Adolescent Menstrual Health Literacy in Low, Middle and High-Income Countries: A Narrative Review

Holmes, Kathryn; Curry, Christina; Sherry, M.; Ferfolja, Tania; Parry, Kelly; Smith, Caroline; Hyman, Mikayla; Armour, Mike

doi:10.3390/ijerph18052260

Cited by 56 publications

(61 citation statements)

References 73 publications

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“…So far, only one research is published by using the nationally representative 2014 BDHS data which explored the basic socio-demographic factors associated with the MR service use. This is line of the other studies conducted in LMICs (Holmes K et al, 2021; Chae et al, 2017). However, as far know no research has been conducted yet in Bangladesh to current level of knowledge on MR service use.…”

Section: Introductionsupporting

confidence: 92%

Pattern and risk factors of menstrual regulation service use among ever-married women in Bangladesh: evidence from a nationally representative cross-sectional survey

Alam

Khan

Sawangdee

2022

Preprint

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Background : Around 47% of the total conceptions in Bangladesh are unintended which leads to several adverse consequences, including maternal and child mortality. Availability of menstrual regulation (MR) service and its use can help women to end conception at an earlier stage, as such, reducing adverse consequences related to the unintended pregnancy. We explored the prevalence and determinants of MR service knowledge and its use among ever-married women in Bangladesh. Methods : A total of 20 127 ever-married women data from the 2017 Bangladesh Demographic and Health Survey were analyzed. Knowledge about menstrual regulation (MR) and its use were our outcomes of interest. Several individual, household and community-level factors were considered as explanatory variables. The multilevel mixed-effects Poisson regression model was used to determine the factors associated with MR service knowledge and its use in Bangladesh. Results : Around 71% of the total analyzed women reported they know about MR service while only 7% of them reported they used this service within three years of the survey date. MR service knowledge was found to be higher among women with increased age and education and engaged in income-generating employment. Knowledge about MR service was also found to be higher among women whose husbands were higher educated and engaged in physical work or business. Rural women and women who resided in the community with lower poverty and higher illiteracy were reported lower knowledge of MR service. MR service use was found higher among higher-aged women, women whose husbands were either physical workers or businessmen, women who have an increased number of children and inherent in the community with lower poverty. Lower use of MR service was found among women who resided in the Chattogram, Khulna, and Mymensingh divisions and women who resided in the community with increased illiteracy. Conclusion : Use of MR service is very low in Bangladesh. This could be responsible for higher adverse consequences related to unintended pregnancy including higher maternal and child mortality. Policies and programs are important to aware women of MR.

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Section: Introductionsupporting

confidence: 92%

Pattern and risk factors of menstrual regulation service use among ever-married women in Bangladesh: evidence from a nationally representative cross-sectional survey

Alam

Khan

Sawangdee

2022

Preprint

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“…School presenteeism and absenteeism may have a long-lasting impact on women’s and PWM’s educational attainment, social and economic participation, and ultimately health outcomes [ 71 , 72 ]. Other studies have assessed productivity loss in the workplace due to menstrual-related issues [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Experiences of menstrual inequity and menstrual health among women and people who menstruate in the Barcelona area (Spain): a qualitative study

et al. 2022

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Introduction Menstrual health and menstrual inequity have been neglected in social, economic, healthcare and political spheres. Although available evidence is scarce, it already suggests a link between experiencing menstrual inequity (which refers to the systematic disparities in accessing menstrual health and education, menstrual products and spaces for menstrual management, among other aspects) and menstrual health outcomes. The aim of this study was to explore experiences of menstrual health and menstrual inequity among women and people who menstruate aged 18–55 in Barcelona and surrounding areas (Spain). Methods A qualitative study, using a critical feminist perspective, was conducted. Sampling was purposeful and selective. Recruitment was through sexual and reproductive health centres, social media and snowball sampling techniques. Thirty-four semi-structured photo-elicitation interviews were conducted between December 2020 and February 2021. Interviews took place in sexual and reproductive health centres, public spaces, and by telephone. Data were analysed using Reflexive Thematic Analysis. Results Three themes were identified: “Systemic neglect of menstruation and the menstrual cycle”, “When “the private” becomes public: menstrual management” and “Navigating menstrual health: between medicalization and agency”. Experiences of menstrual inequity appeared to be widespread among participants. They referred to the impact of having to conceal menstruation and the barriers to managing menstruation in public spaces. Choosing menstrual products was often influenced by price and availability; several participants reported menstrual poverty. A general lack of menstrual education was described. Menstrual education was usually gained through personal experience and self-learnings, or through families and friends. Menstruation and the menstrual cycle had a significant impact on participants’ day-to-day. Accessing and navigating the healthcare system was challenging, as participants mostly reported feeling dismissed and almost exclusively offered hormonal contraception as a panacea to address menstrual health. Conclusions The impact of menstrual inequity appears to be far-reaching. Multidimensional structural policies should promote agency in individuals and communities to enable opportunities for menstrual education, access to menstrual products, healthcare services and adequate menstrual-management facilities. Health professionals’ training is also necessary to improve access to and quality of menstrual healthcare. Policies need to be inclusive of non-binary and trans people, and vulnerable populations.

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“…However, it suggests that some minimal information has been provided in time. A large body of qualitative research has consistently found that participants felt underprepared, and report experiencing high levels of fear and distress at menarche if they are unaware of menstruation ( 15 – 21 ). Indeed, this was reported as the most consistent finding across 76 included studies in a systematic review of qualitative research on menstrual experiences in low-and middle-income countries ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Monitoring Menstrual Health Knowledge: Awareness of Menstruation at Menarche as an Indicator

Hennegan

Swe²,

Than³

et al. 2022

Front. Glob. Womens Health

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As initiatives to support menstrual health are implemented globally, monitoring progress through a set of comprehensive indicators provides important feedback to direct policies and programs. One proposed core indicator is awareness of menstruation at menarche. That is, at the time of menarche an adolescent girl knowing that menstrual bleeding is something she will experience. In this investigation, we undertook secondary analysis of data collected across four studies to support interpretation of this indicator. We (1) describe the proportion of each sample aware of menstruation at menarche, (2) test variations in awareness according to sociodemographic characteristics, and (3) describe the associations between this indicator and self-reported experience at menarche, social support, and confidence to manage menstruation. Studies included cross-sectional survey data from 421 schoolgirls in Magway, Myanmar, 537 schoolgirls in Soroti, Uganda, 1,359 schoolgirls in Netrokona, Bangladesh, and 599 adult women working in Mukono, Uganda. Awareness of menstruation at menarche varied from 84% in Myanmar to 34% in Bangladesh. Older age at menarche was associated with awareness. Awareness at menarche was not associated with household poverty in the adolescent samples, but greater poverty was associated with lower levels of awareness among adult women. In Myanmar, girls aware of menstruation had significantly higher odds of reporting that they felt prepared (2.85 95% CI 1.34–6.08), happy (OR = 3.81 95% CI 1.74–8.37) and knew what was happening at menarche (OR = 2.37 95% CI 1.34–4.19). However, they also reported higher levels of embarrassment (OR = 1.76 95% CI 1.04–2.97) and did not report significantly less fear (OR = 1.24 95% CI 0.82–1.85). Awareness of menstruation at menarche was associated with higher scores on a menstrual knowledge quiz in both Myanmar (b = 9.51 95% CI 3.99–15.04) and Bangladesh (b = 4.78 95% CI 1.70–7.87). In these studies girls aware of menstruation at menarche also had higher odds of reporting they felt confident discussing menstruation with support sources and managing menstruation at school, while these differences were not significant among schoolgirls in Uganda. Findings support the usefulness of awareness of menstruation at menarche as an indicator to describe minimal knowledge of menstruation and suggest that awareness may signal greater knowledge, social support, and confidence in some settings.

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Adolescent Menstrual Health Literacy in Low, Middle and High-Income Countries: A Narrative Review

Cited by 56 publications

References 73 publications

Pattern and risk factors of menstrual regulation service use among ever-married women in Bangladesh: evidence from a nationally representative cross-sectional survey

Pattern and risk factors of menstrual regulation service use among ever-married women in Bangladesh: evidence from a nationally representative cross-sectional survey

Experiences of menstrual inequity and menstrual health among women and people who menstruate in the Barcelona area (Spain): a qualitative study

Monitoring Menstrual Health Knowledge: Awareness of Menstruation at Menarche as an Indicator

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