Menstrual hygiene management and school absenteeism among female adolescent students in Northeast Ethiopia

Abstract

BackgroundAdolescence in girls has been recognized as a special period marked with the onset of menarche. Even though menstruation is a natural process, it is associated with misconceptions, malpractices and challenges among girls in developing countries. However, much is not documented; school-absenteeism and dropout are a common problem among girls in rural Ethiopia. Focusing among school girls, this study has examined knowledge about menstruation, determinants of menstrual management and its influence on school-attendance in Northeast Ethiopia.MethodsWe conducted a mixed-method research combining quantitative and qualitative methods in Northeast Ethiopia. The quantitative study was conducted among 595 randomly selected adolescent school girls. Nine in-depth interviews; five school-dropout girls and four female teachers, and four focus group discussions among school girls were conducted in 2013.ResultsThe mean age at menarche was 13.98 (±1.17) years. About 51% of girls had knowledge about menstruation and its management. Only a third of the girls used sanitary napkins as menstrual absorbent during their last menstruation. Girls from urban areas, had mothers of secondary and above education and, families of higher monthly expenditure had more chance of using sanitary napkins than their counterparts. More than half of the girls reported to have been absent from school during their menstruation period. Those who did not use sanitary napkins were more likely to be absent from school [AOR-95% C.I: 5.37 (3.02 - 9.55)]. Fifty eight percent of girls reported that their school-performance had declined after they had menarche. In addition, the qualitative study indicated that school-dropout was common among girls who experienced teasing and humiliation by classmates when their clothes were stained with blood as they do not use sanitary napkins.ConclusionThough there is an effort to increase girls’ school enrollment, lack of basic needs, like sanitary napkins that facilitate routine activates of girls at early adolescence are observed to deter girls’ school-attendance in rural Ethiopia. Special support for girl students, especially when they have their first menstruation and separate functioning sanitary facilities are necessities that should be in school at all times if gender equality and girls empowerment is to be achieved.

Practices of Managing Menstrual Hygiene by Girls in Public Boarding Secondary Schools - The Case of the Hhohho Region of Swaziland

“…One main problem is the impact of cultural practices and lack of services for menstrual hygiene management on girls' access to education [17]. A study in South India reported that half the girls attending school were withdrawn by their parents once they reached menarche, mostly to be married.…”

Menstruation and Menstrual Hygiene Practices of Adolescent School Going Girls: A Descriptive Study

“…As a result girls preferred to stay at home during their menstruation period. [4] The possible role for menstruation in limiting school attendance has received significant attention in popular media, nearly all of which argues that menstruation is likely to be significant factor in schooling. For example, Krist of (2009) writes: "education experts increasingly believe that a cost-effective way to keep high school girls from dropping out in poor countries is to help provide them with sanitary products."…”

“…Dysmenorrhea was significantly associated with school absenteeism and decreased academic performance, sports participation and socialization with peers. [4] Policy advocates for girls" education have suggested there are large losses in schooling due to menstruation and the lack of proper sanitary hygiene in developing countries. This has resulted in media attention and money directed towards sanitary product provision, despite little or no hard evidence on possible impacts.…”

Empowerment of Adolescent Girls for Sexual and Reproductive Health Care: A Qualitative Study

“…In girls, this period as a specific stage of life requires special attention and consideration 2 because the beginning of adolescence is associated, on the one hand, with the onset of puberty and menstruation and, on the other hand, with the discovery of sexual desires 3,4 . Misconceptions and wrong health behaviors in the process of menstruation and puberty endanger the health of girls 5 .…”