A comparison of the menstruation and education experiences of girls in Tanzania, Ghana, Cambodia and Ethiopia

Abstract

The barriers to menstrual hygiene management faced by adolescent schoolgirls in low-income countries are gaining interest at practice and policy levels. The challenges include inadequate water, sanitation and disposal facilities for the management of menses with privacy and dignity, and insufficient guidance to help girls feel confident in attending school during menses. The studies described here aimed to examine how menarche impacts the lives of schoolgirls in three low-income countries (Ghana, Cambodia and Ethiopia). The focus included girls' school participation; their relationship with parents, teachers and peers; their evolving sanitation and hygiene needs; their understanding of cultural issues and taboos around menses; and what education, if any, they received prior to and during puberty. This comparative analysis was aimed at identifying similarities between the three countries that would enable the adaptation to each context of a training book on menstruation issues for girls, which was developed from a previous study conducted in Tanzania. In all three countries, participatory activities were utilised with girls and results were analysed using grounded theory. Findings included: similarities regarding the importance of culture in perpetuating negative attitudes towards menstruation, limited provision of health information and insufficient facilities within schools. Differences were revealed regarding menstrual myths, parent-child dynamics, sources of guidance and student-teacher relations. There is a critical knowledge gap around menstruation and girls' education in these contexts that must be addressed to ensure that girls experience a positive menarche and can manage menstrual hygiene.

‘Behaving well’: the transition to respectable womanhood in rural South Africa

“…Many participants described a process of transitioning to womanhood that unfolded in a series of developmental stages beginning with the physical transformations that occur during puberty such as menarche (see also Mensch, Bruce, and Greene 1998; Sommer 2009; Sommer et al 2015). Puberty also set in motion a series of behavioural changes including: increased attention to one’s appearance because of a burgeoning interest in boys, more domestic responsibilities, beginning sexual activity, and for many, giving birth.…”

Menstrual Hygiene Practice and Associated Factors among Secondary School Girls in Wegera District, Northwest Ethiopia; a Cross-Sectional Study

“…A study done on comparison of the menstruation and education experiences of girls in Africa reported 84% of girls in Afghanistan never wash their genital areas, where as 80% of girls in Afghanistan use water but no soap for washing their menstrual protection and 30% of girls in Malawi do not use the latrine when menstruating. This was also noted by 20% of women in communities in India [12,13]. A study in Nigeria on the practice of menstrual hygiene of girls 73 (60%) changed sanitary pads three times a day,whereas similar studies reported 11% of girls in Ethiopia and 60% of girls in India only change their menstrual cloths once a day [2,14].…”

“…Girls in rural Ethiopia also expressed a hesitancy to buy sanitary pads in public shops due to the cultural or social implications of becoming a woman in Ethiopian society (e.g. readiness to marry and have children) [12].…”

Menstruation and the Cycle of Poverty: A Cluster Quasi-Randomised Control Trial of Sanitary Pad and Puberty Education Provision in Uganda

“…[19–21] Taboos around the topic mean many adolescent girls are unprepared for menarche, and that management practices are not discussed openly. [19, 20, 22] In the confined school environment, with a lack of access to adequate latrines or separate latrines for males and females, menstrual management presents a significant challenge.…”