Menstrual Hygiene Practices in Context of Schooling: A Community Study among Rural Adolescent Girls in Varanasi

INTRODUCTION:

Up until now, poor menstrual hygiene in developing countries has been an insufficiently acknowledged problem. The lack of attention to this issue is striking as we cannot achieve several Millennium Development Goals (MDGs), that is, 2, 3 4,5, and 5B. This study aimed to assess the level of awareness about menarche and hygienic practices during menstruation in context of schooling.

MATERIALS AND METHODS:

Community-based cross-sectional study using a mix method approach (qualitative and quantitative). It was conducted among 650 adolescent girls in the field practice area of Rural Health and Training Centre, Chiraigaon block of district Varanasi between January and June2011. Pretested, semistructured interview schedule was used. Data were analyzed statistically by using Statistical Package for Social Sciences (SPSS) software.

RESULTS:

Out of the total 650 respondents, 590 (90.78%) had attained menarche at the time of interview and only one-third of the respondents (29.4%) were aware of menstruation before menarche and sisters (55%) played the key role in providing information to them. Only 31% respondents were using sanitary pads during menstruation. Self-reported reproductive tract infection (RTI) was observed more in respondents not maintaining hygienic practices (6.6%) as compared to those maintaining hygiene (2.6%).

CONCLUSION AND RECOMMENDATIONS:

From the Focus Group Discussions (FGDs) as well as quantitative survey it was observed that the awareness about menarche before its onset was still poor in rural areas. Significant association (P < 0.05) was observed between respondent education and their awareness about menarche before its onset. Therefore, it is recommended that teachers can play an influential role in informing them about changes during adolescence, especially about menarche and other issues related to menstruation. As per the present study, sisters and mothers were the major source of information. Therefore, there is a need for the provision of comprehensive family life education for the parents also.

Below:  Association of hygienic practices during menstruation and respondent's socioeconomic and demographic characteristics

Full article at:   http://goo.gl/g4rl4D

By:  Kansal S1, Singh S1, Kumar A1.

• 1Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
• Indian J Community Med. 2016 Jan-Mar;41(1):39-44. doi: 10.4103/0970-0218.170964. 

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Do Menstrual Hygiene Management Interventions Improve Education and Psychosocial Outcomes for Women and Girls in Low and Middle Income Countries? A Systematic Review

BACKGROUND:

Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls.

OBJECTIVES:

To summarise and critically appraise evidence for the effectiveness of menstruation management interventions in improving women and girls' education, work and psychosocial wellbeing in low and middle income countries.

METHODS:

Structured systematic searches were conducted in peer-reviewed and grey literature to identify studies evaluating education and resource provision interventions for menstruation management. Individual and cluster randomised controlled trials were eligible for inclusion, as were non-randomised controlled trials. Study characteristics, outcomes and risk of bias were extracted using a piloted form. Risk of bias was independently assessed by two researchers.

RESULTS:

Eight studies described in ten citations were eligible for inclusion. Studies were highly heterogeneous in design and context. Six included assessment of education-only interventions, and three provided assessment of the provision of different types of sanitary products (menstrual cups, disposable sanitary pads, and reusable sanitary pads). A moderate but non-significant standardised mean difference was found for the two studies assessing the impact of sanitary pad provision on school attendance: 0.49 (95%CI -0.13, 1.11). Included studies were heterogeneous with considerable risk of bias. Trials of education interventions reported positive impacts on menstrual knowledge and practices, however, many studies failed to assess other relevant outcomes. No trials assessed or reported harms.

CONCLUSIONS:

There is insufficient evidence to establish the effectiveness of menstruation management interventions, although current results are promising. Eight trials have been conducted, but a high risk of bias was found and clinical heterogeneity precluded synthesis of most results. Whilst trials provided some indication of positive results, further research is needed to establish the role of menstruation hygiene management in education performance, employment and other psychosocial outcomes. This review provides a concise summary of present trials and highlights improvements for future work.

Below: Review authors’ judgements about methodological items for each included study

Full article at:   http://goo.gl/fH2C4K

By:  Hennegan J1, Montgomery P1.

• 1Centre for Evidence-Based Intervention, University of Oxford, Oxford, United Kingdom.
• PLoS One. 2016 Feb 10;11(2):e0146985. doi: 10.1371/journal.pone.0146985. eCollection 2016. 

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Impact of Advertising on Tampon Wear-Time Practices

OBJECTIVES

To determine whether advertising nighttime tampon use for up to eight hours was understood to be consistent with label recommendations and (2) to determine whether television and print advertising with this message affected tampon wear times in adults and teens.

METHODS

A comprehension study (online advertising and follow-up questionnaire) among women aged 14–49 years (300 per group) who viewed either the test or a control advertising message; (2) Diary-based surveys of tampon wear times performed prior to (n = 292 adults, 18–49 years, 74 teens, 12–17 years) and after (n = 287 adults, 104 teens) the launch of national advertising.

RESULTS

Significantly more test message viewers than controls stated tampons should be worn less than or equal to eight hours (93.6% vs. 88.6%, respectively, P = 0.049). A directionally higher percentage of test message viewers said they would use a pad if sleeping longer than eight hours (52% vs. 42% of controls). Among the women who used tampons longer than eight hours when sleeping, 52% reported they would wake up and change compared with 45% of controls. No significant difference between baseline and follow-up diary surveys was found among teens or adults in various measures of tampon wear time (mean wear times; usage intervals from less than two hours to more than 10 hours; percentage of tampons used for more than or equal to eight hours; frequency of wearing at least one tampon more than eight hours).

CONCLUSIONS

Advertising nighttime tampon wear for up to eight hours effectively communicated label recommendations but did not alter tampon wear times. The informational intervention had limited impact on established habits.

Below:  Typical inquiries about tampon wear times and overnight tampon use

Below:  Advertising comprehension study comparing two messages. (A) Wear-time message: Protection for up to 8 hours, even at night (test). (B) Product performance message: Fluid absorbency and leakage protection (control)

Below:  Tampon absorbency choices from diary surveys conducted prior to and after the launch of advertising with a message that tampons can be used at night for up to eight hours

Full article at:   http://goo.gl/Vy7pI1

By:   Kara E. Woeller,1 Kenneth W. Miller,1 Amy L. Robertson-Smith,2 and Lisa C. Bohman3

¹Global Product Stewardship, Feminine Care Business Unit, The Procter & Gamble Company, Cincinnati, OH, USA.

²Research and Development, The Procter & Gamble Company, Cincinnati, OH, USA.

³Quantitative and Clinical Sciences, The Procter & Gamble Company, Cincinnati, OH, USA.

CORRESPONDENCE: Email: moc.gp@ek.relleow

  

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Menstrual Hygiene Practices & Its Association with Reproductive Tract Infections & Abnormal Vaginal Discharge among Women In India

OBJECTIVE:

The objective was to explore the determinants of menstrual hygienic practices and its effect on Reproductive Tract Infections (RTI) among ever married women in India.

METHODS:

District Level Household and Facility Survey-3 (DLHS) India data have been used in the study. The respondents constituted ever married women (N = 577,758) in the age group of 15-49. Bivariate and multivariate techniques were employed using IBM SPSS statistics 20. Individual effects of socio economic, demographic and gynecological factors on menstrual hygienic practices, RTIs and abnormal vaginal discharged respectively were calculated using binary logistic regression.

RESULTS:

A meager 15% of women used sanitary pad/locally prepared napkins during menstruation in India. Both RTI and Vaginal discharge were positively related with non-use of hygienic methods. The women who used unhygienic method during menstruation were more likely to have any symptom of RTI (OR = 1.046, p < 0.001, CI = 1.021-1.071) and vaginal discharge (OR = 1.303, p < 0.001, CI = 1.266-1.341).

CONCLUSION:

The reason for the symptoms of RTI may be diverse and not only limited to the unhygienic menstrual practices although this may be one of the reasons causing reproductive morbidity. Awareness, affordability and privacy are some of the major concerns that need immediate attention to promote the use of sanitary pad during the time of menstruation. Establishing relation between menstrual practices and RTI is in its initial stage of investigation and hence needs further research.

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By:  Anand E1, Singh J2, Unisa S3.

• 1International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai 400088, India. Electronic address: enuanand@hotmail.com.
• 2School of Health Systems Studies, Tata Institute of Social Sciences, Deonar, Mumbai 400088, India.
• 3International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai 400088, India.

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Assessment of Knowledge and Practice of Menstrual Hygiene among High School Girls in Western Ethiopia

The issue of menstrual hygiene is inadequately acknowledged and has not received proper attention. Use of sanitary pads and washing the genital area are essential practices to keep the menstrual hygiene. Unhygienic menstrual practices can affect the health of the girls and there is an increased vulnerability to reproductive tract infections and pelvic inflammatory diseases and other complications. Therefore, the objective of this study was to assess the knowledge and practice of menstrual hygiene among high school girls at Nekemte town, Oromia region, Western Ethiopia.

A school based cross-sectional study design was employed in Nekemte Town, Western Ethiopia. A multi stage sampling technique was used to select 828 female high school students. Data collection was carried out from May 04 to May 30, 2014 using a pre- tested structured questionnaire. The data were entered into a computer using Epi-info version 3.5.1 and then exported to SPSS for Windows version 20.0 for analysis. Bivariate and multivariate logistic regression analysis was done at 95 % confidence interval.

In this study, 504 (60.9 %) and 330 (39.9 %) respondents had good knowledge and practice of menstrual hygiene respectively. The findings of the study showed a significant positive association between good knowledge of menstruation and educational status of mothers (AOR = 1.51, 95 % CI = 1.02 – 2.22), having radio/TV (AOR = 2.42, 95 % CI: 1.64 – 3.56). Educational status of the mother (AOR = 2.03, 95 % CI = 1.38 – 2.97) and earning permanent pocket money from parents (AOR = 2.73, 95 % CI = 1.76 – 4.26) revealed significant positive association with good practice of menstrual hygiene.

The findings showed that the knowledge and practice of menstrual hygiene is low. Awareness regarding the need for information about good menstrual practices is very important. So, health education program should be setup to create awareness and practice of good menstrual hygiene.

Below:  Respondents’ sources of information about menstruation in Nekemte Town, Oromia region, Western Ethiopia, 2014

Full article at: http://goo.gl/gwZPrj

By: Shivaleela P. Upashe^*, Tesfalidet Tekelab and Jalane Mekonnen

College of Medical and Health sciences, Wollega University, Nekemte, Oromia, Ethiopia

  

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"Bitten By Shyness": Menstrual Hygiene Management, Sanitation, and the Quest for Privacy in South Africa

Little is known about how menstruation is managed in low-income settings and whether existing sanitation systems meet women's needs. Using the 'Photovoice' method with 21 women in participatory workshops and in-depth interviews, we collected data on menstrual hygiene management in three sites in Durban, South Africa. 

All women reported using disposable sanitary pads. Although they were aware that disposable pads were non-biodegradable, incompatible with water-borne flush systems, and fill up pit latrines, they had little experience with reusable products. Considerable energy was devoted to concealing and containing 'menstrual waste', and women expressed concern about inadequate privacy during menstruation. All sites lacked discreet disposal options and reliable water access, while outdoor sanitation facilities were considered unsafe. 

Findings highlight the need for advocacy to improve safety and privacy of facilities for women in this setting.

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By: Scorgie F, Foster J, Stadler J, Phiri T, Hoppenjans L, Rees H, Muller N.

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