area verses 4.8% in slum area school girls. (p = 0.0001). 95.3% of urban and 92.8% of slum area school girls were disposing pads in routine waste. Conclusion: The study found significant differences in menstrual knowledge and MHM practices between urban and slum area school girls, with urban girls reporting comparatively better knowledge as well as MHM practices. Both the group of girls reported 100% usage of sanitary pads, but improper disposal practices need attention. Proper disposal facilities in schools are recommended to prevent environmental pollution.

Menstrual hygiene management practice and associated factors among secondary school girls in eastern Ethiopia: The influence of water, sanitation and hygiene facilities.

Inadequate water supply, poor sanitation and hygiene (WASH) facilities in schools, insufficient puberty education and a lack of hygienic menstrual hygiene management (MHM) items (absorbents) cause girls in developing countries like Ethiopia to view menstruation as shameful and uncomfortable. However, there was little evidence of female MHM practice and associated factors among secondary school girls in eastern Ethiopia. To assess MHM practice and associated factors among secondary school girls in eastern Ethiopia. Institutional-based cross-sectional study design was conducted. A total of 473 secondary schoolgirls were selected using a stratified sampling technique. Data were collected using a self-administered structured questionnaire, double-entered to Epidata version 3.1 and exported to SPSS version 26 for analysis. Descriptive analysis was computed using frequency, percentage, mean and standard deviations. Multivariable logistic regression was applied to assess the association of the school water, sanitation and hygiene facilities with MHM. Adjusted odd ratio (AOR) with its 95% confidence interval was computed to show the strength of the association between dependent and independent variables. The goodness of fit of the model was tested by the Hosmer-Lemeshow goodness of fit test. Out of 473 study participants, 72.93% of them (95% CI: 68.74-76.76) reported good MHM practices. The study also found that availability of continuous water supply (AOR = 2.40, 95% CI: (1.42-4.01)); types of toilet (AOR = 2.01, 95% CI: (1.20-3.40)), confined space (AOR = 3.02, 95% CI: (1.49-4.76)) and having females' toilets alone inside in the school (AOR = 2.70, 95% CI: (1.20-4.40)) were significantly associated with female students' good MHM practice. The survey revealed that some of the secondary schoolgirls practiced poor menstrual hygiene management (MHM), which needs further improvement. The study also found that the availability of continuous water supply in the school, types of toilet facility in the school, availability of private space to manage periods at school, learning about MHM in schools and availability of female toilets kept locked inside were factors significantly associated with MHM practice of students, which require integration of Zonal Health and education bureau to jointly work towards the improvement of school WASH facilities.

MENSTRUAL HYGIENE EDUCATION FOR ADOLESCENT GIRLS IN INDONESIA: A SYSTEMATIC LITERATURE REVIEW

Introduction: Implementing Menstrual Hygiene Management (MHM) among Indonesian adolescents is still low due to a lack of knowledge. The impact of this quiet MHM practice is the risk of reproductive tract infections, so various educational efforts are needed to improve the knowledge and skills of adolescents in MHM practices.&#x0D; Objectives: to identify educational interventions to improve adolescent girls' menstrual hygiene.&#x0D; Method: This study used a systematic literature review method with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) approach in selecting articles from various previous studies. Research articles were obtained by accessing six electronic databases published in 2013-2023 with a population of adolescent girls. Fifteen papers that met the criteria were received.&#x0D; Results: Menstrual health education interventions carried out individually were the use of bibliotherapy, and in groups were peer education and snakes and ladders edutainment, while in mass were counselling, lectures and demonstrations. Educational interventions in terms of the media used were printed media, including bibliography, index card matches, modules, pocketbooks, leaflets, booklets, and electronic media, namely slides and videos.&#x0D; Conclusion: The educational interventions improved MHM's knowledge, attitudes, and practices, and each intervention carried out had different results in each improvement aspect. The most widely used method was peer education, and the most commonly used media were videos and leaflets.

An epidemiological study of period poverty among females of reproductive age group in Lucknow (U.P.).

Females in developing countries face brunt of lack of access to affordable menstrual supplies and inequitable distribution of menstrual health education and are victims of period poverty. The objective of the present study was to estimate prevalence of period poverty and to determine association of period poverty with socio-demographic determinants, menstrual knowledge, menstrual hygiene management practices, and reproductive health. This was an analytical cross-sectional study, conducted at an urban primary health care centre. Reproductive age group (20-49 years) females attending the primary health care centre from December 2022 to May 2023 were selected for study. Data were collected on semi-structured, pre-tested questionnaires. The collected data were entered in M.S Excel and analysed in STATA version 17.0. Chi-square test was used for comparison of qualitative data, and for quantitative data, unpaired t-test was used. The prevalence of period poverty in the present study was 92 (29.7%). The mean age of females with period poverty was 29.72 ± 7.13 years, and it was 26.45 ± 6.62 years with no period poverty (P 0.001). Period poverty was significantly associated with socio-demographic variables. Period poverty had significant association with menstrual knowledge, menstrual hygiene management practices, and reproductive health. Many females cannot afford menstrual health products to meet their monthly needs, and this may affect their education and socio-economic status. Improved access to affordable sanitary products is requisite of females.

The Knowledge, Pattern and Practice of Menstrual Hygiene among Female Secondary School Students in Ogbomoso, South-west Nigeria

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

Influence of Menstrual Hygiene Management Knowledge, Attitudes and Practices and School Attendance among Girls in Public Primary Schools in Kisumu West Sub-County, Kisumu County, Kenya

School based comprehensive sexuality education that addresses Menstrual Hygiene Management (MHM) knowledge practices – including hygiene practices and management of menstrual pain may be an avenue for addressing both poor MHM practices and absenteeism, if they are locally adapted and practiced. Inadequate knowledge, lack of access to quality sanitary materials, cultural beliefs and taboos around menstruation and MHM, are common challenges that can negatively affect Education, Employment, Health and psychosocial outcomes. The study aimed at examining Menstrual Hygiene Management Knowledge, Attitudes and Practices in public primary schools in public Primary schools in Kisumu west sub-county. The respondents consisted of class 6-8 girls, teachers, Head teachers, and MoE officials who were key informants for the study. Data was collected using structured questionnaires and interview schedules. The data analyzed using Statistical Package for Social Sciences (SPSS) version 22 software. Both quantitative and qualitative findings were presented in the study. The study revealed that there is high prevalence of poor MHM among adolescent girls, and there exist a strong association between poor MHM and low knowledge. The study concluded that menstrual hygiene management in public primary schools is greatly influenced by knowledge, attitudes and practices of school management and girls’ perceptions. The study recommends the need for comprehensive education interventions in school settings, delivered during early adolescence to reach pre-menarche girls, particularly in rural settings for improve menstrual hygiene practices. The government should have a clear monitoring tool to ensure pupils receive accurate and timely information on menstruation and menstrual hygiene management.

The Influence of School Based Menstrual Hygiene Management Programs on School Attendance among Girls in Public Primary Schools in Kisumu West Sub-County, Kisumu County, Kenya

Most governments have prioritized Menstrual Hygiene Management (MHM) practices for safe schools. However, girls and women in Low and Middle-Income Countries (LMIC) still face significant challenges in managing their menstruation. This study examined the influence of school based MHM Programs on school attendance among girls in public Primary schools in Kisumu west sub-county, Kisumu County, Kenya. The study was anchored on the Sanitary Hardware theory. The study employed descriptive survey research design where both qualitative and quantitative methods were used. Questionnaires were administered to a selected sample of 356 respondents drawn from a target population of 3233. The sample size was arrived at using the Yamane (1967) formula. The respondents consisted of class 6-8 girls, teachers, Head-Teachers, and MoE officials who were key informants for the study. The collected data was filtered, organized, coded and later analyzed using Statistical Package for Social Sciences (SPSS) version 22 software. Analysis was done in form of descriptive and inferential statistics. From the findings, the F ratio is 111.855, which means that improvement due to fitting the model is much greater than the model inaccuracies (F (1, 336) = 111.855, p=0.001). This implies that Menstrual Hygiene Management school-based programs are useful predictor of school attendance. The researcher therefore recommends that schools should be able to ensure consistent availability of water for use by girls during menstruation. They should be empowered to involve themselves in making reusable pads to assist those who cannot afford disposable pads use locally available materials in menstrual management.

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.

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.

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.