AWARENESS OF MENSTRUAL HYGIENE: ASSESSMENT OF KNOWLEDGE AND PRACTICE OF MENSTRUAL HYGIENE AMONG ADOLESCENT COLLEGE GOING GIRLS OF NAGUNOOR,KARIMNAGAR

Year : 2019 | Volume : 7 | Issue : 3 Page : 22-29

Mohapatra I¹,Samantaray SR², VivekanandA³, ,Soujanya B⁴

¹Associate Professor, ²Associate Professor, ³Professor, ⁴Senior resident, Department of Obstetrics and Gynaecology,Prathima Institute of Medical Sciences.

Address for correspondence Dr.SUBHARANJAN SAMANTARAY. C-Blook 303 Prathima institute of medical sciences, Karimnagar

E-mail:demurerosy@gmail.com

Abstract

Objective:

To assess the knowledge, attitude and practices of menstrual hygiene among the college going adolescent girls.

Materials and methods:

The study was done among the adolescent girls of age group 18-20 years from Government residential college of Nagunoor, Karimnagar district, Telangana.300 girls from the above mentioned college were selected.Data collection was done using a semistructured questionnaire with a total number of 30 questions from June 25, 2018 to July 15, 2018.

Results:

Meanage of menarche in the study subjects was 11.7 years.47.7% of participants had some knowledge about menstruation before menarche, and the most common source of information was either mother(58 cases i.e. 40.5%) or teacher(34 cases i.e. 23.7%) .83% cases thought that menstruation is a physiological process and 7.3% cases thought it to be pathological.40% cases used sanitary pads during menstruation. Amongst the girls using clothes, 52%girls cleaned the clothes with soap and water.75% of the girls were not allowed to attend religious functions. 60% of them were not allowed to do household works.

Conclusion:Menstrual hygiene is amatter that has to be dealt with at all levels. Though the basic awareness regarding menstrual process is satisfactory, but still many social taboos are linked with it. Health policy makers should build up a way to tackle with these problems so that adolescent girls can have the access tohealthy menstrual practices.

Key words: Adolescence,menstrual practices

BACKGROUND:

Adolescence, as defined by the World health organization is the period of life spanning the ages between 10 and 19 years.1Adolescent girls form a part of susceptible age group because of theirstatus in society, age and health. Mind-set towards menstruation and menstrual practices developed at menarche may persistthroughoutlife. 2The study of menstrual practices of adolescent girls reveals health issues that are linked with their adjustment to reproductive life and it also provides the base for developing health education strategies. Faulty beliefs and practices regarding menstruation will influencewellbeing of a great number of women in the reproductive age group. Many studies done in the past have revealed that adolescent girls have incomplete and inaccurate information about the physiology of menstruation and its hygiene. They also revealed that mothers, friends, teachers, social media and relatives were the main resource of information to young girls3, 4, 5

The data about the level of knowledge and attitude towards menstruation of young girls is valuable for developing a programme for improving the understanding level in the society. Hence this cross sectional study was carried out.

The objectives of this study were:

1. To assess the knowledge, attitude and practices of menstrual hygiene among the college going adolescent girls.

2. To study various social factors which play a role in preventing the acceptance and following of menstrual hygiene practices among the respondent population.

MATERIALS AND METHODS:

1. Study design: Community based cross sectional study.

2. Study setting: The study was done among the adolescent girls of age group 18-20 years from Government residential college of Nagunoor, Karimnagar district, Telangana.

3. Study population: 300 girls from the above mentioned college were selected for the study.

4. Sample selection: the residential college had 1200 adolescent girls from which 300 girls were selected randomly.

5. Study tools and techniques: Data collection was done using a semi-structured questionnaire with a total number of 30 questions. The data collection technique was personal interview of the subjects. The questionnaire covered knowledge about menstruation, menstrual practices and social factors associated.

6. Timeperiod: Data collection was done from June 25, 2018 to July 15, 2018.

RESULTS:

TABLE-1 shows the demographic details of the subjects .The age group included in the study ranges from 18-20 years, of its maximum (47%) being 18 years age. Majority of the girls (73.4%) belong to above poverty line group. 61% of the girls had uneducated parents. TABLE-2 shows the menstrual details of the girls. Mean age of menarche in the study subjects was11.7 years. Maximum number of girls (54.7%) had discomfort during their first cycle. 186 girls (62%) girls complained of abdominal pain during the time of menstruation. Most of girls had menstrual flow for 3-5 days (50%).

TABLE-3 depicts the knowledge amongst the girls about menstruation. 143(47.7%) of participants had some knowledge about menstruation before menarche, and the most common source of information was either mother(58 cases i.e. 40.5%) or teacher(34 casesi.e. 23.7%) . 83% cases thought that menstruation is a physiological process and 7.3% cases thought it to be pathological. 164(55%) cases knew uterus to be the source of menstruation.204(68%) cases said that their school performance was affected by menstrual cycles and 180(60%) cases considered menstrual blood to be unhygienic. TABLE-4 reviews the practices during menstruation. About 120(40%) cases used sanitary pads during menstruation. Amongst the girls using clothes, 70(52%) girls cleaned the clothes with soap and water. But majority of these girls dried the clothes inside the hostel (78%). Most of the girls (86 i.e. 52%) used dustbin for disposal of the used sanitary pads and 120(67%) girls disposed them by wrapping it in paper. Maximum number of girls (176) used water and soap to clean their external genitalia. Only 47% of the girls had toilet facilities at home. TABLE-5 depicts the different types of restrictions imposed on the girls during the time of menstruation. 75% of the girls were not allowed to attend religious functions. 60% of them were not allowed to do household works. 20% of the girls were separated and 37% girls were not allowed to sleep on the routine bed. 7% girls were not allowed to go outside their house and 78.6% of girls would not touch the stored food during menstruation.

DISCUSSION:

Our study reveals that the mean age of menarche is 11.7 years. This observation corroborates with studies done by Narayana et al,Dasgupta et al,Khanna et alandTen VTA. 2,5,6,7But this is lesser than that observed in the studies done by Shiela et al and Grover et al.8,9Awareness regarding menstruation and menarche is generally low in Indian culture. Our study showed that 47.7% of participants had prior knowledge about menstruation before menarche. This finding is better than the observation made by Subhash B Thakre et al where it was found to be only 40%.10But still this observation is not satisfactory, because maximum participants were ignorant about menstruation prior to puberty.

Mothers and teachers were the main source of information to the girls (40.5% and 23.7%) as compared to study done by Subhash B Thakre et al where mothers were first informants in 71.33% of cases.10This disparity in finding is possibly due to poor educational status of mothers and less communication between mothers and daughters regarding this issue. Our study finding is consistent with other studies done by Narayana et al andDasgupta et al.2,5 This survey show that 83% cases knew that menstruation is a physiological process. This is concordant with the study done by Dasgupta et al.5But this result is contrary to that of study done by Madhusudan et al where only 43.9%of subjects knew that menstruation is a physiological process.11 This disparity is possibly due to less knowledge about physiology of menstruation in the rural areas when compared to urban population. 54.67% of subjects in the present survey knew uterus to be the source of menstrual bleeding. This is similar to study done by Narayana et al where one third of the subjects had this information.2 This figure is better might be because of the role of both mothers and teachers as informants regarding menstruation, its causes and hygienic practices.

Regarding the practices followed during menstruation, only 40% of cases used sanitary pads while 60% girls were using clothes. Out of the girls using clothes,52% of girls cleaned clothes with soap and water. 59% of girls used water and soap to clean their external genitalia. This is contrary to the finding seen byBhattacherjeeet alwhere 71.3% of girls used sanitary napkins and 47.5% girls cleaned clothes with soap and water.12 Less usage of sanitary napkins in our study is possibly due to poor economic status of our study population. But only 30.2% subjects as observed by Bhattacherjee et al cleaned their external genitalia properly. This is due to better hygienic practices education given to the girls in the residential college.52% girls of the girls used dustbin for disposal of used pads.Similar findings were reported byNarayan et al,Mudey A B et alandDasgupta et al.2,3,5

Place of storage of absorbent is equally important as storing the sanitary pads or clothes in bathrooms or damp places can harbor dust and insects. In the present study 40% of the girls stored the absorbent separately. Amongst them 16.7% of girls stored them in the bathroom. This rate is low as compared to the study done by Subhash B Thakre et al where it was found to be 49.8%.10

Only a small percentage of girls (13.8%) changed pads during college hours similar to the study by Subhash B Thakre et al (11.37%). The possible cause of this might be the lack of proper toilet facilities in the school.10

Considering the social factors associated with menstruation, it is seen that various restrictions are imposed on the girls during menstruation time due to the age old rituals in their communities. 74.67% of girls were not allowed to attend religious functions. This is similar to other studies.3, 5, 8 36.7% of girls slept on separate bed and 78.6% of girls did not touch stored food. 20% of girls were separated from rest of the family members. All these findings are corresponding to study done by Subhash B Thakreet al.10 These restrictions are the result of ignorance and false perceptions about menstruation. These false beliefs also develop an altered attitude towards menstruation.

CONCLUSION:

Menstrual hygiene is a matter that has to be dealt with at all levels. Our study revealed that most of the girls had some knowledge about menstruation, but the menstrual practices followed are not up to satisfactory level.Though the basic awareness regarding menstrual process is satisfactory in our study, but still many social taboos are linked with it. It is very essential that mothers should have appropriate awareness about menstruation and they should talk openly about this with their daughters. The role of schools and teachers is also equally important foracquiring correct knowledge and attitude towards menstruation. However many efforts have to be made to curtailthe misbelieves and longstanding unnecessary practices followed during menstrual periods. Menstrual waste disposal facilities and toilet facilities should be provided in schools and colleges so that absenteeism due to menstruation could be reduced. Education should be focused towards both girls and boys for the development of better understanding and attitude. Health policy makers should build up a way to tackle with these problems so that adolescent girls can have the access tohealthy menstrual practices. Aawareness has to be brought against misconceptions, restrictions and social taboos associated with menstruation to improve and promote better menstrual hygienic practices.

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