Chandra-Mouli Venkatraman, Patel Sheila Vipul
Geneva, Switzerland
Chapel Hill, NC, USA
This review aims to answer the following questions: (1) how knowledgeable are adolescent girls in low- and middle-income countries (LMIC) about menstruation and how prepared are they for reaching menarche, (2) who are their sources of information regarding menstruation, (3) how well do the adults around them respond to their information needs, (4) what negative health and social effects do adolescents experience as a result of menstruation, and (5) how do adolescents respond when they experience these negative effects and what practices do they develop as a result? Using a structured search strategy, articles that investigate young girls’ preparedness for menarche, knowledge of menstruation, and practices surrounding menstrual hygiene in LMIC were identified. A total of 81 studies published in peer-reviewed journals between the years 2000 and 2015 that describe the experiences of adolescent girls from 25 different countries were included. Adolescent girls in LMIC are often uninformed and unprepared for menarche. Information is primarily obtained from mothers and other female family members who are not necessarily well equipped to fill gaps in girls’ knowledge. Exclusion and shame lead to misconceptions and unhygienic practices during menstruation. Rather than seek medical consultation, girls tend to miss school, self-medicate, and refrain from social interaction. Also problematic is that relatives and teachers are often not prepared to respond to the needs of girls. LMIC must recognize that lack of preparation, knowledge, and poor practices surrounding menstruation are key impediments not only to girls’ education, but also to self-confidence and personal development. In addition to investment in private latrines with clean water for girls in both schools and communities, countries must consider how to improve the provision of knowledge and understanding and how to better respond to the needs of adolescent girls.
（1）低收入和中等收入国家（LMIC）的少女对月经了解多少，以及她们为初潮做了怎样的准备；（2）她们关于月经的信息来源有哪些；（3）周围的成年人对她们的信息需求回应得如何；（4）青少年因月经会经历哪些负面的健康和社会影响；（5）青少年在经历这些负面影响时会如何应对，以及因此会形成哪些行为习惯？采用结构化搜索策略，我们确定了一些研究文章，这些文章调查了LMIC中年轻女孩对初潮的准备情况、月经知识以及围绕月经卫生的行为习惯。总共纳入了2000年至2015年间发表在同行评审期刊上的81项研究，这些研究描述了来自25个不同国家的少女的经历。LMIC中的少女往往对初潮了解不足且未做好准备。信息主要来自母亲和其他女性家庭成员，而她们不一定有足够的能力填补女孩知识方面的空白。排斥和羞耻导致了月经期间的误解和不卫生行为。女孩们往往不去寻求医疗咨询，而是缺课、自行用药并避免社交互动。同样存在问题的是，亲属和教师往往没有准备好回应女孩的需求。LMIC必须认识到，在月经方面缺乏准备、知识以及不良行为习惯不仅是女孩教育的关键障碍，也是她们自信和个人发展的关键障碍。除了在学校和社区为女孩投资建设配备清洁用水的私人厕所外，各国还必须考虑如何改善知识的提供和理解，以及如何更好地回应少女的需求。
