Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
School of Civil Engineering, University of Leeds, Leeds, UK.
Glob Health Action. 2024 Dec 31;17(1):2297512. doi: 10.1080/16549716.2023.2297512. Epub 2024 Jan 17.
The lack of menstrual hygiene management (MHM) information and facilities in schools is a major contributor to adolescent girls' school absenteeism in low- and middle-income countries like Bangladesh.
This paper examines the changes over time in school MHM facilities, knowledge and perceptions among adolescent girls, in relation to school absenteeism between 2014 and 2018 in Bangladesh.
We examined changes in MHM and school absenteeism among schoolgirls using nationally representative data from the Bangladesh National Hygiene Baseline Survey 2014 and National Hygiene Survey 2018. Given the repetitive nature of our data and its clustering within participants, our method included performing descriptive analysis, bivariate analysis, and multivariate Generalised Estimating Equation (GEE) modelling to analyse these changes.
Results showed that adolescent girls' menstruation-related absenteeism decreased between 2014 and 2018. Percentage of adolescents who missed school decreased from 25% to 14% (PD: -11; CI: -16 to -6.1), while the average number of missed days reduced from 2.8 to 2.5 (PD: -0.33; CI: -0.57 to -0.10). In the GEE model, we found that living in rural areas (coef: -5.6; CI: -10.06 to -1.14), parental restrictions on going outside (coef: 4.47; CI: 0.75 to 8.2), education levels of girls (coef: -9.48; CI: -14.17 to -4.79), girl's belief that menstruation affects school performance (coef: 23.32; CI: 19.71 to 26.93), and using old cloths (coef: -4.2; CI: -7.6 to -0.79) were significantly associated with higher absenteeism. However, participant's age, type of school, knowledge of menstruation before menarche, receiving information regarding MHM, separate place for changing absorbents, and separate latrine and urine facility were not significantly associated with the changes in absenteeism over time.
This paper emphasised the associations between changes in school absenteeism, parental restrictions on students, students' education levels, and menstruation-related misperceptions. Ongoing research, policy reviews, and targeted interventions to improve MHM perceptions among girls are required to provide long-term benefits for adolescent girls in Bangladesh.
在孟加拉国等中低收入国家，学校缺乏经期卫生管理（MHM）信息和设施，是导致青少年女生缺课的主要原因。
本文旨在探讨 2014 年至 2018 年间，孟加拉国少女的学校 MHM 设施、知识和认知方面的变化与学校缺课率之间的关系。
我们利用 2014 年孟加拉国国家卫生基线调查和 2018 年国家卫生调查的全国代表性数据，研究了女生的 MHM 和学校缺课率的变化情况。鉴于我们的数据具有重复性且其聚类在参与者中，我们的方法包括进行描述性分析、双变量分析和多变量广义估计方程（GEE）建模，以分析这些变化。
结果显示，2014 年至 2018 年间，少女的经期相关缺课率有所下降。缺课的青少年比例从 25%降至 14%（PD：-11；CI：-16 至-6.1），而平均缺课天数从 2.8 天减少到 2.5 天（PD：-0.33；CI：-0.57 至-0.10）。在 GEE 模型中，我们发现居住在农村地区（系数：-5.6；CI：-10.06 至-1.14）、父母对外出的限制（系数：4.47；CI：0.75 至 8.2）、女孩的教育水平（系数：-9.48；CI：-14.17 至-4.79）、女孩认为月经会影响学业成绩（系数：23.32；CI：19.71 至 26.93）以及使用旧布条（系数：-4.2；CI：-7.6 至-0.79）与较高的缺课率显著相关。然而，参与者的年龄、学校类型、初潮前对月经的了解、接受有关 MHM 的信息、更换吸收剂的专用场所、单独的厕所和尿液设施与缺课率的变化均无显著相关性。
本文强调了学校缺课率变化、父母对学生的限制、学生的教育水平以及与月经相关的误解之间的关联。需要进行持续的研究、政策审查和有针对性的干预，以改善女孩对 MHM 的认知，从而为孟加拉国的少女带来长期利益。
