Perceptions, Practices, and Challenges Regarding Menstrual Hygiene Among Women in Karachi, Pakistan: A Comparison Between General Population and Healthcare Workers

Abstract

Background Menstruation is a natural physiological phenomenon, yet considered a stigmatized subject, particularly in low- and middle-income countries like Pakistan. It is seldom discussed openly, leading to flow of incorrect and incomplete knowledge. The resultant unhealthy practices not only affect the health of the menstruator but can also contribute to considerable psychosocial stress. Menstrual hygiene management (MHM) is an important facet, which is associated with a variety of practices and beliefs in different parts of the world, some of which may not be correct. Identifying these poor methods is necessary in order to rectify them. Hence, our study aimed at determining the level of knowledge, beliefs, and practices pertaining to menstruation in the general female populace of Karachi. Healthcare workers have a potential role in the dissemination of authentic knowledge and practices. Therefore, we assessed and compared the accuracy and reliability of the aforementioned parameters in them and the need for an educational intervention. Methods A descriptive, cross-sectional study was conducted on females visiting the Gynecologic and Obstetrics Outpatient Department (OPD), and healthcare workers employed at Dr. Ruth K. M. Pfau Civil Hospital Karachi and Dow University Hospital Ojha. Using non-probability convenience sampling, a self-structured questionnaire was used to collect data from 353 respondents over a duration of three months from October 2019 to January 2020. Data was tabulated in Statistical Package for the Social Sciences (SPSS) version 24.0 (IBM Corp., Armonk, NY, US). In accordance with the objectives of the study, descriptive analysis was performed, and data was presented in the form of frequencies and percentages. Results Of the 353 participants, 176 were from the general population and 177 were healthcare workers. At menarche, only 28.4% of the general population and 29.4% of healthcare workers had an idea of menses and proper placement of absorbent. Significantly lower number of females from the general population were found to be aware of tampons and menstrual cups (15.9% and 11.4% respectively) as compared to healthcare workers. For both groups, the source of knowledge was mostly their mother. The study showed that 77.8% of the general population and 66.1% of healthcare workers avoided bathing on certain days during menses, with the most common reason being that "it causes irregular flow". As compared to healthcare workers, a significantly higher number of women from the general population had restrictions of activity (53.4%) and avoided washing of groin area during menstruation (31.2%). Majority of women from the general population mentioned that they were scared when they menstruated for the first time. The most common absorbent used by respondents was pads, followed by cloth. The data showed 64.2% of females from the general population and 28.8% of healthcare workers abstained from eating certain foods. Seeking treatment for gynec...

Knowledge, attitude, and practices regarding menstrual cup among reproductive women in a rural tertiary care Hospital

“…In contrast, the present study reported a low percentage of the study population who had good knowledge about the menstrual cup (5.8%). This finding is similar to the finding of the study by Arshad Ali et al In this study authors reported that only 11.4% of the general study population knew about the menstrual cup [8] . The present study reported that most of the participants use sanitary napkins (96.7%) during their menstruation cycle for maintenance of menstruation hygiene.…”

Unmet Menstrual Hygiene Needs among the Impoverished Women, their Perceptions and Health Hazards

“…Similar findings were provided in a study conducted in St. Louis, Missouri, USA, where over two-fold (64%) of women were unable to afford the necessary menstrual hygiene supplies, during their reproductive cycles 1,4 . A Canadian poll indicated that one-third of menstruators struggled to manage their finances to afford menstrual supplies 9 . Notably, by recording the association between economic status and the ability to acquire menstrual hygiene supplies, the researchers discovered that over two-thirds of low-income women could not afford these essential hygiene items 12 .…”

“…Due to the limited dissemination of information, individuals hold myths and preconceived notions that manifest in their hazardous menstruation practices. This not only has medical consequences, such as an increased risk of urinary tract infections (UTIs) and reproductive tract infections (bacterial vaginosis, vaginal scabies, candidiasis), but also contributed to significant emotional stress 9 .…”

Assessment of an Educational Intervention on the Perception of Adolescent Girls towards Menstrual Hygiene in Ogun State, Nigeria

“…However, menstrual hygiene can be defined as making use of clean, hygienic menstrual material to absorb blood that can be changed in privacy as often as possible; making use of soap and water for washing the body as required and being able to dispose of used menstrual waste properly [5]. In low and middle-income countries such as Nigeria, several misconceptions are linked with menstruation as it is considered as something that should be suffered in silence and 'shrouded in secrecy [6]. Menstruating women and girls are believed to be impure and contaminated and have limited or no access to appropriate toilets and facilities for handwashing [7].…”

“…Furthermore, many adults, as well as parents and close relations in Nigeria, are hesitant to openly discuss issues regarding sexual health, reproduction, and menstruation [8]. As a result, it serves as a major challenge to proper Education regarding menstrual hygiene and has blocked the access of adolescent girls to the right kind of information, especially in the rural and tribal communities [6,9].…”