Menstrual health and factors associated with school absence among secondary school girls in Luang Prabang Province, Lao People’s Democratic Republic: A cross-sectional study

Abstract

In Lao People’s Democratic Republic (Lao PDR), information on school sanitation and menstrual health among secondary school girls is limited. This study aimed to explore knowledge and practices surrounding menstrual health and to identify factors associated with school absence due to menstruation among secondary school girls in Lao PDR. The study involved 1,366 girls from grade 9 to grade 12 in six secondary schools in Luang Prabang Province. Data on socio-demographics and menstrual health of the girls and data on school toilets was collected. Logistic regression analysis was performed to identify the factors associated with school absence due to menstruation. The mean age was 15.8 years old. The average age of menarche was 12.9 years old. Of 1,366 girls, 64.6% were shocked or ashamed when they reached menarche and 31.8% had been absent from school due to menstruation in the six months before this study was conducted. Factors associated with school absence due to menstruation were age ≥ 16 years old (AOR = 1.79, 95% CI 1.37–2.34), higher income (AOR = 2.38, 95% CI 1.16–4.87), menstrual anxiety (AOR = 1.55, 95% CI 1.09–2.20), using painkillers (AOR = 4.79, 95% CI 2.96–7.76) and other methods (AOR = 2.82, 95% CI 1.86–4.28) for dysmenorrhea, and disposing used pads in places other than the school’s waste bins (AOR = 1.34, 95% CI 1.03–1.75). Living with relatives (AOR = 0.64, 95% CI 0.43–0.95) and schools outside the city (AOR = 0.59, 95% CI 0.38–0.90) were significantly less associated with school absence. Although the association between school toilets and school absence was not examined, the results of this study suggest that school toilets should be gender-separated and equipped with waste bins in the toilet. Furthermore, menstrual education should start at elementary schools and teacher training on menstrual health should be promoted.

What factors are related to the socioeconomic gaps in school achievement between boys and girls in Bogotá, Colombia?

“…Studies about the impact of water, sanitation, and hygiene in women´s well-being, suggest that lack of menstrual products for girls is highly associated with school absenteeism (Fisher et al, 2017;Kayser et al, 2019;Mills & Cumming, 2016;WaterAid, 2013). Findings show that one of the reasons why girls do not go school when they have their menstruation cycle is because they feel embarrassed (Inthaphatha et al, 2021;Miiro et al, 2018;Vashisht et al, 2018).…”

Menstruation behaviour influencer model: a grounded theory of menstrual experiences of shame, embarrassment, stigma and absenteeism among pubescent girls in semi-urban and rural secondary schools in Enugu State, Nigeria

“…They include but are not limited to irregular menstrual patterns, lack of proper sanitation facilities including girl-sensitive toilets, water, and soap; unhealthy cultural practices that segregate menstruating girls, teasing and ridicule from peers, and lack of access to analgesics for pain relief. These affect their health, their potential freedom to access education, employment, overall safety and quality of life [ 10 ]. Globally, about 52% of the female population is of reproductive age [ 5 ].…”

Period shaming behavior among male students in Luang Prabang Province, Lao People’s Democratic Republic: A cross-sectional study

“…According to a recent study in Luang Prabang Province, 77.7% of girls avoided changing pads at school, and 31.8% of girls were absent from school due to menstruation. The school absence might be due to the inadequate toilet facilities that did not support girls in fully participating schools (i.e., there were no gender-separated toilets, and no waste bins in the toilets), therefore, girls avoided using school toilets [ 9 ]. Inadequate facilities may impose poor menstrual hygiene practices in girls, and poor hygiene often leads to negative menstrual experiences, including menstrual shaming, particularly, when the toilets are not gender separated.…”