Perception and practices of menstruation restrictions among urban adolescent girls and women in Nepal: a cross-sectional survey

Abstract

Background: Menstruation, a natural biologic process is associated with restrictions and superstitious beliefs in Nepal. However, factual data on women's perspectives on menstrual practices and restrictions are scarce. This study aimed to assess socio-cultural perceptions of menstrual restrictions among urban Nepalese women in the Kathmandu valley. Methods: Using a clustered random sampling, 1342 adolescent girls and women of menstruating age (≥15 years) from three urban districts in the Kathmandu valley completed a survey related to menstrual practices and restriction. This was a cross-sectional survey study using a customized program allowing pull-down, multiple choice and open-ended questions in the Nepali language. The self-administered questionnaire consisted of 13 demographic questions and 22 questions related to menstruation, menstrual hygiene, socio-cultural taboos, beliefs and practices. Univariate descriptive statistics were reported. Unadjusted associations of socio-cultural practices with ethnicity, education, four major social classes, three major religions, marital status and family type were assessed using logistic regression models. Results: More than half (59%) of the participants were aged between 15-< 25 years. The majority were Hindus (84.5%), reported not praying during menstruation (83.1%) and were encouraged by their mothers (72.1%) to practice a range of menstrual restrictions. Purifying either the kitchen, bed, bedsheets or other household things on the fourth day of menstruation was reported by 66.1% of the participants, and 45.4% saw menstruation as a "bother" or "curse." There were differences among social classes, where participants of the Janajati caste, an indigenous group, were more likely to enter places of worship [OR (95%CI): 1.74 (1.06-2.86)] and pray [OR (95%CI): 1.79 (1.18-2.71)] while menstruating, compared to the Brahmins. Participants with a master's degree were more likely to pray while menstruating, compared to participants with less than a high school education [OR (95%CI): 2.83 (1.61-4.96)].

Acceptability and feasibility of using vaginal menstrual cups among schoolgirls in rural Nepal: a qualitative pilot study

“…The use of unhygienic clothes to replace pads or tampons may cause restriction in movement, skin irritation, concerns about leaking and odor [ 8 , 9 ], and increase the risk of urogenital infections [ 10 , 11 ]. In Nepal, many families impose restrictions on menstruating girls and women, which may vary based on religion, social group and education level [ 12 ]. The severest restriction is "Chhaupadi", meaning the isolation of menstruating women in small huts made of mud and stones with no doors or windows, which is still practiced in the Far-Western Development Region of Nepal [ 13 ].…”

Menstrual Restriction on Health, Education, and Empowerment: A Review of Literature

“…14 A recent study byAmrita Mukherjee and team in 2020, found that 45.5% of the total participants (n=1342) saw menstruation as a bother or curse, 66.1% purify the kitchen, bed, bedsheets, or other household things on the fourth days and 72.1% were encouraged by their mothers to practice the restrictions. 15 Now, it is not only the problem of the developing world, it is believed to exist globally. However, the data are scarce.…”

The Stressor in Adolescence of Menstruation: Coping Strategies, Emotional Stress & Impacts on School Absences among Young Women in Nepal

“…South Asian countries, in particular, have been noted for the depth of restrictions surrounding limitations in types of food, rules on which cultural/religious events menstruating females may attend, and who they may interact with/near [11]. Such restrictions are deeply rooted in the traditional beliefs and teaching of Hindu culture, which possess strong superstitions surrounding the impurity of blood [12].…”