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

Shweta Gupta


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.



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

Full Text:



United Nations Development Programme. Sustainable Development Goals: Goal 5 Gender Equality Targets. 2013. Available: Accessed: 27 February 2013.

Sommer M, Caruso BA, Sahin M, Calderon T, Cavill S, Mahon T, et al. A Time for Global Action: Addressing Girls’ Menstrual Hygiene Management Needs in Schools. PLoS Med. 2014;13:e1001962. doi: 10.1371/journal.pmed.1001962. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

van Eijk AM, Sivakami M, Thakkar MB, Bauman A, Laserson KF, Coates S, et al. Menstrual hygiene management among adolescent girls in India: a systematic review and meta-analysis. BMJ Open. 2014;6:e010290. doi: 10.1136/bmjopen-2015-010290. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

Adukia A. Sanitation and Education. 2014. Available: Accessed: 29 January 2014.

Phillips-Howard PA, Nyothach E, Ter Kuile FO, Omoto J, Wang D, Zeh C, et al. Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya. BMJ Open. 2014;6:e013229. doi: 10.1136/bmjopen-2014-013229. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

Chandra-Mouli V, Patel SV. Mapping the knowledge and understanding of menarche, menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries. Reprod Health. 2013;14:30. doi: 10.1186/s12978-017-0293-6. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

Das P, Baker KK, Dutta A, Swain T, Sahoo S, Das BS, et al. Menstrual hygiene practices, WASH access and the risk of urogenital infection in women from Odisha, India. PLoS One. 2015;10:e0130777. doi: 10.1371/journal.pone.0130777. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

Devi BS, Swarnalatha N. Prevalence of RTI/STI among reproductive age women (15-49 years) in urban slums of Tirupati town, Andhra Pradesh. Health Popul Perspect Issues. 2007;30:56–70. [Google Scholar]

Parashar A, Gupta BP, Bhardwaj AK, Sarin R. Prevalence of RTIs among women of reproductive age group in Shimla City. Indian J Community Med. 2006;31:15–7. doi: 10.4103/0970-0218.54924. [CrossRef] [Google Scholar]

Narayan KA, Srinivasa DK, Pelto PJ, Veerammal S. Puberty rituals reproductive knowledge and health of adolescent schoolgirls in south India. Asia Pac Popul J. 2001;16:225–38. [Google Scholar]

Anand E, Singh J, Unisa S. Menstrual hygiene practices and its association with reproductive tract infections and abnormal vaginal discharge among women in India. Sex Reprod Healthc. 2015;6:249–54. doi: 10.1016/j.srhc.2015.06.001. [PubMed] [CrossRef] [Google Scholar]

Ronitzsch S. Dropping out of school because of menstruation? An analysis of factors of success for menstrual hygiene management-projects in low and lower-middle income countries: Philipps-University Marburg, Germany; 2015. [Google Scholar]

UNICEF. WASH in Schools. 2014. Available: Accessed: 29 January 2014.

Office of the Registrar General & Census Commissioner India, Ministry of Home Affairs, Government of India. Census in India. 2013. Available: Accessed: 29 January 2014.

Garg S, Anand T. Menstruation related myths in India: strategies for combating it. J Family Med Prim Care. 2015;4:184–6. doi: 10.4103/2249-4863.154627. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

Muralidharan A, Patil H, Patnaik S. Unpacking the policy landscape for menstrual hygiene management: implications for school Wash programmes in India. Waterlines. 2015;34:79–91. doi: 10.3362/1756-3488.2015.008. [CrossRef] [Google Scholar]

Sommer M, Vasquez E, Worthington N, Sahin M. WASH in schools empowers girls' education. Proceedings of the menstrual hygiene management in schools virtual conference 2012. New York, USA: UNICEF and Colombia University, 2013. [Google Scholar]

Garg R, Goyal S, Gupta S. India moves towards menstrual hygiene: subsidized sanitary napkins for rural adolescent girls-issues and challenges. Matern Child Health J. 2012;16:767–74. doi: 10.1007/s10995-011-0798-5. [PubMed] [CrossRef] [Google Scholar]

Health Education to Villages. Toilet facilities in all schools. 2013. Available: Accessed: 29 January 2014.

Government of Tamil Nadu, Department of Social Welfare and NMP. Health Services. 2013. Available: Accessed: 29 January 2014.

Yagnik AS. Construction of negative images of menstruation in Indian TV commercials. Health Care Women Int. 2012;33:756–71. doi: 10.1080/07399332.2012.684814. [PubMed] [CrossRef] [Google Scholar]

Guterman M, Mehta P, Gibbs M. Menstrual taboos among major religions. Internet J World Health Soc Polit. 2007;5:8213. [Google Scholar]

Ministry of Drinking Water and Sanitation, Government of India. Menstrual Hygiene Management: National Guidelines. 2015. Available: Accessed: 29 January 2014.

Garikipati S, Boudot C. To pad or not to pad: towards better sanitary care for women in Indian slums. J Int Dev. 2013;29:32–51. doi: 10.1002/jid.3266. [CrossRef] [Google Scholar]

Sahoo P. Ladies, be careful when you throw away the napkin. Hindustan Times 24 Aug 2015.

Sambyal SS. Government notifies new solid waste management rules. 2014. Available: Accessed: 29 January 2014.

Ministry of Environment and Forests, Government of India. Solid waste management rules, 2015. Available: Accessed: 29 January 2014.

Saha D. PMs claim of toilets for girls in every school fails scrutiny. Available: Accessed: 29 January 2014.


  • There are currently no refbacks.

ISSN 2348 –0874