Menstrual hygiene management in rural schools of Zambia: a descriptive study of knowledge, experiences and challenges faced by schoolgirls

Abstract

IntroductionWhile in school, girls require an environment that is supportive of menstrual hygiene management (MHM) in order to ensure regular school attendance and participation. Little is known about schoolgirls access to and practice of MHM in rural Zambia. This study explores girls’ experiences of MHM in rural schools of Zambia from the perspectives of schoolgirls, schoolboys and community and school-based adults key to MHM for schoolgirls.MethodsIn July and August 2015, we conducted this qualitative exploratory study in six rural schools of Mumbwa and Rufunsa districts of Zambia. Twelve in-depth interviews (IDIs) and six focus group discussions (FGDs) were conducted among girls ages 14–18 who had begun menstruating. Two FGDs with boys ages 14–18 and 25 key informant interviews were also conducted with teachers, female guardians and traditional leaders to provide the context within which schoolgirls practice MHM.ResultsMost girls reported learning about menstruation only at menarche and did not know the physiological basis of menstruation. They reported MHM-related challenges, including: use of non-absorbent and uncomfortable menstrual cloth and inadequate provision of sanitary materials, water, hygiene and sanitation facilities (WASH) in schools. In particular, toilets did not have soap and water or doors and locks for privacy and had a bad odor. Girls’ school attendance and participation in physical activities was compromised when menstruating due to fear of teasing (especially by boys) and embarrassment from menstrual leakage. Boys said they could tell when girls were menstruating by the smell and their behaviour, for instance, moving less and isolating themselves from their peers. Girls complained of friction burns on their inner thighs during their long journey to school due to chaffing of wet non-absorbent material used to make menstrual cloth. Girls preferred to dispose used menstrual materials in pit latrines and not waste bins for fear that they could be retrieved for witchcraft against them. Though traditional leaders and female guardians played a pivotal role in teaching girls MHM, they have not resolved challenges to MHM among schoolgirls.ConclusionWhen menstruating, schoolgirls in rural Zambia would rather stay home than be uncomfortable, inactive and embarrassed due to inadequate MHM facilities at school. A friendly and supportive MHM environment that provides education, absorbent sanitary materials and adequate WASH facilities is essential to providing equal opportunity for all girls.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6360-2) contains supplementary material, which is available to authorized users.

Period teasing, stigma and knowledge: A survey of adolescent boys and girls in Northern Tanzania

“…A non-trivial share of the girls (13%) report having experienced period teasing, and fear of period teasing is almost universal (over 80%). The majority of previous qualitative studies that survey girls portray teasing as a common phenomenon and a major source of anxiety for girls [ 3 , 5 ]—we confirm this finding. The only other quantitative study to date, which was a non-representative poll of 1,000 U.K. girls aged 14-21, revealed that one in five girls have experienced teasing or bullying surrounding their periods [ 37 ].…”

“…In recent years, an abundance of research and publicity has identified menstruation as an obstacle to gender equality in education, health, and work, particularly in low and middle income countries. Qualitative research has found that a substantial portion of girls’ anxieties about managing their menstruation while at school stems from their fears about boys’ negative reactions [ 1 – 5 ], impacting well-being and school performance. While many studies aim to understand and improve girls’ menstrual hygiene management (MHM), boys’ attitudes and knowledge of the topic remains under-explored and thus limits their inclusion as agents of positive change.…”

“…One acute manifestation of boys’ negative attitudes is period teasing—harassment linked directly to girls’ menstruation. Though early studies [ 9 ] highlighted the harms of general and sexual harassment for girls’ educational outcomes, period teasing specifically is a relatively novel and under-explored research topic [ 5 , 10 ].…”

“…In sub-Saharan Africa, the menstrual health research on adolescent males is very limited. Six focus groups with 38 adolescents and five in-depth interviews were conducted in The Gambia [ 16 ], and two focus groups of 16 adolescents were conducted in rural Zambia [ 5 ]. Similarly to schoolboys in Taiwan, the boys expressed an interest in learning more about menstruation, although mothers did not agree that they should learn about the topic.…”

Mensural Hygiene Management in Schools of Oromia Region, Ethiopia

“…During menstruation, girls fear teasing by boys and embarrassed if their menstruation is seen. (8) Evidences reveal that adequate menstrual hygiene and management is about availability of sanitary pad, water and soap and separate room for privacy to change and disposal facility. (9) Nonetheless, lack of awareness about the problem at family, school and community level, consideration of menstruation as taboo and consequent teasing and bullying by boys, poor availability of supply including sanitary pad, water, soap, disposal facilities and privacy at school level contributed to girl's school dropout and their poor performance.…”