The effect of a school-based educational intervention on menstrual health: an intervention study among adolescent girls in Bangladesh

Abstract

ObjectivesTo assess the impact of a school-based menstrual education programme on: (1) menstrual knowledge, beliefs and practices, (2) menstrual disorders experienced, and (3) restrictions on menstruating adolescents.DesignIntervention study.SettingAraihazar area, Bangladesh.Participants416 adolescent female students aged 11–16 years, in grade 6–8, and living with their parents.InterventionsA school-based health education study conducted from April 2012 to April 2013.Primary and secondary outcome measuresWe randomly selected 3 of 26 high schools in the study area. We delivered 6 months of educational intervention by trained (by an obstetrician and gynaecologist) research assistants (RAs) on menstrual hygiene among school girls. RAs read the questionnaire and participants answered. The changes in knowledge, beliefs and practices regarding menstruation, menstrual disorders experienced, and the restrictions and behaviours practiced by menstruating adolescents were compared between the baseline and the follow-up assessments.ResultsAfter health education, participants reported a significant improvement (p<0.001) in ‘high knowledge and beliefs’ scores compared to baseline (51% vs 82.4%). Significant improvement was also observed in overall good menstrual practices (28.8% vs 88.9%), including improvements in using sanitary pads (22.4% change after the intervention), frequency of changing pads/cloths per day (68.8%), drying the used absorbent (77.6%), methods of disposing of the used absorbent (25.5%), and cleaning of genitalia (19.2%). During the follow-up, the participants reported significant improvements in the regularity of their menstrual cycle (94.5% vs 99.5%) and fewer complications during menstruation (78.6% vs 59.6%).ConclusionsThe programme produced significant changes in the knowledge, beliefs and practices of menstrual hygiene, complications from lack of hygiene, and the behaviour and restrictions of the menstruating adolescents. These results demonstrate the feasibility of implementing a health education programme for adolescents on menstrual hygiene in secondary schools serving rural Bangladesh.

Educating Mothers and Girls about Knowledge and Practices toward Puberty Hygiene in Tabriz, Iran: A Randomized Controlled Clinical Trial

“…Mothers' lack of knowledge and correct information, or insufficient attention to questions related to puberty could be among the reasons for the lack of sufficient knowledge and the incorrect practice of these adolescents. This agrees with the studies conducted by Haque et al (25) and Koff et al (26) that showed a direct relationship between the initial information of the girls (and its sufficiency) and suitable knowledge and practice; most girls had also low levels of knowledge and poor practice regarding puberty hygiene and observing hygiene issues.…”

Effect of Planned Health Educational Program on Menstrual Knowledge and Practices among Adolescent Saudi Girls

“…Some of these issues include abnormal abdominal pain, urinary tract infections, reproductive tract infections, and absenteeism from school [2,4]. In many developing countries, a culture of silence engulfs the topic of menstruation and its related concerns [2]. Taboos and beliefs carried through generations that impart negative notions about menstruation in adolescent girls [5].…”

“…The start of menstruation is one of the most significant changes that occur for girls during the adolescent period [1,2]. Notably, the first menarche occurs between the ages of approximately 11 to 14 years for most girls [2,3].…”

“…Poor menstrual practices and inadequate self-care are significant determinants of morbidity and other hurdles among the age group. Some of these issues include abnormal abdominal pain, urinary tract infections, reproductive tract infections, and absenteeism from school [2,4]. In many developing countries, a culture of silence engulfs the topic of menstruation and its related concerns [2].…”

Menstruation: gap in knowledge, belief and practice among adolescent girls in an urban area of Belagavi

“…11 Regarding perineal hygiene, 464 (74.3%) girls knew that poor perineal hygiene predisposes to RTI which is slightly more when compared to the study conducted in Bangladesh were 68.3% of the girls knew about it. 12 About 228 (36.5%) of the adolescent girls had menstrual problems and the most common complaints were dysmenorrhoea (20.6%) and oligomenorrhoea (10.3%). Of these girls, 50 (21.9%) approached gynaecologist for treatment, 45 (19.8%) took self-medication, 29 (12.7%) approached a qualified doctor and 102 (44.7%) did not seek any treatment.…”