Shah Vishna, Nabwera Helen, Sonko Bakary, Bajo Fatou, Faal Fatou, Saidykhan Mariama, Jallow Yamoundaw, Keita Omar, Schmidt Wolf-Peter, Torondel Belen
Environmental Health Group, Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
Department of Education and Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Int J Environ Res Public Health. 2022 Mar 11;19(6):3337. doi: 10.3390/ijerph19063337.
Poor knowledge and management of menstruation impacts girls' school attendance and academic performance. This paper aims to explore how menstrual hygiene management practices and related factors influence school absenteeism and drop-out among primary and secondary school girls in rural Gambia. Mixed-method studies were conducted among students and key informants from 19 schools from July 2015-December 2017. Focus group discussions, in-depth interviews, cross-sectional surveys, menstrual diaries, and school water, sanitation and hygiene (WASH) facility observations were used. Key findings from the interviews were that menstrual pain, cultural beliefs, fear of peers knowing menstrual status, and poor school WASH facilities led to school absenteeism, however, they had no impact on school drop-out. Of the 561 girls surveyed, 27% reported missing at least one school day per month due to menses. Missing school during the most recent menstrual period was strongly associated with menstrual pain (extreme pain adjusted odds ratio (AOR) = 16.8 (95% CI: 7.29-38.74)), as was having at least one symptom suggestive of urinary tract infection (AOR = 1.71 (95% CI: 1.16-2.52)) or reproductive tract infection (AOR = 1.99 (95% CI: 1.34-2.94)). Clean toilets (AOR = 0.44 (95% CI: 0.26-75)), being happy using school latrines while menstruating (AOR = 0.59 (95% CI: 0.37-0.93)), and soap availability (AOR = 0.46 (95% CI: 0.3-0.73)) were associated with reduced odds of school absenteeism. This study suggests menstrual pain, school WASH facilities, urogenital infections, and cultural beliefs affected school attendance among menstruating girls in rural Gambia.
对月经的认知不足和管理不善会影响女孩的上学出勤率和学业成绩。本文旨在探讨月经卫生管理措施及相关因素如何影响冈比亚农村地区中小学女生的缺课和辍学情况。2015年7月至2017年12月期间，对来自19所学校的学生和关键信息提供者开展了混合方法研究。采用了焦点小组讨论、深入访谈、横断面调查、月经日记以及学校水、环境卫生和个人卫生（WASH）设施观察等方法。访谈的主要发现是，痛经、文化信仰、担心同龄人知晓月经状况以及学校WASH设施差导致了缺课，然而，它们对辍学没有影响。在接受调查的561名女孩中，27%的人报告每月因月经至少缺课一天。在最近一次月经期间缺课与痛经密切相关（极度疼痛调整优势比（AOR）=16.8（95%置信区间：7.29 - 38.74）），有至少一种提示尿路感染的症状（AOR = 1.71（95%置信区间：1.16 - 2.52））或生殖道感染（AOR = 1.99（95%置信区间：1.34 - 2.94））时也是如此。干净的厕所（AOR = 0.44（95%置信区间：0.26 - 0.75））、月经期间乐意使用学校厕所（AOR = 0.59（95%置信区间：0.37 - 0.93））以及有肥皂供应（AOR = 0.46（95%置信区间：0.3 - 0.73））与缺课几率降低相关。这项研究表明，痛经、学校WASH设施、泌尿生殖系统感染和文化信仰影响了冈比亚农村地区月经初潮女孩的上学出勤率。
