Menstrual hygiene practices among high school girls in urban areas in Northeastern Ethiopia: A neglected issue in water, sanitation, and hygiene research

Abstract

Background Poor menstrual hygiene practices influence school girls’ dignity, well-being and health, school-absenteeism, academic performance, and school dropout in developing countries. Despite this, menstrual hygienic practices are not well understood and have not received proper attention by school WASH programs. Therefore, this study examined the extent of good menstrual hygiene practices and associated factors among high school girls in Dessie City, Amhara Region, northeastern Ethiopia. Methods A school-based cross-sectional study was employed to examine 546 randomly selected high school students in Dessie City, northeastern Ethiopia. Pretested interviewer-administered questionnaires and a school observational checklist were used for data collection. EpiData Version 4.6 and the Statistical Package for the Social Sciences Version 25.0 were used for data entry and analysis, respectively. Bivariate and multivariable logistics regression analyses were employed to identify factors associated with good menstrual hygiene practices. During bivariable analysis, variables with P-values less than 0.25 were retained for multivariable analysis. In the multivariable analysis, variables with a P-value less than 0.05 were declared to be significantly associated with good menstrual hygiene practices. Results Of the respondents, 53.9% (95% CI [49.6, 58.2]) reported good menstrual hygiene practices. The following factors were found to be significantly associated with good menstrual hygiene practices: age range 16–19 years (AOR = 1.93, 95% CI: [1.22–3.06]); school grade level 10 (AOR = 1.90, 95% CI: [1.18–3.07]); maternal education (primary) (AOR = 3.72, 95% CI: [1.81–7.63]), maternal education (secondary) (AOR = 8.54, 95% CI: [4.18–17.44]), maternal education (college) (AOR = 6.78, 95% CI: [3.28–14.02]) respectively]; having regular menses [AOR = 1.85, 95% CI: (1.03–3.32); good knowledge regarding menstruation (AOR = 2.02, 95% CI: [1.32–3.09]); discussing menstrual hygiene with friends (AOR = 1.79, 95% CI: [1.12–2.86]), and obtaining money for pads from the family (AOR = 2.08, 95% CI: [1.15–3.78]). Conclusion We found that more than half of high school girls had good menstrual hygiene practices. Factors significantly associated with good menstrual hygiene practices include high school girls age 16–18 years, girls grade level 10, maternal education being completed primary, secondary and college level, having regular menses, good knowledge regarding menstruation, discussing menstrual hygiene with friends and obtaining money for pads from the family. Therefore, educating of high school student mothers about MHP should be a priority intervention area to eliminate the problem of menstrual hygiene among daughters. Furthermore, in order to improve the MHP among high school girls, further attention is needed to improving knowledge regarding menstruation among high school girls, encouraging high school girls’ families to support their daughters by buying sanitary pads and promoting discussions among friends about menstrual hygiene. Schools need to focus on making the school environment conducive to managing menstrual hygiene by increasing awareness of safe MHP and providing adequate water/sanitation facilities.

Sociodemographic factors and their association with menstrual hygiene practices among adolescent girls in Urban slums of Dibrugarh town, Assam

“…Yohannes Habtegiorgis et al . [ 13 ] performed a study on menstrual hygiene practices among high-school girls in Northeastern Ethiopia in 2020 and have found that during multivariable analysis, maternal education, age, knowledge, and discussing menstrual hygiene with friends were significantly associated with good menstrual hygiene practices. Girls 16–19 years old were 1.9 times more likely to have good menstrual hygiene practices than girls in the 13–15-years age group (AOR = 1.93, 95% CI: 1.22–3.06).…”

Drivers of menstrual material disposal and washing practices: A systematic review

“…Where the physical state of WASH infrastructure was mentioned, it related to the quantity of available and physically functional toilets/latrines [22,26,28,32,33,37,40,44,46,58,63,73,75,76,78,81,86,87,89,91], the design of toilets/latrines [32,37,40,44,48,51,57,63,64,68,71,73,75,81,83,87,90,97], the quality and availability of running water in and around toilets or latrines [18,20,31,33,37,39,40,45,46,48,49,…”

“…availability of soap for washing [20,33,49,53,54,[56][57][58]60,61,63,64,66,67,73,77,90,91] and the availability of a physically functional disposal mechanism and/or service for used material [18,28,[31][32][33][34][35][36][37]42,[44][45][46][47][48]52,53,57,58,60,62,63,[66][67][68]71,76,77,82,83,86,90,91,…”

“…Social perceptions of appropriate infrastructure were driven by the presence or absence of a private/safe space for managing menstruation [28,34,36,37,39,40,[44][45][46]48,[51][52][53][54]57,60,63,64,[66][67][68][69]71,74,76,80,81,83,87,[89][90][91][92]96], the cleanliness and maintenance of the facility [25][26][27][28]31,33,36,37,40,43,44,46,48,53,57,63,…”

“…For example, menstruators that used reusable materials often dried them discreetly to hide them from others, often drying their washed materials inside, sometimes in a hidden corner [38,50,51,55,73,74,84,[91][92][93][94], under their clothes [60,69,74,76,81], hidden under or within other drying items [25,36,49,60,65,73,96], or generally inside out of view [48,52,58,68]. There were instances of drying menstrual materials outside [46,49,50,55,56,65,73,98] but typically in cases where menstruators believed that there was adequate separation of homes so that neighbours could not see. When using disposable materials, many menstruators wrapped their used menstrual materials in newspaper or polythene bags before disposal, so as to obscure their waste [24,25,32,40,41,43,47,54,60,…”