MENSTRUAL HYGIENE MANAGEMENT IN GIRLS AND WOMEN

Little attention has been given to understanding the ways in which MHM contributes to school absenteeism and other gender disparities. One notable initiative that has been implemented in rural communities and schools during programmes that promote sanitation and hygiene behaviours and provide improvements to the sanitation infrastructure including MHM friendly facilities. Schools with such programmes will most likely have ventilated improved toilets with a covered pit and a designated hand washing facility with a cleaning agent (soap/ash).

Understanding the differences between MHM practices across schools with and without SLTS can provide important insights on the effectiveness of SLTS for MHM. This study was conducted to understand girls’ experiences of managing their menstruation and to further explore how the menstrual hygiene environment within schools may affect their Water, sanitation and hygiene (WASH) interventions aimed at keeping girls in school through provision of sanitary materials, water, soap and privacy show mixed impact on school absenteeism. Research has shown that cleanliness of school latrines reduced the odds of absenteeism and others suggest that one in ten school-aged girls in low and middle income countries fail to attend school during menstruation or drop out of school at puberty due to the absence of menstrual hygiene management (MHM) facilities.

Quantitative studies reveals that moderate to non-significant improvements to school attendance associated with MHM interventions .Nonetheless, WASH for MHM should be considered as a basic right to ensure girls’ comfort, self-confidence and school attendance to reduce gender disparities in education, health and socio-political and economic participation. Menstrual hygiene management requires availability of access to clean and absorbent menstrual material, privacy, water and soap, and disposal facilities for used menstrual materials. However, most schools in developing countries, especially in rural areas, have inadequate facilities including water supply for girls to wash hands, external genitalia and soiled clothes, nor do they have provision for privacy, soap, sanitary pads and disposal of soiled sanitary pads.

Girls’ participation and psychological well-being while in class is affected when they do not have access to sanitary pads or adequate alternatives because they fear staining their clothes and subsequently being teased and humiliated by their classmates. It is not surprising then, that attendant hormonal disruptions notwithstanding, girls’ school performance has been noted to decline after they attain menarche. Education of girls directly impacts national health and national development as well as economic and social progress. Educated women tend to have fewer children, lead healthier lifestyles and raise healthier families by making more informed choices. Being more likely to practice and seek appropriate preventive and medical services such as personal hygiene, nutrition and immunization, they help reduce infant morbidity and mortality in the nation, this in turn leads to lowered fertility rates and higher market productivity thereby improving the national economy. However, this potential is cut short with girls dropping out or not attending school, which is reflected in the low female literacy levels of approximately 58%. About 44% of girls are reported to drop out of school before completing their secondary education .

One reason for this interruption could be inadequate provision for MHM that does not allow all girls to attend school with dignity and comfort during their menstruation while menstruating, schoolgirls in rural areas and communities would rather stay home than be uncomfortable, inactive and embarrassed due to inadequate MHM facilities at school. A friendly and supportive MHM environment that provides education, absorbent sanitary materials and adequate WASH facilities is essential to providing equal opportunity for all girls. While in school, girls require an environment that is supportive of menstrual hygiene management (MHM) in order to ensure regular school attendance and participation. Little is known about schoolgirls access to and practice of MHM in rural areas. This show girls’ experiences of MHM in rural schools from the perspectives of schoolgirls, schoolboys and communities and school-based adults key to MHM for school girls.

Most girls reported learning about menstruation only at menarche and did not know the physiological basis of menstruation. The girls reported MHM-related challenges, including: use of non-absorbent and uncomfortable menstrual clothes and inadequate provision of sanitary materials, water, hygiene and sanitation facilities (WASH) in schools. In particular, toilets did not have soap and water or doors and locks for privacy and had a bad odor. Girls’ school attendance and participation in physical activities was compromised when menstruating due to fear of teasing (especially by boys and their fellow females) and embarrassment from menstrual leakage. Boys said they could tell when girls were menstruating by the smell and their behaviour, for instance, moving less and isolating themselves from their peers. Girls complained of friction burns on their inner thighs during their long journey to school due to chaffing of wet non-absorbent material used to make menstrual clothes.

Girls preferred to dispose used menstrual materials in pit latrines and not waste bins for fear that they could be retrieved for witchcraft against them. Though traditional leaders and female guardians played a pivotal role in teaching girls MHM, they have not resolved challenges to MHM among Menstrual Hygiene is vital to the empowerment and well-being of women and girls worldwide. It is about more than just access to sanitary pads and appropriate toilets, though those are important. It is also about ensuring women and girls live in an environment that values and supports their ability to manage their menstruation with dignity, maintaining their integrity as well as pride as a female they are proud to be and will forever be.

Menstrual Hygiene Management (MHM) refers to a stage in the live time of girls and women, where irreversably women and adolescent girls will have to make use of clean menstrual management materials to absorb or collect blood that consistently comes out of their body through their private parts for a specific number of days. Girls at schools and women at work, offices or even at home are expected to change their sanitary kits in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required, and having access to facilities to dispose off used menstrual management materials.

Globally, at least 500 million women and girls lack proper access to menstrual hygiene facilities. Several factors influence difficult experiences with menstruation, including inadequate facilities and materials, menstrual pain, fear of disclosure, and inadequate knowledge about the menstrual cycle. In most cases, only 1 in every 2 girls have knowledge about menstruation before their first period, while in some other cases, only 1 in every 4 girls know about it before their first period. In some rural areas, 1 out of 2 girls misses one to three days out of school per month due to lack of access to sustainably solutions to leakage, fall-off, stain and stigmatization during their menstruation.

In our society today, for 1 out of 2 girls, mothers are the most important source of information about menstruation as they are very observant and the female child tends to be very close and free to communicate with their mothers rather than their fathers, then followed by those whom they observe their characters goes hand in hand whom at the long run luckily happens to be their friends and are fee and willing to discuss whatever it is they are passing through as well as trying their very best to keep each other little secrets safe and confidential.

Menstrual Hygiene Day ( MAY 28) is a special day dedicated to bringing awareness around the vital role that good menstrual hygiene management (MHM) plays in empowering women and adolescent girls worldwide to become self-confident, self-reliant, independent and all that they can be individually. The vision behind MH Day is a world in which every woman and girl is able to manage her menstruation in a hygienic way, in safety, privacy, and with dignity and integrity wherever they maybe irrespective of gender, tribe, race or even environment .

Menstruation is a phenomenon unique to the females, the onset of menstruation is one of the most important changes occurring among the girls during their adolescent years. The first menstruation (menarche) occurs between 11 and 15 years with a mean of 13 years. Adolescent girls constitute a vulnerable group, particularly in areas where female child is been neglected and treated as a bad omen to the development of the society. Menstruation is still regarded as something unclean, dirty, bad omen, taboo, a disease, a curse, a stigma and many distabilizing, cruel,ill-mannered words and categorization in many of our developed and developing society.

Reaction to menstruation depends upon the kind of awareness and knowledge about the subject. The manner in which a girl learns about menstruation and its associated changes may have an impact on her response to the event of menarche. Although menstruation is a natural process, it is linked with several misconceptions and practices, which sometimes result into adverse health outcomes. Hygiene-related practices of women during menstruation are of considerable importance, as it has a health impact in terms of increased vulnerability to Reproductive Tract Infections (RTI). The interplay of socio-economic status, menstrual hygiene practices and RTI are noticeable. Today millions of women are suffering from RTI and its complications are that, oftenly the infection is transmitted to the offspring of the pregnant mother. Women having better knowledge regarding menstrual hygiene and safe practices are less vulnerable to RTI and its consequences. Therefore, increased knowledge about menstruation right from childhood may escalate safe practices and may help in mitigating the suffering of millions of women and girls out there in our society.

Menstrual hygiene, is a very important risk factor for Reproductive Track Infections and it is a vital aspect of health education for adolescent girls. Educational television programmes, trained school nurses/health personnel, motivated school teachers and knowledgeable parents can play a very important role in transmitting the vital message of correct menstrual hygiene to the adolescent girl of today. Reproductive Tract Infections, which has become a silent epidemic that devastates women’s life is closely interrelated with poor menstrual hygiene. Therefore, proper menstrual hygiene and correct perceptions and beliefs can protect the women folk in the society from this suffering. Before bringing any change in menstrual practices, the girls should be educated about the facts of menstruation, physiological implications, about the significance of menstruation and development of secondary sexual characteristics, and above all, about proper hygienic practices with selection of disposable sanitary menstrual absorbent. This can be achieved through educational television programmes, menstrual hygiene cross section talks with girls and women in various schools and communities, school nurses/health personnel, compulsory sex education in school curriculum and knowledgeable parents, so that her received education would indirectly wipe away the age-old wrong ideas and make her feel free to discuss menstrual matters including cleaner practices without any hesitation.

All mothers irrespective of their educational status should be taught to break their inhibitions about discussing with their daughters regarding menstruation much before the age of menarche. Lack of privacy is an important problem. In resource poor contexts, where women do not have access to basic facilities such as water, bathroom and privacy, the standard of hygiene one can maintain is severely compromised. There is a need to improve the housing conditions with respect to basic facilities. Universalized use of sanitary pads can be advocated to every girl only by making it available at affordable prices (social marketing).

Through the help of talks show programmes, training, seminar and lots more, has helps in revealing that menstrual hygiene is far from satisfactory among a large proportion of the adolescents while ignorance, false perceptions, unsafe practices regarding menstruation and reluctance of the mother to educate her child are also quite common among them. Thus, reinforcement needs to be put in place to encourage, promote and assure safe and hygienic practices among the adolescent girls thereby bring them out of our traditional beliefs, misconceptions and restrictions regarding menstruation.

Menstruation and menstrual practices are still clouded by taboos and socio-cultural restrictions resulting in adolescent girls remaining ignorant of the scientific facts and hygienic health practices, which sometimes result into adverse health outcomes.

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