Background: During menstruation, school girls face obstacles connected to menstrual hygiene management in schools. Due to their monthly period, up to 20% of girls miss school globally, and one in ten will drop out entirely. Three hundred thirty-five million girls attended school without access to running water or soap. In Ethiopia, 67% of girls have no access to education on puberty and menstrual health; menstrual hygiene management continues to be one of the major problems among school girls. Thus, context-specific assessment of the practice may be useful in developing customized intervention approaches. Thus, the objective of the study was to assess practices of menstrual hygiene management and associated determinants among secondary school girls in East Hararghe, Ethiopia from 1 to 30 December 2020. Methods: A school-based cross-sectional survey was undertaken with 486 randomly selected female students. Data were collected by pretested self-administered questionnaire. Descriptive statistical tests and multivariate logistic regression were used to describe the study variables and to examine the association. Statistical package for social science version 23 was used for data analysis, and a p-value of 0.05 was considered as a cut-off point for statistical significance. Results: Of the total, 328 (68%) of the study participants practiced appropriate menstrual hygiene. Besides, 350 (72.6%) had a good level of understanding about menstrual hygiene. A higher level of knowledge (adjusted odds ratio = 2.12, 95% confidence interval = 1.28, 3.53), a greater wealth indexed family (adjusted odds ratio = 7.14, 95% confidence interval = 3.98, 12.88), earning permanent pocket money (adjusted odds ratio = 0.495, 95% confidence interval = 0.299, 0.821), and being in grade level (11–12) (adjusted odds ratio = 3.45, 95% confidence interval = 1.75, 4.501) were significant predictors of the good menstrual hygiene practice. Conclusion: One-third of the school girls had poor menstrual hygiene practices which may affect their school performance and the reproductive health. Hence, tailored menstrual hygiene information should be given to school girls and parents. Besides, efforts ought to be made for the provision of affordable sanitary materials in schools.

The practice of menstrual hygiene management and associated factors among secondary school girls in eastern Ethiopia: The need for water, sanitation, and hygiene support

Objective We investigated some aspects of menstrual health and hygiene among young female students at Birzeit University in the West Bank of the occupied Palestinian territory. Design Cross-sectional study in a large central university. Participants Out of a total of 8473 eligible female students, a calculated sample size of 400 students aged between 16 and 27 years was obtained. Setting Large central university, West Bank, occupied Palestinian territory (oPt). Measures An anonymous structured international research instrument consisting of 39 questions based on the Menstrual Health Questionnaire, in addition to few questions relevant to the context, was administered. Results 30.5% of participants were not informed about menstruation before menarche, and 65.3% reported that they were not ready when they got their first period. The highest reported source of information regarding menstruation was family (74.1%), followed by school (69.3%). About 66% of respondents reported that they need more information on various topics of menstruation. The most common type of menstrual hygiene products used were single-use pads (86%), followed by toilet paper (13%), nappies (10%) and reusable cloths (6%). Of the total 400 students, 14.5% reported that menstrual hygiene products are expensive, and 15.3% reported that they always/sometimes had to use menstrual products that they do not like because they are cheaper. Most (71.9%) of the respondents reported that they used menstrual products for longer time than recommended due to inadequate washing facilities at the university campus. Conclusions The findings provide useful evidence on the lack and the need for menstrual-related information for female university students, inadequate infrastructure to help them manage their menstruation with dignity and pointed to some menstrual poverty in accessing menstrual products. A national intervention programme is needed to increase awareness regarding menstrual health and hygiene among women in local communities and female teachers in schools and universities to enable them to disseminate information to and meet the practical needs of girls at home, at school and at the university.

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Menstrual health and hygiene among young Palestinian female university students in the West Bank: a cross-sectional study

A Modified Menstrual Attitudes Scale: Heteronormative Attitudes, Sexism, and Attitudes Toward Menstruation in Male and Female Adults

Good menstrual hygiene management in schools means that schoolgirls have access to adequate school toilets that meet criteria for basic sanitation and hygiene service, but also that they have basic knowledge about menstrual hygiene. The aim of this work is to assess sanitation and hygiene conditions for adequate menstrual hygiene management in rural schools in the Šumadija and Pomoravlje districts. The study was conducted on the territory of the rural areas of Šumadija and Pomoravlje districts in 2016. It encompassed 238 schools, of which 108 in Šumadija and 130 in Pomoravlje district. To assess sanitation and hygiene conditions for adequate menstrual hygiene management, a questionnaire was created, with questions related to: existence of toilets at schools and whether they are functional, accessible, single-sex, and ensure privacy, to provision of soap and toilet paper, handwashing facilities, bins with a lid in toilet cubicles for schoolgirls, and to provision of menstrual hygiene education. This research showed that a high percentage of school toilets in rural areas meet the basic service criteria (more than 90% for sanitation and about 85% for hygiene) in respect of toilet type and whether toilets are single-sex, usable, and with functional handwashing facilities. However, the obstacles to reaching the criteria for advanced service level are the insufficient provision of facilities for the disposal of menstrual products in toilet cubicles (76.9%), as well as the absence of menstrual hygiene education in 50% of schools. The research indicated the need to improve sanitation and hygiene conditions in order to reach advanced service level that would include better menstrual hygiene management in rural schools in Serbia. Also, a continued research should be focused on the role of social and economic aspects concerning schoolgirls and their families in the attainment of adequate menstrual hygiene.

Menstrual hygiene management in rural schools in Šumadija and Pomoravlje districts (Serbia)

Background. Girls and women face substantial menstrual hygiene management (MHM) challenges in low and middle-income countries. These challenges are related to inadequate knowledge, and insufficient water, sanitation and hygiene (WASH) facilities. Currently, literature on MHM among college-attending women in Bhutan is scarce. We aimed to explore knowledge, attitudes, and practices (KAP) of female college students from all ten government colleges of Bhutan, documenting conditions of available MHM facilities, from August to September 2018. Methods: A cross-sectional KAP survey was conducted with a random sample of female students from all years and a random sample of MHM facilities at each college and hostel. A questionnaire was adapted from a similar study conducted with school students in Bhutan. Socio-demographics, overall KAP findings, and differences in KAP between first and final year students were analyzed; college and hostel toilets were reported. Results: 1,010 participants completed the self-administered questionnaire. Comprehensive knowledge of menstruation was low (35.5%). Half (50.3%) reported their mother as source of information and 35.1% of the participants agreed that women should not enter a shrine during menstruation. Approximately 4% of median monthly pocket money was spent on absorbents with 96.9% absorbents wrapped before disposal. Half (55.1%) reported menstruation affecting daily activities and 24.2% missed college due to dysmenorrhea. One fifth of participants (21.3%) reported unavailability of water in college, 80.1% of participants reported absence of soap for hand washing and 24.1% described no bins for disposal. In 33.7% of hostel toilets, participants reported doors missing locks. Our team’s observations had similar findings. Conclusion: Female students living in hostels during college years lose considerable resources during their formative years of learning: time, energy, and money, due to issues of menstruation management. Although the overall understanding of menstruation was low, our participants’ MHM practices scored highly, and the vast majority of them asked for a platform to discuss menstruation. Despite some agreement with menstrual taboos (e.g. visiting shrine), only 5.1% were uncomfortable conversing about MHM. Improved public health knowledge, psychosocial/medical support, and WASH infrastructure with freely available menstrual products could lead to more effective MHM practices among female college students.

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Rinchen Wangdi

Papers

Menstrual Hygiene Management—Knowledge, Attitudes, and Practices Among Female College Students in Bhutan