|
| |
 |
|
| ORIGINAL ARTICLE |
|
| Year : 2020 | Volume
: 8
| Issue : 1 | Page : 29-34 |
|
Awareness and practices regarding menstrual hygiene among adolescent girls residing in the village of Rasulabad in Wardha district
Vaishnavi Hatwar, Jagruti N Chaple
Department of Kriya sharir, Mahatma Gandhi Ayurved College, Hospital & Research Centre (MGACH & RC), Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
| Date of Submission | 29-Apr-2020 |
| Date of Decision | 30-Apr-2020 |
| Date of Acceptance | 16-May-2020 |
| Date of Web Publication | 2-Jul-2020 |
Correspondence Address:
Dr. Jagruti N Chaple
Department of Kriya Sharir, Mahatma Gandhi Ayurved College Hospital & Research Centre (MGACH & RC), Salod (H), Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra.
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JISM.JISM_42_20
Background: Menstruation and menstrual practices in rural areas are still a matter of concern. Knowledge and awareness about menstrual hygiene is lacking among rural adolescent girls. Increase in knowledge in their early childhood may help to mitigate sufferings of many women. With this background, this study was conducted in a small village of Wardha district. Aims and Objectives: The aims of this work were to study awareness and practices regarding menstrual hygiene among adolescent girls residing in a village of Wardha district, to assess the awareness about menarche, to find out the prevailing practices for menstrual hygiene, and to ascertain the association of awareness of menstruation before menarche and practices for menstruation hygiene with educational status of respondents and their mothers. Materials and Methods: A community-based cross-sectional study was conducted among adolescent girls in the age group 12–19 years, who were personally interviewed based on a predesigned structured questionnaire. Data for this survey were collected by house-to-house visits using a structured questionnaire through interviewing and observation during Community Health Check Program from Mahatma Gandhi Ayurveda College, Hospital & Research Centre. Results: Age of menarche of most of the girls was between 12 and 16 years. 63% girls were unaware about knowledge of menstruation before menarche. In this study, mothers were found to be the source of knowledge of 71% girls. 74% girls knew that menstruation is a physiological process. 79% girls used sanitary napkins. Conclusion: Many are still unaware about knowledge of menstruation before menarche and source of bleeding. There is a need to create awareness among young girls about menstruation hygiene and its process. Keywords: Adolescent girls, menarche, menstrual hygiene, rural area, Wardha district
How to cite this article:
Hatwar V, Chaple JN. Awareness and practices regarding menstrual hygiene among adolescent girls residing in the village of Rasulabad in Wardha district. J Indian Sys Medicine 2020;8:29-34 |
How to cite this URL:
Hatwar V, Chaple JN. Awareness and practices regarding menstrual hygiene among adolescent girls residing in the village of Rasulabad in Wardha district. J Indian Sys Medicine [serial online] 2020 [cited 2023 Jun 7];8:29-34. Available from: https://www.joinsysmed.com/text.asp?2020/8/1/29/288809 |
| Introduction | |  |
Menstruation is a major milestone in the life of a woman. Onset of menstruation at the age of 12–14 encounters many responses such as fear and anxiety. Providing early awareness may help to control such situation. Various resources are responsible to provide sex education, which include friends, relatives, teachers, mass media, and health-care workers. Mothers can be the major source to provide this knowledge. But literacy of the mother is equally important. The menstrual period is a physiological process that occurs throughout the reproductive years of every woman.[1],[2]
Majority of females have very limited or no knowledge about menstruation and the importance of personal hygiene while menstruating. Maintaining adequate hygiene during menses is necessary to stay away from infections as well as for general comfort and easy mobility. Due to lack of knowledge, many women follow very unsafe practices such as using coir and unsanitary cloth pads during their menses.[3] According to United Nations Children’s Fund (UNICEF), there are 243 million adolescents comprising 20% of the total population of India, which clearly shows that India is truly “young.”[4] This sheer number itself is a big challenge in itself; adolescents aged 15–19 years constitute 10% and majority of them live in rural areas. Menarche marks the beginning of a multitude of physical, physiological, and psychological changes in the lives of the adolescent girls. Menstruation is still regarded as something unclean or dirty in Indian society and it is strongly related with misconceptions and cultural restrictions. Menstrual hygiene depends on the educational, socioeconomic, and cultural statuses of a family. School curriculums also have some role in menstrual health.[5] Learning about hygiene during menstruation is a vital aspect of health education for adolescent girls as patterns that are developed in adolescence are likely to persist in adult life.[6]
Poor menstrual hygiene causes increased vulnerability to reproductive tract infections (RTI). Currently, millions of women suffer from RTI and infection is transmitted to the offspring. Women having knowledge regarding menstrual hygiene are less vulnerable to RTI and its consequences. Therefore, increased knowledge about menstruation from adolescent period helps in decreased suffering of millions of women.[7] To give more emphasize to the menstrual health, a day is being celebrated on May 28th as “Menstrual Hygiene day” by the WASH (Water, Sanitation and Hygiene) United.[8] By recognizing the importance of promotion of menstrual hygiene, government of India started a scheme of making available subsidized sanitary napkins to adolescent girls in the rural part of India since August 2011.[9] Along with personal hygiene, proper disposal of the absorbent used is also important. Disposing one-time use sanitary pads is difficult in some places due to lack of daily garbage collection facilities. They should be wrapped in newspaper before disposing. If cloth is used, then it should be properly washed and dried in open air and sunlight and stored in sterile or clean place. Time-to-time change of absorbent according to flow is to be checked. Long-time use of the same cloth may lead to urinary tract infections or RTIs. Therefore, in India, where female child is neglected one, menstruation is still regarded as something unclean or dirty in Indian society. The reaction to menstruation depends on awareness and knowledge about the subject and this is need of today. So, the aim of this study was to determine the perception of different aspects of menstruation and menstrual hygiene. The objectives of the study were to assess the awareness and practices regarding menstrual hygiene among adolescent girls and to ascertain the association of awareness of menstruation before menarche and practices for menstruation hygiene with educational status of the respondents and their mothers.
| Materials and Methods | | |
A community-based cross-sectional study was conducted among adolescent girls residing in the village of Rasulabad in Wardha district. The adolescent girls in the age group 12–19 years were personally interviewed on the basis of predesigned structured questionnaires from July 2018 to January 2019. Data were analyzed statistically by simple proportions. Ethical clearance and permission were obtained from the Institutional Ethical Committee (IEC), DMIMS (deemed-to-be university), Sawangi (Meghe), Wardha. Permission was secured through a formal letter with Ref. No. DMIMS(DU)/IEC/2018-19/7324. Before interviewing, a verbal consent of the respondent was taken.
Sample Size
This study included a sample size of 100 adolescent girls.
Inclusion Criteria
The inclusion cirtieria of the study included all girls between the age group of 12 and 19 years residing in Rasulabad (rural area) of Wardha district.
| Observations and Results | | |
Observation is noted and presented in the form of tables. During the survey, 100 girls in the age group of 12–19 years were interviewed, and their responses were collected.
[Table 1] shows the age-wise percentage of respondents, of which 3% girls belong to 12 years’ age group, 9% girls belong to 13 years’ age group, 11% girls belong to 14 years’ age group, 15% girls belong to 15 years’ age group, 16% girls belong to 16 years’ age group, 17% girls belong to 17 years’ age group, 19% girls belong to 18 years’ age group, and 10% girls belong to 19 years’ age group.
[Table 2] shows that 70% of the respondents were of Hindu religion. [Table 3] shows that 71 respondents have mothers as their knowledge source, 5.64% are illiterate, 87.32% had attained primary education, 7.04% have attained secondary education & none of them has attained higher education. [Table 4] shows that 26% girls had their menarche at the age of 14 years and only 1% girls had their menarche at the age of 18 years. 37% had knowledge of menstruation before menarche and 63% had no knowledge of menstruation before menarche.,  | Table 3: Percentage of respondents according to the literacy of their mothers
Click here to view |
,
As shown in [Table 5], only 29% of girls knew that the source of bleeding is uterus and 71% of girls were unaware of this. 74% of girls knew that menstruation is a physiological process, whereas 26% girls were not aware that menstruation is natural. | Table 5: Percentage of respondents according to their knowledge about menstruation
Click here to view |
79% of girls used sanitary napkins, 9% used old cloth, and 12% used new cloth.
Of 21 respondents who were using clothes instead of pads, economic consideration was the major issue.
Percentage of respondents according to the disposal method of absorbents used are as shown in [Table 6]. Respondents bathing regularly, hand washing and cleaning their external genitalia daily during menstruation was found to be 100%. | Table 6: Percentage of respondents according to the disposal method of absorbents used
Click here to view |
84% of the respondents used soap for handwashing and 16% used hand-wash.
[Figure 1] shows the response of the girls to their first menstruation, indicating that 44% of girls were presented with no response, 42% had fear, 9% had bad response, and only 5% had anxiety. | Figure 1: Percentage of respondents according response to first menstruation
Click here to view |
[Figure 2] shows that were found to be the source of knowledge in 71% respondents.
[Figure 3] shows that 68% girls were studying in 9th–12th classes.
| Discussion | | |
This study reveals that the age of menstruating girls ranged from 12 to 16 years, whereas Agarwal et al.’s[10] study showed that the age of menstruating girls ranged from 12 to 17 years. In this study knowledge about menstruation to adolescent girls, source from mothers (71%) followed by teachers(15%), friends and relatives along with other family members were the sources of information. The literacy of mother stud 87.32%
So, all mothers irrespective of their educational status should be taught to break their hesitation about discussing with their daughters regarding menstruation much before the age of menarche. Similar findings were observed by Ramachandra,[11] where mother was the first informant. In this study, no one reused cloth without proper washing and drying. The important findings reported in this study are that 79% of girls use sanitary napkins and 61% dispose them by burning, as stated similarly in the study by Hema Priya.[12]
The varied reaction menarche may depend on the extent to which the girls have been prepared regarding the same. Fear was the reaction observed in the study conducted by Dube and Sharma.[13] In this study, 79% of girls used sanitary napkins, so universalized use of sanitary pads can be advocated to every girl only by making it available at affordable prices. Moreover, 63% girls had no knowledge of menstruation before menarche, so school curriculums should also have some role in menstrual health. A study conducted by Dirija[14] reported that 72.01% of the urban participants and only 39.01% of the rural participants had knowledge prior to menstruation. It was observed that 100% of the respondents were bathing regularly, handwashing, and cleaning their external genitalia daily during menstruation.
This study also shows that 71% of girls do not know that the source of bleeding is uterus. So many are still unaware about knowledge of menstruation before menarche and source of bleeding. In addition, the response of girls to their first menstruation is analyzed; that is, 44% of girls were presented with no response but 42% had fear so. There is a need to make them aware about this. It is concluded that where women do not have access to basic facilities such as water, bathroom, and privacy, the standard of hygiene one can maintain is severely cooperated. There is a need to improve the housing conditions with respect to basic facilities.
According to Ayurveda, the following are some recommendations for having healthy menstrual cycle: consuming simple, freshly prepared, and hot food items; and adding spices such as ginger, cardamom, cumin, coriander, and cinnamon in the diet. Cleansing involves the downward movement of waste out of the body. So the direction of flow should not be interrupted by any upward movements such as excessive talking, thinking, sexual intercourse, and even Pranayam and Yoga. All these activities need energy and our body needs to all its store energy toward cleansing. Suppuration of urges such as urination, defecation, and sneezing should be avoided. All these will cause the upward flow of Vata which will disturb the free flow of cleansing action. Meditation will bring peace of mind which again assists the action of Vata. Hydrating the body with warm teas such as ginger tea, lemon tea with honey, cumin, coriander, and fennel teas is recommended. Maintaining the balance of doshas even at the time without menstruation is also important. The better way to maintain dosha in equilibrium is to do yearly cleanse. Seasonal cleansing is a highly effective way to balance and rejuvenate all bodily tissues so that they function optimally. Practicing Pranayam for balancing the mind as it helps to equalize the right and left side of brain and yoga as per constitution will keep your body strong and energetic.[15]
| Conclusion | | |
It can be concluded that the knowledge on menstruation is suboptimal and the practices are unacceptable for proper hygiene. Along with personal hygiene, proper disposal of absorbent used is also important. It is essential to design a mechanism to address and for the access of healthy menstrual practices. Periodic gynecology checkup should be recommended to all school-going girls. It should be followed by appropriate remedial measures. So, Ayurveda also blesses us with the outlook that this is ultimately a cleanse. And by viewing it as such, we can work with our body toward greater health, instead of running against its natural work. Many are still unaware about knowledge of menstruation before menarche and source of bleeding. Hence, there is a need to make them aware about this.
Financial Support and Sponsorship
Datta Meghe Institute of Medical Sciences (DU).
Conflicts of Interest
There are no conflicts of interest.
| References | | |
| 1. | Beek JS, Williams W. Puberty and Dysmenorrhea Treatment. Novice’s Gynecology. Philadelphia: Williams and Wilkins Publication Inc. 1996.  |
| 2. | Hegde A, Shetty A, Kamath VG, Bhaskaran U, Kamath A, Roy K, et al. Reproductive health matters among Indian adolescents: A qualitative study. J Midwife Reprod Health 2017;5:890-6. |
| 3. | Available from: https://sanitation.indiawaterportal.org/english/resources. [Last accessed on 2020 Apr 5]. |
| 4. | UNICEF. The State of the World’s Children 2011: Adolescence: An Age of Opportunity. Available from: http://www.unicef.org/sowc2011/pdfs/India.pdf. [Last accessed on 2016 Nov 10]. |
| 5. | Dhingra R, Kumar A, Kour M. Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls. Ethno-Med 2009;3:43-8. |
| 6. | Lawan UM, Yusuf NW, Musa AB. Menstruation and menstrual hygiene amongst adolescent school girls in Kano, northwestern Nigeria. Afr J Reprod Health 2010;14:201-7. |
| 7. | Dasgupta A, Sarkar M. Menstrual hygiene: How hygienic is the adolescent girl? Indian J Community Med 2008;33:77-80. [ PUBMED] [Full text] |
| 8. | WASH United. Menstrual Hygiene Management. Berlin, Germany: WASH United. 2016. Available from: http://wash-united.org/our-work/issues/menstrual-hygiene-management/articles/our-work-issues-menstrual-hygiene-management. [Last accessed on 2017 Apr 4]. |
| 9. | Jogdand K, Yerpude P. A community based study on menstrual hygiene among adolescent girls. Indian J Maternal Child Health 2011;13:1-6. |
| 10. | Agarwal N, Soni N, Singh S, Soni G. Knowledge and practice regarding menstrual hygiene among adolescent girls of rural field practice area of RIMS, Raipur (C.G.). India Int J Reprod Contracept Obstet Gynecol 2018;7:2317-21. |
| 11. | Ramachandra K. A study on knowledge and practices regarding menstrual hygiene among urban adolescent girls. Int J Contem Pediatrics 2016;3:142-5. |
| 12. | Hema Priya S, Partha N, Seetharaman N, Ramya MR, Nishanthini N, Lokeshmaran A, et al. A study of menstrual hygiene and related personal hygiene practices among adolescent girls in rural Puducherry. Int J Community Med Public Health 2017;4:2348-55. |
| 13. | Dubey S, Sharma K. Knowledge attitude and practice regarding reproductive health among urban and rural girls: A comparative study. Ethno Med 6:85-94. |
| 14. | Datta A, Manna N. Menstruation and menstrual hygiene among adolescent girls of West Bengal, India: A school based comparative study. Glob J Med Pub Health 2012;1:50-78. |
| 15. | Available from: . |
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]
|
Search Pubmed for