Determinants of Menstrual Hygiene Management Practices among Schoolgirls: A Cross-Sectional Study in the Savannah Region of Ghana

Abstract

Introduction. Menstruation is crucial in the reproductive lives of all women. The advent of menses in most settings is accompanied by physical and psychological health, religious, social, and cultural implications. The research intends to identify determinants of menstrual hygiene management (MHM) practices among adolescent girls in Junior High Schools in the West Gonja Municipality of the Savannah Region of Ghana. Methods. The study employed an analytical cross-sectional design with 430 adolescent schoolgirls selected through multistage sampling techniques. A structured questionnaire was used to collect data and analyzed using STATA version 14. A logistic regression model was run to determine the predictors of MHM practices. Results. The study discovered that 63.7% of the girls had sufficient knowledge of menstruation and menstrual hygiene. Almost all girls (97%) used some form of absorbent materials during menses, with over half of these girls (58.6%) using commercial sanitary pads, 30.5% using cloth, 3.7% using cotton, and 4.2% using tissue papers with 3.0% reported not using any absorbent material. Only 44.4% reported reusing their absorbent materials. Out of which, the majority (88.5%) of the schoolgirls cleaned their reusable absorbent material using soap and water with 77.5% drying absorbent materials in the sun. Overall, 84.9% practiced good MHM. Type of school [Adjusted Odds Ratio (AOR) =6.0; 95% Confidence Interval (CI) (2.64-13.59)], pocket money [AOR =2.5; 95% CI (1.27-4.86)], and residence [AOR =2.8 95% CI (1.55-5.18)] were the most significant determinants of menstrual hygiene management practice. Conclusion. About two-thirds of the schoolgirls are knowledgeable in menstrual hygiene but access to management materials is problematic whereas approximately half of the girls have access to sanitary pads and the rest resort to the use of cloth and cotton. Pocket money and residential status were the most important predictors of the menstrual hygiene management. The government initiative to provide schoolgirls with sanitary pads could go a long way to improve menstrual hygiene management if implemented across all schools in Ghana, particularly in rural areas.

Knowledge and Practices of Menstrual Hygiene Management: A Descriptive Cross-Sectional Study among Adolescent Girls in North Gonja District in the Savannah Region of Ghana

“…Although, in the Savannah Region, the MHM practices rate as reported by a study is over 80% [16], another study in the same area has it that, most girls in this area have their MHM practices influenced by religion, and culture [2]. They further argue that in Northern Ghana, menstruating girls are restricted from cooking and secluded from certain religious activities such as performing regular prayers and recitation of the Holy Qur'an [2].…”

“…The z-score is 1.96, m=0.05 and the proportion of people who practice good menstrual hygiene management is 84.9% according to a study conducted in the West Gonja Municipality [16].…”

The Increasing Cost of Sanitary Products and the Potential Impact on Menstrual Hygiene Management Practices in Ghana

“…Unfortunately, the prices of sanitary pads are skyrocketing making some adolescents stay home until their menses ends. This is corroborated by Asumah et al, [6] who indicated that people with pocket money are able to afford sanitary products and thus practice good MHM. The discomfort brought on by the monthly flow has been made worse by the expensive expense of sanitary pads.…”

“…At the moment, up to 20% tax tariff and 12.5% Value Added Tax (VAT) are placed on imported sanitary products because they are considered extravagant or luxury goods per the Ghana Revenue Authority's manuals [8]. Some civil society organizations have resorted to giving out sanitary pads for free to girls who have reached their menarche; particularly those in the rural areas of low-income countries as a motivation to boost girls' presence and involvement in school activities during their menses [3,[6][7][8]. However, this initiative is unsustainable as these donations are often done on the menstrual hygiene days, besides, the pad donation alone is not enough to meet the required sanitary needs of the women.…”

“…The call for collaboration to promote menstrual hygiene is justified because, without sanitary pads, a section of adolescent girls would practice poor menstrual hygiene. Poor menstrual hygiene management can lead to issues such as absenteeism from school, subpar academic performance, school dropout, and illness [6,7]. This can significantly affect government efforts to the realization of Sustainable Development Goals (SDG) 4 and 5 on quality education for all and gender equality and empowering all women and girls respectively.…”