Menstrual hygiene practice among adolescent girls in Ethiopia: A systematic review and meta-analysis

Background Adolescent girls face several challenges relating to menstruation and its proper management. Lack of adequate sanitary products, inadequate water supply, and privacy for changing sanitary pads continue to leave adolescent girls with limited options for safe and proper menstrual hygiene in many low-income settings, including Ethiopia. These situations are also compounded by societal myths, stigmas surrounding menstruation, and discriminatory social norms. This systematic review and meta-analysis aimed to estimate the pooled proportion of safe menstrual hygiene management among adolescent girls in Ethiopia using the available studies. Methods We searched PubMed, Google Scholar, African Journal Online (AJOL), Hinari, Science Direct, ProQuest, Direct of Open Access Journals, POPLINE, and Cochrane Library database inception to May 31, 2021. Studies reporting the proportion of menstrual hygiene management among adolescent girls in Ethiopia were considered. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. Since the included studies revealed considerable heterogeneity, a random effect meta-analysis model was used to estimate the pooled proportion of menstrual hygiene management (MHM). Results Of 1,045 identified articles, 22 studies were eligible for analysis (n = 12,330 participants). The pooled proportion (PP) of safe MHM in Ethiopia was 52.69% (95%CI: 44.16, 61.22). The use of commercial menstrual absorbents was common 64.63% (95%CI: 55.32, 73.93, I2 99.2%) followed by homemade cloth 53.03% (95%CI: 22.29, 83.77, I2 99.2%). Disposal of absorbent material into the latrine was the most common practice in Ethiopia 62.18% (95%CI: 52.87, 71.49, I2 98.7%). One in four girls reported missing one or more school days during menstruation (PP: 32.03%, 95%CI: 22.65%, 41.40%, I2 98.2%). Conclusion This study revealed that only half of the adolescent girls in Ethiopia had safe MHM practices. To ensure that girls in Ethiopia can manage menstruation hygienically and with dignity, strong gender-specific water, sanitation, and hygiene (WASH) facilities along with strong awareness creation activities at every level are needed.

Adolescent Movement Cares About Menstrual Hygiene Management (MHM)

Lack of knowledge about The Menstrual Hygiene Management (MHM) and poor water sanitation is a problem in adolescents in Indonesia. This community service activity aims to increase students' knowledge and awareness about MHM. This community service was carried out in October 2019 at SD Muhammadiyah Karangkajen I and SD Muhammadiyah Karangkajen II followed by 25 students from grades IV, V and V. The design of this activity is the provision of training on MKM by providing training modules and applying several learning methods including lectures, discussions, and simulations that begin with pretest and end postest. The results showed there was a difference in the average value of knowledge of students to MKM and statistically significant p<0.05. It is expected that students can do MHM appropriately and provide the right information to friends. Teachers are expected to play an active role in providing information about reproductive health so that students get accurate information

Evaluating the Impact of (WASH) Program on Education in the New Juaben North Municipal of Ghana: Evidence from SDA College Demonstration Basic Schools

The study assessed the causes of inefficiencies in the WASH programme at the Demonstration Basic Schools in the New Juaben North Municipal Assembly; examined the effects of the inefficiencies on the learners at the schools, and suggested appropriate strategies to improve the WASH programme. The researcher employed a qualitative approach to achieve these objectives. The population included headteachers, teachers and learners for the study. The study used purposive sampling technique to select 8 participants. This comprised three head teachers, two teachers and three learners from the school. The findings of the study showed that challenges that confront the WASH programme at the schools were inadequate water supply, poor sanitation and hygiene systems, lack of adequate handwashing points, unclean and not properly maintained toilets, lack of quality toilet facilities, lack of menstrual hygiene management (MHM), inadequate sanitary materials, and unhygienic toilet conditions. It is recommended that the government and authorities should improve the WASH system in the school. Moreover, adequate WASH facilities should be provided considering the various guidelines for WASH to ensure that facilities are adequate, sufficient, accessible, and safe for use by learners. Also, the Ghana Education Service should infuse sanitation education into the new or existing curriculum.

Menstrual Hygiene Management Amidst COVID-19 Pandemic in Nigeria’s Epicentre: The Reality of Girls and Women in a Low-Income Community

Menstrual Hygiene Management (MHM) is typically a constant reality for post menarche and premenopausal females globally. However, unlike other natural routine physiological experiences, a healthy monthly MHM comes with considerable financial implications. Hence, this study examines the financial ability of girls and women in a Nigerian low-income community to access materials needed for MHM monthly. The possible implication of the COVID-19 pandemic was also considered. Semi-structured questionnaires were administered to 130 respondents selected via systematic-random sampling. Data were analyzed using SPSS version 20. The respondents’ age ranged between 14 to 40 years, while 82.3% worked informal jobs. Half of the respondents reported they were unable to purchase sanitary pads and other items required for monthly MHM. Over 65% of the respondents revealed they suffered anxiety thinking about the financial burden associated with monthly MHM, while about one-third of the respondents were more financially capable before the pandemic. Common alternatives to sanitary pads used were tissue paper, cloth napkins, old sanitary towels, and newspapers. Moreover, 64% of the respondents reported had at least a form of vaginal/urinary tract infection in the past 3 months. The results clearly show that period poverty remains a barrier to achieving gender equality. The fact that 1 out of every 2 females in the study area reportedly suffered period poverty shows the dire need for socio-economic interventions. Local and State Governments must consider subsidizing products required for MHM to improve and maintain the health of girls and women in low-income communities.

Does India’s Menstrual Hygiene Management Scheme exclude the disabled?

The Menstrual Hygiene Scheme of the Government of India wishes to generate awareness among adolescent girls, and provide them with hygienic and affordable sanitary napkins. The scheme has been criticised for many reasons by various reviewers. However, we draw attention to a hitherto unaddressed gap that the scheme has effectively overlooked, the menstrual hygiene needs of disabled adolescent girls, and has thereby denied them their right to health and healthcare. This exacerbates health disparities, and raises questions of public health ethics. We conclude with recommendations on how to redress the situation and make the scheme more inclusive.

Menstrual Hygiene Management Practices for Adolescent Girls among Public Secondary Schools in Kibondo District, Tanzania

The study aimed at examining menstrual hygiene management practices among adolescent girls in public secondary schools in Kibondo District. The study used the mixed research approach with the convergent parallel design. The study was comprised of the sample size of 99 respondents from four out of 17 schools, including ten parents, 12 female teachers, 68 students, 4 matrons, 4 Heads of schools and 1 District Education Officer. Data collection was done through semi-structured interview, focus group discussion and questionnaire. Qualitative data analysis was done through content analysis while quantitative data were analyzed descriptively with the help of the Statistical Package for Social Science (SPSS) version 20 and presented in tables through percentages, and frequencies. The study discovered that there are problems in MHM practices among public secondary schools under investigation. There were shortages of menstrual hygiene management practice facilities such as toilets and private areas to change absorbent pads, disposable mechanisms and water. The study recommended that adolescent girls should be provided with sanitary pads and education. There is need to improve MHM facilities such as water, disposable mechanisms and private rooms for changing absorbent materials for effective management of menstrual periods. Menstrual hygiene management topics should be integrated into the syllabi in order to increase awareness on MHM to adolescent girls. Teachers and health workers should closely provide guidance and health talks to adolescent girls, advising them on how to manage their menstrual-related illness effectively for their good performance in school.

Disparities in menstrual hygiene management between urban and rural schoolgirls in Northeast, Ethiopia

Introduction Even though menstruation is a normal biological process, adolescents are facing managing their menstruation when they are at school. It causes girls to miss their class on average three days every month. Studies in some countries showed that the magnitude of menstrual hygiene management problems is higher in rural adolescent girls, but little is known in the Ethiopia context. The objective of this study was to assess and compare menstrual hygiene management practices among rural and urban schoolgirls, Northeast, Ethiopia. Methods An institution-based comparative cross-sectional study was employed among 1078 schoolgirls (539 urban and 539 rural) from February to March 2020. The participants were selected using a multi-stage sampling technique. A structured self-administrative questionnaire and observational checklist were used for data collection. Bivariate and multivariable logistic regression analysis with a 95% confidence interval was employed. A P- value less than 0.05 was used to declare statistical significance. Results Overall, the magnitude of good menstrual hygiene practice was 52.9% (95%CI: 50.3%-56.5%), which was 65.9% (95% CI: 62.8%-70.7%) among urban and 39.9% (95% CI: 36.2%-44.6%) among rural schoolgirls. Among urban schoolgirls, the odds of good menstrual hygiene management practice was higher for girls aged below 18 years (AOR = 1.58, 95%CI: 1.05–2.39), learned about menstrual hygiene at school (AOR = 1.89, 95%CI: 1.21–2.97), heard about menstrual hygiene before menarche (AOR = 4.98, 95%CI: 2.71–9.13), and discussed menstrual hygiene with parents (AOR = 2.56, 95%CI: 1.25–5.27). Whereas, the odds of good menstrual hygiene management practice was higher among those who were knowledgeable on menstrual hygiene (AOR = 5.47, 95%CI: 3.68–8.12), those who learned about menstrual hygiene at school (AOR = 1.75, 95%CI: 1.13–2.70), and girls who heard about menstrual hygiene before menarche (AOR = 3.34, 95%CI: 1.44–7.76) in rural schoolgirls. Conclusions Though the overall menstrual hygiene practice was low, it was relatively better among urban schoolgirls. This calls for more effort to solve these problems and achieve sustainable development goals. Therefore, education and awareness creation on menstrual hygiene for schoolgirls, even before menarche at both settings should be strengthened. Encouraging parent-adolescent discussion on menstrual hygiene would have paramount importance, particularly to urban schoolgirls.