To address these shortcomings, a 'super setting approach' is recommended, in which a Health Promoting School could improve the girls' individual and group needs, and a community setting which would address the broader socio-economic, cultural and environmental conditions. This would enable creating a supportive environment for the girls to manage their periods. To successfully utilize the approach, all stakeholders (parents, teachers, children, governments and communities) should cooperate to generate context-specific solutions for creating safe menstrual care, and better and dignified conditions for adolescent girls. Therefore, this calls for comprehensive, strident advocacy for policy changes at national level, and mediation and involvement at community level.
Menstruation is both a public health concern that requires hygienic management and a human rights issue that demands dignity and health. We conducted six focus groups with 51 respondents from three secondary schools in Mongu District, Western Province, in Zambia to explore factors that influence adolescent girls' understanding, experiences, and practices of menstrual hygiene. Thematic content analysis was used to identify multiple interrelated problems that stem from (1) culture and traditional practices, (2) inadequate accurate health information, and (3) poverty-related conditions. The girls faced menstruation-related inconveniences, bullying and humiliation, stress, infections, poor school attendance and performance, and dropped out of school. Policy recommendations are included.
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