Melaku Abayneh, Addis Taffere, Mengistie Bezatu, Kanno Girum Gebremeskel, Adane Metadel, Kelly-Quinn Mary, Ketema Sisay, Hailu Teklu, Bedada Dinaol, Ambelu Argaw
Ethiopian Institute of Water Resources, Addis Ababa University, P.O.Box 1176, Addis Ababa, Ethiopia.
Department of Environmental Health, College of Health and Medical Science, Dilla University, Dilla, Ethiopia.
Heliyon. 2023 Apr 27;9(5):e15893. doi: 10.1016/j.heliyon.2023.e15893. eCollection 2023 May.
Menstrual hygiene management (MHM) service provision and improving schoolgirls' hygienic practices in schools are among the major challenges for low and middle income countries, including Ethiopia, in meeting the 2030 Sustainable Development Goals. This study was conducted to assess schoolgirls' MHM practices and what influences those practices in Addis Ababa, the capital city of Ethiopia.
A cross-sectional study was conducted on 401 adolescent schoolgirls and 98 school directors that were selected using a multistage sampling method. Pretested semi-structured interviewer-administered questionnaires and observational checklists were used to collect data.
During menstruation, about 90% of schoolgirls used commercially made disposable sanitary pads. However, only 45.9% of girls had access to emergency pads from their schools. Of the 98 directors, 79 (80.6%) responded that they had MHM provisions for schoolgirls. However, 42 (42.9%) schools had no water and soap in the pad changing rooms/toilets, and 70% lacked a covered dustbin for disposal/storage of soiled sanitary pads. Besides, more than 55% of the schools practiced open burning and dumping to dispose of used menstrual materials. More than half of the schools had no sanitary pad changing rooms, three-quarters of them lack MHM education, and only 2.5% had a bathing area. The location of schools (AOR = 5.44, 95% CI: (2.34-12.66)), health club availability (AOR = 3.14, 95% CI: (1.53, 6.42)), being informed about MHM before menarche (AOR = 2.04, 95% CI: (1.04, 4.00)), and availability of emergency sanitary pad at schools (AOR = 2.59, 95% CI: (1.36, 4.91)) were significantly associated with the status of schoolgirls menstrual hygiene practices.
About one-quarter of the schoolgirls had poor menstrual hygiene practices. Being a student in inner-city schools, attending a school that had a health club, being informed about MHM before menarche, and having access to emergency pads from schools were the determinant factors for good menstrual hygiene practices. However, most schools lack water, soap, and a covered dustbin in the pad changing rooms/toilets. Moreover, only a few schools provided MHM education and emergency pads. Improving water and sanitation services along with tailored MHM education are urgently needed to circumvent unsafe MHM practices among adolescent schoolgirls.
在包括埃塞俄比亚在内的低收入和中等收入国家，提供月经卫生管理（MHM）服务以及改善女学生在学校的卫生习惯是实现2030年可持续发展目标的主要挑战之一。本研究旨在评估埃塞俄比亚首都亚的斯亚贝巴女学生的MHM习惯以及影响这些习惯的因素。
采用多阶段抽样方法，对401名青春期女学生和98名校领导进行了横断面研究。使用经过预测试的半结构化访谈问卷和观察清单收集数据。
在月经期间，约90%的女学生使用市售一次性卫生巾。然而，只有45.9%的女孩能从学校获得应急卫生巾。在98名校领导中，79人（80.6%）表示他们为女学生提供了MHM服务。然而，42所学校（42.9%）的卫生巾更换室/厕所没有水和肥皂，70%的学校没有用于处理/存放用过卫生巾的带盖垃圾桶。此外，超过55%的学校采用露天焚烧和倾倒的方式处理用过的月经用品。超过一半的学校没有卫生巾更换室，四分之三的学校缺乏MHM教育，只有2.5%的学校有洗浴区。学校的位置（调整优势比[AOR]=5.44，95%置信区间：[2.34 - 12.66]）、是否有健康俱乐部（AOR = 3.14，95%置信区间：[1.53, 6.42]）、初潮前是否了解MHM（AOR = 2.04，95%置信区间：[1.04, 4.00]）以及学校是否有应急卫生巾（AOR = 2.59，95%置信区间：[1.36, 4.91]）与女学生的月经卫生习惯状况显著相关。
约四分之一的女学生月经卫生习惯较差。在内城区学校就读、所在学校有健康俱乐部、初潮前了解MHM以及能从学校获得应急卫生巾是良好月经卫生习惯的决定因素。然而，大多数学校的卫生巾更换室/厕所缺乏水、肥皂和带盖垃圾桶。此外，只有少数学校提供MHM教育和应急卫生巾。迫切需要改善水和卫生设施服务，并提供量身定制的MHM教育，以避免青春期女学生不安全的MHM行为。
