An empirical study of managing menstrual hygiene in schools: A special reference to Government Upper Primary Schools in District Sambhal, Uttar Pradesh

Abstract

The present study was intended to assess the knowledge, attitude and practice related to menstruation and menstrual hygiene and their determinants among rural school girls of the district of Sambhal in Western Utter Pradesh. Adolescence is a crucial period for girls, marked by the onset of menstruation and associated morbidities. Basic information about the sociodemographic characteristics of the rural school girls, their exposure to mass media and the events related to menarche were also assessed to establish their relationship with the dependent variables. Studies conducted worldwide on menstrual hygiene revealed critical gaps in awareness, sanitation practices and policy. Using a descriptive analytical survey design and multistage sampling, the knowledge, attitude and practices on menstrual hygiene among 563 school girls of 13 to 17 years studying in standards 7 and 8 were identified. Among the respondents, 34.8% had poor knowledge, 41% had favourable attitude and 80.5% had poor practice. About 49% had menstrual pattern disorders, 39% reported symptoms of urinary tract infection. Dysmenorrhoea (67.2%) and back pain (53%) were the predominant physical problems and anger (49.5%) was the major emotional problems.

Statistically significant correlation was obtained between knowledge and attitude (p=0.016) and between attitude and practice (p=0.01); no significant correlation existed between knowledge and practice (p=0.77).

Statistically significant difference was observed in the knowledge scores on menstruation with respect to the educational level of the respondents (p=0.0001), education of their mother (p=0.003), and their habits of reading newspaper (p=0.034), health magazines (p=0.006) and periodicals (p=0.01). Significant difference was also observed in the attitude scores towards menstruation in respect of educational level of students (p=0.001), monthly family income (p=0.016), presence of grandmother in their house (p=0.015), education of mother (p=0.018), reading newspaper (p=0.034) and periodicals (p=0.043).

Multivariable regression analysis has shown that the knowledge of the respondents on menstrual hygiene was significantly associated with mother’s education, attitude of student, and their habits of reading newspaper and periodicals. It was found that the attitude was significantly associated with the educational level of student, presence of grandmother in their house and mother’s education. The practice of menstrual hygiene was significantly associated with age of the student and their standard of living index.

The study concludes to mandate health education in schools by professional nurses, on menstruation and its hygienic management; community education on the scientific aspects of menstruation; and policy implementation towards the construction of girl friendly toilets in houses, schools and public places so that the nation becomes healthy and productive with empowered women.

Key terms: knowledge on menstruation, attitude towards menstruation, practice of menstrual hygiene, menstrual morbidities, health seeking behaviour, determinants of menstrual hygiene, rural school girls.