Tegegne Teketo Kassaw, Sisay Mitike Molla
School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Public Health. 2014 Oct 29;14:1118. doi: 10.1186/1471-2458-14-1118.
Adolescence in girls has been recognized as a special period marked with the onset of menarche. Even though menstruation is a natural process, it is associated with misconceptions, malpractices and challenges among girls in developing countries. However, much is not documented; school-absenteeism and dropout are a common problem among girls in rural Ethiopia. Focusing among school girls, this study has examined knowledge about menstruation, determinants of menstrual management and its influence on school-attendance in Northeast Ethiopia.
We conducted a mixed-method research combining quantitative and qualitative methods in Northeast Ethiopia. The quantitative study was conducted among 595 randomly selected adolescent school girls. Nine in-depth interviews; five school-dropout girls and four female teachers, and four focus group discussions among school girls were conducted in 2013.
The mean age at menarche was 13.98 (±1.17) years. About 51% of girls had knowledge about menstruation and its management. Only a third of the girls used sanitary napkins as menstrual absorbent during their last menstruation. Girls from urban areas, had mothers of secondary and above education and, families of higher monthly expenditure had more chance of using sanitary napkins than their counterparts. More than half of the girls reported to have been absent from school during their menstruation period. Those who did not use sanitary napkins were more likely to be absent from school [AOR-95% C.I: 5.37 (3.02 - 9.55)]. Fifty eight percent of girls reported that their school-performance had declined after they had menarche. In addition, the qualitative study indicated that school-dropout was common among girls who experienced teasing and humiliation by classmates when their clothes were stained with blood as they do not use sanitary napkins.
Though there is an effort to increase girls' school enrollment, lack of basic needs, like sanitary napkins that facilitate routine activates of girls at early adolescence are observed to deter girls' school-attendance in rural Ethiopia. Special support for girl students, especially when they have their first menstruation and separate functioning sanitary facilities are necessities that should be in school at all times if gender equality and girls empowerment is to be achieved.
女孩的青春期被认为是一个以月经初潮开始为标志的特殊时期。尽管月经是一个自然过程，但在发展中国家，它与女孩中的误解、不当行为和挑战相关。然而，相关记录并不多；在埃塞俄比亚农村地区，缺课和辍学是女孩中的常见问题。本研究聚焦于在校女生，调查了埃塞俄比亚东北部地区女孩对月经的了解、月经管理的决定因素及其对上学出勤率的影响。
我们在埃塞俄比亚东北部开展了一项结合定量和定性方法的混合方法研究。定量研究在595名随机抽取的青春期在校女生中进行。2013年进行了9次深入访谈，包括5名辍学女生和4名女教师，并在女生中进行了4次焦点小组讨论。
月经初潮的平均年龄为13.98（±1.17）岁。约51%的女孩了解月经及其管理知识。在上次月经期间，只有三分之一的女孩使用卫生巾作为月经吸收用品。来自城市地区、母亲受过中等及以上教育且家庭月支出较高的女孩比其他女孩更有可能使用卫生巾。超过一半的女孩报告在月经期间缺课。那些不使用卫生巾的女孩更有可能缺课 [调整后比值比-95%置信区间：5.37（3.02 - 9.55）]。58%的女孩报告月经初潮后学习成绩下降。此外，定性研究表明，当不使用卫生巾的女孩衣服被血弄脏而遭到同学嘲笑和羞辱时，辍学在她们中很常见。
尽管努力提高女孩的入学率，但在埃塞俄比亚农村地区，观察到缺乏诸如卫生巾等基本需求（这有助于青春期早期女孩的日常活动）会阻碍女孩上学。如果要实现性别平等和增强女孩权能，对女学生的特别支持，尤其是在她们首次月经期间，以及独立运作的卫生设施应始终配备在学校。
