ORIGINAL ARTICLE
Year : 2019  |  Volume : 2 |  Issue : 2 |  Page : 15-18 |  DOI : https://doi.org/10.46319/RJMAHS.2019.v02i02.004

A study of assessment of Knowledge, Attitude and Practice of menstrual hygiene among high school girls in Tumkur

Savitha Rani BB¹,Vinay KS^2*, Aishwarya D³, Shefali3, Krishna Iyengar^4
1 Assistant Professor, Department of Community Medicine, ² Assistant Professor, Department of General Medicine, ³&4 Interns, ⁴ Professor and Head of the Department of Community Medicine Sri Siddhartha Medical College & Research Centre, SSAHE, Agalakote, Tumakuru

*Corresponding author:
Dr. Vinay K S, Assistant Professor, Department of General Medicine, Sri Siddhartha Medical College, Tumkur
E-mail: vinayks@gmail.com

Abstract
Background: Adolescent girls constitute a vulnerable group with respect to their Physical and mental health. The issue of menstrual hygiene is inadequately acknowledged and has not received proper attention. Materials and Methods: A cross-sectional study was conducted among all adolescent girls from class 8th to 10th of government high school in Tumkur by convenient sampling, using semi structured pre tested questionnaire. Results: Out of 160 adolescent high school girls, most of them 59 (36.9%) attained menarche at age 12 yrs.130 (81.3%) were aware about Menstrual hygiene, 112 (70%)believes teaching regarding reproductive health & menstrual hygiene should be included in their syllabus. 50% didn't attend school during menstruation because of cultural believes. Conclusion: It was observed from the present study that, school girls had good knowledge regarding menstrual hygiene, except that they thought poor hygiene does not lead to infection.

Keywords: Menstrual hygiene, adolescent girls, sanitary napkins.
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Introduction
Adolescent girls constitute a vulnerable group with respect to their Physical and mental health. During puberty, the physical changes occur which transform the body of child into that of an adult. The word adolescence is derived from the Latin word “adolescere"; which means “to grow, to mature”. The WHO has defined adolescence as the age period between 10 to 19 years of age for both the sexes.[1] India has 113 million adolescent girls– which is nearly 10% of its population.[2] Good hygienic practices, such as use of sanitary napkins and adequate washing of the genital areas, are essential during menstruation period. The practice of good menstrual hygiene reduces the incidence of reproductive tract infection (RTI). Reproductive tract infections have become a silent epidemic that has impact on women's lives is closely related to poor menstrual hygiene.[3] A menstrual taboo is any social taboo concerned with menstruation In this regard, menstruation is regarded as unclean or dirty in society.[4] The issue of menstrual hygiene is inadequately acknowledged and has not received proper attention.[5]
Most of the girls receive information regarding menstrual hygiene and reproductive health from their mothers, religious books, older sister, or a peer. However, such information was generally given after menarche rather than before. Hence, there is a need to provide healthy family life education to the woman particularly the adolescent girls.  This study was therefore conducted with the aim of assessing the prevailing knowledge about menstruation and hygienic practices.

Materials and Methods
A cross-sectional study was conducted among 160 adolescent girls from a high School in Tumkur from June 2018 to August 2018. After explaining the purpose and nature of the study, all the girls from 8th, 9th and 10th standard, willing to participate were included. A self-administered, pretested, structured questionnaire consisting of questions on knowledge and practices regarding menstrual hygiene was used as a study tool.
The pretested questionnaire was administered under supervision of the investigator to prevent the participants from sharing responses. Following data collection, queries from the participants relating to menstrual and reproductive health were clarified by the investigator.
Data obtained were analysed using SPSS statistical software package, version 16 (SPSS Inc., Chicago, IL, USA), and findings were reported in the form of descriptive statistics.
Data will be entered and analyzed in SPPSS version 22.0, Descriptive statistics like mean and standard deviation will be calculated. Institutional Ethical committee clearance and Informed consent from study subjects was taken.

Results
Out of 160 adolescent high school 36.9% attained menarche at age 12 yrs, 38.1% at 13yrs and 7.5% didn't attained menarche yet.
81.3% were aware about Menstrual hygiene, 70.61% discussed with others regarding Menstrual hygiene and practice, 83.8% answered napkins should be used during menstuation, 85% tell napkin should be changed frequently and most of them told 4-5 napkins are required per day during menstruation. 88.1% believes poor hygiene doesn't leads to infection.
Most of the school girls i.e., 70% of them wanted menstrual hygiene to be part of their teaching.
37.5% had discussed regarding menstrual hygiene with parents, 85% used sanitary napkins, 6.2% used cloth, most of them (61.3%) used 3-4 napkins per day. 46.8% disposed used napkins in dustbins, 41.2% don't practice of washing intimate area with water and soap during menstruation.
50% did not attain school during menstruation because of cultural belief. 51.2% felt uncomfortable to attend school because of inadequate privacy, 35.0% felt uncomfortable because of pain & discomfort, few (6.3%) felt there was no proper facility to dispose napkins.  

 

Table1: Distribution of study subjects based on their Knowledge about Menstrual hygiene

Knowledge	Frequency	Percentage (%)
About Menarche
Not Applicable	3	1.9
Yes	27	16.9
No	130	81.3
Discussed about menstrual hygiene earlier
Not Applicable	5	3.1
Yes	113	70.6
No	42	26.3
What to use during menstruation
Not Applicable	12	7.5
Napkin	134	83.8
Cloth	14	8.8
Does Poor Menstrual hygiene causes infections?
Yes	19	11.9
No	141	88.1
About Frequency of changing Napkin/Cloth during menstruation
NOT APPLICABLE	10	6.3
1-2 PER DAY	6	3.8
2-3 PER DAY	46	28.7
3-4 PER DAY	47	29.4
4-5 PER DAY	51	31.9
Total	160	100

 

Table 2: Distribution of study subjects based on their Attitude towards Menstrual hygiene

	Frequency	Percentage (%)
Did you got information about Menstrual hygiene in School
Yes	82	51.2
No	78	48.8
Do You wish to be educated in school about Menstrual Hygiene
Yes	112	70
No	48	30
Total	160	100.0

Table 3 : Distribution of study subjects based on Practice of Menstrual hygiene

Practice	Frequency	Percentage (%)
Source of Information
Not heard	96	60.0
FAMILY	34	21.3
SCHOOL	13	8.1
FRIENDS	17	10.6
Discussed about Menstrual Hygiene with whom
NOT APPLICABLE	40	25.0
PARENTS	60	37.5
TEACHER	2	1.3
FRIEND	43	26.9
DOCTOR	15	9.4
Choice of use during menstruation
NOT APPLICABLE	11	6.9
NAPKIN	136	85.0
CLOTH	13	8.1

Discussion
A study of menstrual hygiene conducted among adolescents high school girls, most of the girls 36.9% attained menarche at age 12 yrs. In other studies showed, age of menarche ranged from 10 to 19 years.[3,6]
81.3% were aware about menstrual hygiene,70.61% discussed with others regarding menstrual hygiene and practice, 37.5% had discussed regarding this with parents, study done by Das Gupta et al showed that 37.5% received information from mothers.[3]
It is necessary that every girl child should be aware about menstruation, which is an important event of adolescence and mother should educate her daughters regarding menstrual hygiene and practices to prevent diseases. This gap of right knowledge might be due to poor literacy and socio-economic status of mothers, which have created the inhibitions in mother to talk to her daughter regarding the significance, hygienic practices and a healthy attitude towards menstruation.
85% of our respondents used sanitary napkins, 6.2% used cloth. In another similar study conducted by Teketo et al usage of sanitary napkins was 35.38% and reuse of absorbent
Material was 45.95%.[7] The use of old clothes in rural area is a practice which they get inculcate from their elders and also because of lack of awareness and money. Unclean rags and old clothes increase the chances of RTIs including urinary, vaginal, and perineal infection, which many of them not aware about it.
A study done in south India reported that a majority of the rural school girls who used old clothes, sanitized the materials by boiling and drying them before reuse.[8] It was evident that such practices offered protection against the possible infections.
About 41.2% of study subjects don't practice of washing intimate area with water and soap during menstruation. A study which was conducted by another author revealed that only 34.33% of the girls satisfactory cleaned their genitalia.[9]
Most of them 46.8% dispose the used napkins in dustbins. The commonly practiced methods of disposal of the used absorbent were, wrapping it in paper and either disposing it in a place which was used for solid waste disposal or burning it. The same findings were reported by other studies.[3, 9]

Conclusion
Present study showed high school girls had good knowledge regarding menstrual hygiene, except that they thought poor hygiene does not lead to infection. Most of them had encouraging attitude. Few of them still used cloth during menstruation and majority of them did not maintain intimate area hygiene during menstruation. Menstrual hygiene is an issue needs to be addressed at all levels. A variety of factors are known to affect menstrual behaviours which needs to be discussed to fill the gap in the knowledge.

Limitations
1) Only small sample of population could be selected difficult to generalise the results from that.
2) Due to its cross sectional nature of the study it is difficult to establish a causal relationship.

Acknowledgement
The authors would like to extend their heartfelt gratitude to staffs of Sri Siddhartha High School , staffs of department of Community Medicine, study participants, and their family members.

Financial support and sponsorship: Nil
Conflict of interest: Nil

References
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