Ahmed Shafique, Nimonkar Ravi, Kalra Supreet K, Singh Pardal Maninder Pal, Singh Sumeet
Department of Community Medicine, Armed Forces Medical Services, India.
Department of Pathology, Bharatiya Vidyapeeth Medical College, (DTU), Pune, Maharashtra, India.
J Family Med Prim Care. 2024 Mar;13(3):1012-1019. doi: 10.4103/jfmpc.jfmpc_1329_23. Epub 2024 Apr 4.
Most adolescent women face many restrictions, which become much more severe during menstruation. In India, millions of adolescent girls drop out of school every year due to menstruation-related problems and restrictions. Despite extensive research, a paucity of literature was observed on the level of knowledge, attitude, and practices of adolescent girls regarding menstruation. Hence, we proceeded to undertake the present study, to have a deeper understanding of the menstrual hygiene management of adolescents.
To describe the menstrual hygiene management among adolescent school girls.
(a) To examine the association, if any, between menstrual hygiene management and school absenteeism during menstruation in adolescent school girls.
We conducted a school-based cross-sectional analytical study in an urban area in north India. The study population comprised adolescent school girls of all the high schools in the urban area. With a 95% confidence interval, and 5% margin of error, the sample size was calculated to be 369. However, an even larger sample size of 600 was actually studied. The probability proportional to size sampling approach was followed based on the number of adolescent girls in each school class/section. Participants were selected through a stratified proportionate sampling method. Ethical approval was obtained from the ethical committee of the district director of education of the urban area where the study was conducted before the commencement of the study. Confidentiality of the information collected was ensured. The data collected was quantitative in nature, using a pretested self-administered questionnaire consisting of both open-ended and close-ended questions. Data was checked for its completeness, coded, and entered into Microsoft Excel 2021 Spreadsheet. Subsequently, the data was imported into IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. for data analysis. Standard statistical methods were utilized for data analysis.
The mean age (standard deviation [SD]) of the study participants was 13.68 (1.29). The mean age (SD) at menarche was 13.29 (0.96). Based on the overall menstrual hygiene management score, 377 (62.83%) of the study participants were engaged in good menstrual hygiene management, while 223 (37.17%) were engaged in poor menstrual hygiene management. The mean score (SD) was 7.80 (±0.43). Compared to those aged 17-19 years, those aged 10-13 years had a 0.36 (95% CI 0.17-0.75) decreased odds of good menstrual hygiene, while those aged 14-16 years had a 0.29 (95% CI 0.14-0.59) decreased odds of good menstrual hygiene. The adjusted odds ratios were 0.32 (95% CI 0.19-0.65) and 0.25 (95% CI 0.12-0.41) respectively. Out of 600 study participants, 229 (38.17%) reported school absenteeism at least once in the last 1 year because of menstruation. The mean (standard deviation) duration of school absenteeism was 2.4 (0.78) days per menstrual cycle. The commonest reason for menstruation-related school absenteeism was pain, wherein 105 (45.85%) study participants reported this reason.
In our study, we observed that over two-thirds of the study participants were engaged in good menstrual hygiene practices, while ~40% of them reported menstrual-related school absenteeism. Our study also found evidence that the age of the school girls was associated with their menstrual hygiene management practices. We recommend further research on the impact of menstruation and its management on the academic performance of adolescent school girls. Efforts are also required to develop the capacity of teachers to teach menstrual hygiene education.
大多数青春期女性面临诸多限制，在月经期间这些限制会变得更加严苛。在印度，每年有数百万青春期女孩因与月经相关的问题和限制而辍学。尽管进行了广泛研究，但关于青春期女孩对月经的知识、态度和行为的文献却很匮乏。因此，我们着手开展本研究，以更深入地了解青少年的月经卫生管理情况。
描述青春期在校女生的月经卫生管理情况。
（a）检查青春期在校女生月经卫生管理与月经期间缺课之间是否存在关联（若有）。
我们在印度北部的一个城市地区开展了一项基于学校的横断面分析研究。研究人群包括该城市地区所有高中的青春期在校女生。在95%置信区间和5%误差幅度的情况下，计算得出样本量为369。然而，实际研究的样本量更大，为600。根据每个学校班级/组中青春期女孩的数量，采用按规模大小概率抽样方法。通过分层比例抽样方法选取参与者。在研究开始前，获得了开展研究所在城市地区教育局长伦理委员会的伦理批准。确保所收集信息的保密性。所收集的数据本质上是定量的，使用了一份经过预测试的自填问卷，该问卷包含开放式和封闭式问题。检查数据的完整性，进行编码，并录入Microsoft Excel 2021电子表格。随后，将数据导入IBM社会科学统计软件包（SPSS）Windows版23.0。纽约州阿蒙克：IBM公司，用于数据分析。采用标准统计方法进行数据分析。
研究参与者的平均年龄（标准差[SD]）为13.68（1.29）。初潮时的平均年龄（SD）为13.29（0.96）。根据总体月经卫生管理得分，377名（62.83%）研究参与者的月经卫生管理良好，而223名（37.17%）的月经卫生管理较差。平均得分（SD）为7.80（±0.43）。与17 - 19岁的女孩相比，10 - 13岁的女孩月经卫生管理良好的几率降低了0.36（95%置信区间0.17 - 0.75），而14 - 16岁的女孩月经卫生管理良好的几率降低了0.29（95%置信区间0.14 - 0.59）。调整后的优势比分别为0.32（95%置信区间0.19 - 0.65）和0.25（95%置信区间0.12 - 0.
