Menstrual Hygiene - Research Methodology
Menstrual Hygiene - Research Methodology
Menstrual Hygiene - Research Methodology
ABSTRACT
Background: The onset of menstruation is the most important physical change that occurs among girls during
adolescence. Menstrual hygiene management is an important issue for adolescent girls. Lack of education and
communication regarding reproductive system further adds to the problem. Several studies have shown that the
knowledge regarding menstrual cycle is not sufficient. Insufficient management of menstrual hygiene may result
in symptoms involving genitourinary tracts infection. Adolescent girls’ health is more important in the context
of production and reproduction as future mothers. With this background, the present study was conducted.
Objectives
To assess the Knowledge, Attitude and Practice (KAP) level of Adolescent girls about Menstrual Hygiene
Management (MHM).
To identify the determinants of Menstrual Management with specific emphasize on school attendance.
Materials and Methods
The study design is an exploratory and descriptive study conducted in two Government Higher Secondary
Schools in rural villages of Sithayankottai and Sitharevu in Dindigul District. A structured questionnaire was
used as study tool to collect data from the respondents. Universal sampling method was adopted to the study.
All the 606 adolescent girls in the age group of 10-18 years of the selected two schools of the study area were
the respondents of the study. The questionnaire was pretested to verify the clarity, absence of ambiguity,
objectivity, sequence and simplicity. The questionnaire had been pretested among 10 adolescent girls of another
school. Based on pretest necessary corrections and modifications were carried out accordingly before
administering for data collection. Data Analysis: The collected data were computed and tabulated in Microsoft
excel and analyzed. The findings were described in terms of proportions and percentage. Period of the study
was from June 2019 to August 2019.
Results: A total of 606 adolescent girls were studied to measure their level of KAP on menstruation and
menstrual hygiene practices. Overall, percentage of knowledge about menstrual cycle among them is very low.
18.7% of girls had menstrual awareness and the source of knowledge for most of the girls was teachers,
followed by relatives and friends. Out of the total sample universe only 11.1% of girls received information from
their mothers. Menstrual hygienic practices among the surveyed population were found to be satisfactory but
needs improvement in disposal of menstrual waste. Conclusion: The knowledge about menstrual cycle is found
to be very poor among the respondents as schools are playing little role in educating about menstruation.
Schools need to be encouraged in imparting right information and encouraging girls to speak out and to
practice right Menstrual Hygiene Management.
I. INTRODUCTION
Adolescence is a transitional phase of growth and development between childhood and adulthood,
which is not only physical but also emotional and psychological. According to WHO, adolescent is defined as
any person between the ages of 10 to 19 years. 1.2 billion Adolescents stand at the crossroads between
childhood and the adult world. Around 243 million of them live in India. The onset of menstruation is the most
important physical change that occurs among girls during adolescence. It is not uncommon for the girl to have
many questions and concerns related to menstrual cycle. Menstrual hygiene management is an important issue
for adolescent girls as they do not have experience. Even most of the parents lack the required information about
the menstrual cycle and issues related to its management. Lack of education and communications regarding
reproductive system further adds to the problem. Several studies have shown that the knowledge regarding
menstrual cycle is not sufficient and correct. The religious practices, restrictions, and myths related to menstrual
cycle create more confusion about the correct practice and very little information is given to adolescent girls, in
such culture. Studies done to assess the practices related to menstrual hygiene had also indicated the need for
improvement. Menstruation and menstrual hygiene are still shadowed by taboos, cultural and social restrictions,
1. General Objective
To improve the Menstrual Hygiene Management (MHM) among school going Adolescent girls (10-18 years) in
Athoor Block of Dindigul District, Tamil Nadu.
2. Specific Objectives
1) To assess the KAP level of Adolescent girls about Menstrual Hygiene Management (MHM).
2) To identify the determinants of Menstrual Management with specific emphasize on school attendance.
Out of the 606 respondents 44.2% respondents were in the age group of 13-15 years. 96.7% of the respondents
were attending school from home and the rest were staying in hostels. 77.8% of the respondents were living in
nuclear family.
The above table indicates that 54.2% of the respondents live in own house with toilet facility, 26.6% of the
respondents have own house without toilet facility and 15.3% live in rental/leasing house with toilet facility and
3.9% of the respondents live in rental/leasing house without toilet facility.
Table 3 – Type of Toilet facilities used and water supply in their home (n=606)
Sithayankottai School Sitharevu School
Toilet Facility used
Numbers (%) Numbers (%)
Separate (Home) 204 (66.9) 217 (72.1)
Public (Community toilet) 103 (33.8) 98 (32.6)
OAD 110 (36.1) 106 (35.2)
Water facility in toilets
33.2% of the respondents were using public (Community) toilets and 35.7% of the respondents were practicing
OAD in both villages. 55.6% of the respondents had no water facility in their home toilet. Non availability of
water facilities is a drawback to the adolescent girls to adopt proper menstrual hygiene management.
From the above table, it could be inferred that out of the total respondents’ (606) parents 28.3% were illiterates
in Sithayankottai and 31.1% of parents were illiterates in Sitharevu. The illiteracy level is higher among mothers
when compared to Fathers of the respondents.
As per the above table, majority of parents of the respondents (79%) fall under the lower income group of below
Rs.10,000/- per month. Only 4.3% of parents fall under the income group of Rs.20001 and above income group.
We could infer from this table that majority of adolescent girl students belong to lower income family.
Menstrual Pattern in Adolescent Girls Table 1: Menstrual pattern in Adolescent girls (n=606)
Pattern
59.1% of the respondents attained menarche in the age group of 13-15 years. 18.8% of girls have reported blood
flow more than 6 days. Among 77.4% of girls, the length of menstrual cycle was 28-30 days. 7.5% of the
respondents had answered that they were not aware of the duration of blood flow during menstrual period and
6.8% of answered that they were not aware of their length of menstrual cycle.
Distribution of respondents according to their knowledge about menstruation Table 1: Knowledge about
menarche before Menstruation (n=606)
Sithayankottai School Sitharevu School
Knowledge about menarche
Numbers (%) Numbers (%)
The above table reveals that majority of the adolescent girl respondents (61.7%) had responded that
they did not have knowledge about menarche before they attained menstruation cycle. 38.3% of girls knew
about menstruation before menarche. Teachers were the source of information for 18.7% girls followed by
relatives 17.8%, friends 15.9%, mother 11.1% and 13.1% had answered that they received information regarding
menstruation from other sources. It could be inferred, from the above table, that mothers are not the major
source of information to their girl children regarding menstruation.
Distribution of respondents according to their hygienic practices during menstruation Table 1 – How
many times do you take bathing in a day during menarche (n=606)
Sithayankottai School Sitharevu School
Bathing frequency
Numbers (%) Numbers (%)
One time 131 (62.7) 151 (69.9)
Two times 73 (34.9) 61 (28.2)
Three times 5 (2.4) 4 (1.9)
Not attained 96 (31.5) 85 (28.2)
To clean genital organs is necessary
Regarding hygienic practices 66.3% girls had responded that they bath once a day during menarche and 31.6%
only twice. 56.4% girls had said that keeping genital organs clean is necessary. From the above table we could
infer that nearly half of the respondents (43.6%) did not consider that keeping genital organ clean is necessary.
From the above table it could be interpreted that majority of the respondent girls (70.1%) who attained menarche
do not know to properly dispose the used sanitary napkins. Only 39.7% respondent girls who attained menarche
had said that they burned the used sanitary napkins through incinerator in Sithayankottai school.
67.5% girls said that unhygienic practices during menstruation lead to itching and irritation. 42.8% girls of the
respondents had accepted that eating Sweets, Papaya, and Pineapple will lead to over bleeding. 54.6% accepted
that taking iron rich food is not necessary during menstruation.
The above table depicts that out of 425 respondent girls 44.3% of the respondent girls responded that they could
not concentrate on study during the menstrual period and 40.3% had expressed that they could not able to go
schools during menstrual period.
IV. DISCUSSION
Current study examined KAP towards MHM among school going adolescent girls in Sithayankottai and
Sitharevu Govt. Higher secondary school, Athoor Block of Dindigul District. The age group of 606 respondents
was in between 10-18 years of age. Around 96.7% of the respondents were coming from home for higher
secondary schooling; nearly 77.8% of them were from nuclear families that might be a reason for not having
proper knowledge on menstrual management; it was surprising to see 69.5% of the respondents were having
toilet facility at their house. Around 33.2% of the respondents still depend on the public (community) toilets.
Around 55.6% of them were not having water facility at their toilets; 16.2% of their mothers are illiterates who
must have lacked in menstrual hygiene and sanitation related issues. Nearly 79% of their parents were having
income of less than 10,000/- per month. Almost 100% of the respondent girls (except 0.3%) did not know the
organ of menstrual bleeding. Majority of the respondent girls (70.1%) who attained menarche do not know to
properly dispose the used sanitary napkins. Only 39.7% respondent girls who attained menarche had said that
they burn the used sanitary napkins through incinerator. Around 43.6% of respondents feel that keeping genital
organ clean during menstrual period is not necessary. 61.2% of them were feeling a bad smell during
menstruation along with 67.5% of them were having a common infections like itching and irritation. Around
42.8% of the respondents believed that eating sweets, papaya, and pineapple would lead to over bleeding. 54.6%
of the respondents not accepted that taking iron rich food is necessary during menstruation. 44.3% of the
respondent girls responded that they could not concentrate on study during the menstrual period and 40.3% of
respondent girls had expressed that they could not attend schools during menstrual period.
School health education should be developed to empower adolescent girls with proper and correct
knowledge on MHM, so that they may adopt appropriate personal health practices. Educating adolescent girls
about the myths and misconceptions on menstruation should be removed completely right at their young age so
that a menstrual hygiene can be developed and practiced throughout their life term. It would be wonderful if the
teachers and research organizations take up the responsibility of providing healthier workable menstrual
hygienic practices to all young girls in the school so that if might turn into a blossoming and healthy society in
India.
REFERENCES
[1]. Srivastava S, Chandra M. Study on the knowledge of school girls regarding menstrual and reproductive health and their perceptions
about family life education program. Int J Reprod Contracept Obstet Gynecol 2017;6:688-93.
[2]. Arunmozhi R, Antharam P. A cross sectional study to assess the levels of knowledge practices of menstrual hygiene among
adolescent girls of Chennai higher secondary schools, Tamil Nadu, 2013. Med EJ 2013;3:211.
[3]. Shanbhag D, Shilpa R, D’Souza N, Josephine P, Singh J, Goud BR, et al. Perceptions regarding menstruation and practices during
menstrual cycles among high school going adolescent girls in resource limited settings around Bangalore city, Karnataka, India. Int
J Collab Res Intern Med Public Health 2012;4:1353-62.
[4]. Malhotra A, Goli S, Coates S, Mosquera-Vasquez M. Factors associated with knowledge, attitudes, and hygiene practices during
menstruation among adolescent girls in Uttar Pradesh. Waterlines 2016;35:277-305.
[5]. Bodat S, Ghate MM, Majumdar JR. School absenteeism during menstruation among rural adolescent girls in Pune. Natl J
Community Med 2013;4:212-6.
[6]. Mazumder R, Sikdar DP. Menstruation Hygiene Management among Adolescent School Girls in India. International Journal of
Multidisciplinary Approach and Studies. 2017;4(3): 103-107.
[7]. Kumar A, Srivastava K. Cultural and social practices regarding menstruation among adolescent girls. Social work in public health.
2011;26(6):594-604.
[8]. Alavi M, Poushaneh K, Khosravi A. Menarche health: knowledge, attitude and practice of the adolescent girls in Tehran, Iran. 2009.
[9]. Santina T, Wehbe N, Ziade FM, Nehme M. Assessment of beliefs and practices relating to menstrual hygiene of adolescent girls in
Lebanon. Int J Health Sci Res. 2013;3(12):75-88.
[10]. Sedghi Sabet M, Hasavari F, Saied Fazel Poor F. A Survey Of Knowledge, Attitude, And Health Behaviour Of Girl Studeuts About
Menarche. Journal of Guilan University of Medical Sciences. 2003;12(47):31-8.
[11]. Agoyi M, Odeyemi K, Ogunyemi D. Knowledge, Attitude and Hygiene Practices Toward Menstruation and the Prevalence of
Menstrual Patterns and Disorders Among Adolescents. The Journal of Sexual Medicine. 2017;14(5):e262.
[12]. Alam M-U, Luby SP, Halder AK, Islam K, Opel A, Shoab AK, et al. Menstrual hygiene management among Bangladeshi
adolescent schoolgirls and risk factors affecting school absence: results from a crosssectional survey. BMJ open.
2017;7(7):e015508.