Scholarly Research Journal for Interdisciplinary Studies, Online ISSN 2278-8808, SJIF 2019 = 6.38, www.srjis.com PEER REVIEWED & REFERRED JOURNAL, NOV-DEC, 2019, VOL- 7/55
HEALTH AND HYGIENE AMONG ADOLESCENT GIRLS: A SHOVEL ANALYSIS AND ASSESSING KNOWLEDGE THROUGH EXTENSION EDUCATION Mrs. Musharraf Jahan Assistant Professor, Centre of Continuing & Adult Education and Extension Aligarh Muslim University, Aligarh (India) Abstract Menstrual hygiene should be a vital part of healthcare among the adolescent girls. Various aspects such as physiology, pathology and psychology of menstruation have been found to associate with health and well-being of women and girls, hence it is an important issue concerting to the female population. During this period, an adolescent girl is regarded most vulnerable for developing any kind of reproductive tract infections, urinary tract infections and various sexual transmitted diseases. Menstrual hygiene deals with special healthcare needs and requirements of adolescent girls during the period. Therefore, increased knowledge about health and hygiene through extension education shoot up safe practices and may assist in mitigating the suffering of large number of adolescent girls. Keywords: Health, Menstrual Hygiene, Adolescent, Extension Education, Environment
Scholarly Research Journal's is licensed Based on a work at www.srjis.com Introduction Adolescent girls constitute a vulnerable group, particularly in India where female child is neglected. Hygiene related practices of adolescent girls during menstruation are of considerable importance, as it has a health impact in terms of increased vulnerability to reproductive tract infections. The interplay of socio-economic status, menstrual hygiene practices are noticeable. Today, large numbers of adolescent girls are suffering from this problem of reproductive tract infections (RTI). Health and hygiene should be an imperative part of the healthcare. The United Nations 1 defines adequate menstrual hygiene management as „women and adolescent girls using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required, and having access to facilities to dispose of used menstrual management materials.‟ Particularly in developing and or under developed countries, girls and women face substantial barriers to achieve adequate menstrual management. The World Health Organization also defines adolescence as individuals 1Sommer, M, Sahin, M. (2013): „Overcoming the Taboo: Advancing the Global Agenda for Menstrual Hygiene Management for School Girls‟ AMJ Public Health, p.103
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between 10 and 19 years of age. The adolescent girls have been recognized as a special period in their life cycle that requires specific and special attention2. Personal hygiene practices such as hand washing, bathing and cleaning regularly play a vital role in safeguarding oneself from infections. But the private issues are mainly found in adolescent girls due to custom variations. Traditional practices and superstitions are followed due to lack of proper knowledge among adolescent girls and their families. National Rural Health Mission has also operationalised a programme to promote the menstrual hygiene among adolescent girls (10-19 Years) in rural areas which lays out the contours of the schemes, including the management, monitoring and supervisory structure. The central government has also developed reading material and training modules including a communication package to enable training of ASHA and other groups at the village and community level3. In India The Adolescent Reproductive and Sexual Health (ARSH) and the Adolescent Education Programme (AEP) are core components of national health programmes that address adolescent health. Reviewing the Health and Hygiene among Adolescent Girls A study was conducted by M Sarkar and A Dasgupta4 in the area of Rural Health Unit and Training Centre, Singur, Hooghly, West Bengal among the adolescent schoolgirls in the field practice results revealed that more than half of the girls (51.25%) were ignorant about the use of the sanitary pads during menstruation. For cleaning purpose, 97.5% girls used both soap and water. 42.5% girls used old cloth pieces and 6.25% girls used new cloth pieces and only 11.25% girls used sanitary pads during menstruation. In the line of the discussion, a study conducted in Delhi by Shantanu Sharma5 covering total 85 adolescent girls between the ages of 10-19 years old in 2015 revealed that 85.9% girls used sanitary pads and 46.4% girls practiced different restrictions during menstruation. A community based cross sectional study was carried out infield practice areas of the Karad Maharashtra on „menstrual hygiene among adolescent girls, a study from urban slum areas‟
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Ghai, OP, Paul VK, Bagga A., (2009): “Essential Pediatrics”, 7the ed. New Delhi, CBS Publishers and Distributors Pvt. Ltd. 3 Please refer to the National Rural Health Mission‟s Operational Guidelines „Promotion of Menstrual Hygiene Among Adolescent Girls (10-19 Years) in Rural Areas 4 A Dasgupta, M Sarkar, Menstrual Hygiene: How Hygiene is the Adolescent Girl?, Indian Journal of Community Medicine, Vol 33 (2), 2008, pp. 77-80 5 Sharma Shantanu et al (2017): “Menstrual hygiene practices among adolescent girls in a resettlement colony of Delhi: a cross-sectional study”,International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Vol-6 No.5
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conducted by Tanvi Nitin Deshpande et al6 revealed on educational status that the educational status of the mother played a crucial role in influencing the adolescent girls in the family and it was found that majority (47%) of the mothers were illiterate, while in a study conducted among school going girls only 7.49% of the mothers were illiterate.At the adolescent girls lived in slum areas and the majority of the girls were school dropouts, their knowledge about menstruation was very poor. The girls in majority were unaware of the scientific care process. Only 24 % girls were aware of the term menstruation before menarche. Mother was the first informant in 84% adolescent girls. It also becomes important to discuss the prevailing diseases due to improper care health and hygiene in the mean time of the menstruation. Research shows that dysmenorrheal is the most common menstrual problem in many of the adolescent girls, having the abdominal pain, back pain and abdominal cramps. It is the most disturbing health problem faced by young women with ovulatory cycles. In this study, dysmenorrheal was experienced by 40% girls, while the prevalence of dysmenorrhea was found to be 61 percent in the study conducted in Chennai city by Sharanya T on reproductive health status and life skills of adolescent girls dwelling in slums in Channai7. A similar study conducted by Dudeja 8 found that 56.4% girls were of the process of menstruation before menarche and 60.7% girls revealed mother as their source of information while 31.8% declared that they obtained information from their friend. Other sources of information were sisters, friends and relatives. As we know that the unhygienic and improper practices during this period can lead to serious reproductive tract infections, urinary tract infections and various sexually transmitted diseases. It would be very important to mention here about an important study related to the teacher education. A study conducted in Ethiopia reported teacher to be the first source of information in 43.1% of adolescent girls regarding the health and hygiene in due course of menstrual cycle9.
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Deshpande, Tanvi Nitin et al (2018): “Menstrual Hygiene among Adolescent Girls- A study from urban slum areas” Journal of Family Medicine and Primary Care, November-December, 7 (6), pp. 1439-1445 7 Sharanya, T. (2014): “Reproductive Health Status and Life Skills of Adolescent Girls dwelling in Slums in Chennai” Natl Medical Journal India, 27, pp 305-10 8 Dudeja P, Sindhu, A, Shankar P, Gadekar (2016): ”A Cross sectional study to assess awareness about menstruation in adolescent girls of an urban slum in western Maharashtra”, International Journal of Adolescent Medicine Health 9 Gultie T, Hailu, D, Workineh Y (2014): “Age of Menarche and Knowldege about menstrual hygiene management among adolescent school girls in Amraha Province, Ethiopia”, Implication to health care workers and school teachers. PlOS, 9, E-108644
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Factual analysis The above discussion and findings reinforce the need to encourage safe and hygienic practices among the adolescent girls and bring them out of traditional beliefs, misconceptions and restrictions regarding menstruation. The above studies highly recommended strengthening the menstrual hygiene management programmes of the country and having a greater outreach through extension education. Multiple strategies need to be used to address this, such as education on reproductive health and menstruation provided in school, media campaigns and improving water and sanitation for improving school retention of adolescent girls and their overall health. The study revealed in its comparative analysis of the several previous studies the health and hygiene was unsatisfactory among the adolescent girls. This was because of low level of education and improper assumptions about the phenomenon of menstruation. Hence, it is very crucial to educate adolescent girls especially coming from extremely backward areas about the physiological facts of menstruation, wipe off false taboos, and lead them to proper hygienic practices to safeguard themselves against reproductive tract infections. In our country, various schools, Anganwadi health centres, social welfare foundations and nongovernmental organizations should stand to disseminate awareness about menstrual hygiene, pattern and problems. It is a strong belief that an educated woman is a first teacher of a family that is why education of the mother and the adolescent girl is very important. But presently, as we live in a male dominated society, educating men about basic needs of women of his family during menstruation will help in contributing toward cleaner and healthier menstruation practices. Therefore, when the whole family is in acquaintance with the phenomenon of menstruation, age old restrictions, traditional perceptions, false beliefs, and wrong attitude can be effectively eliminated. Conclusion Teaching via adult and continuing education leave a positive impact and greatly influence the mind of adolescent girls concerning the health and hygiene. It is noted that there are several reasons behind the truth that the issue of menstrual hygiene is seldom being discussed in the school curriculum even it is also mentioned in Millennium Development Goals. Therefore, to understand the consequences and importance of hygiene and health practices among adolescent girls, it is important to learn the modern practices about the same so that future interventions can be planned accordingly. Copyright Š 2017, Scholarly Research Journal for Interdisciplinary Studies
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Adolescent girls having better knowledge regarding menstrual hygiene and safe practices are less vulnerable of infectious diseases. Through the extension education it may be very sophisticated to educate the adolescent girls and generate awareness among them and its complications and consequences. Therefore, increased literacy among the adolescent girls through the extension knowledge about this right from childhood may escalate safe practices and may help in mitigating the suffering of millions of adolescent girls. There is also urgent need of community based observation system.The adolescent girls had no information about proper method of disposal of sanitary pad as found in above study. It should be in adult education system to educate for such scientific practices to dispose the sanitary pad. Before bringing any change in menstrual practices, the girls should be educated about the facts of menstruation, physiological implications, about the significance of menstruation and development
of secondary sexual characteristics, and above all about proper hygienic
practices with selection of disposable sanitary menstrual absorbent. This can be achieved through educational programmes, school curriculum and knowledgeable parents (adult education). The correct perception and beliefs can protect the adolescent girls from any kind of suffering.
Adult education programme will definitely increase awareness among
adolescent girls on menstrual hygiene, build self-esteem, and empower girls for greater socialization as well as ensure safe disposal of sanitary napkins in an environment friendly manner. References: Dasgupta,A, M Sarkar, (2008): “Menstrual Hygiene: How Hygiene is the Adolescent Girl?”, Indian Journal of Community Medicine, Vol 33 (2), 2008, pp. 77-80 Deo, DS, GhattargiCH, (2005) : “Perceptions and Practices regarding menstruation: a comparative study in urban and rural adolescent girls”, Indian Journal of Community Medicine, Vol 33, 2005 Deshpande, Tanvi Nitin et al (2018): “Menstrual Hygiene among Adolescent Girls- A study from urban slum areas”Journal of Family Medicine and Primary Care, November-December, 7 (6), pp. 1439-1445 Dudeja P, Sindhu, A, Shankar P, Gadekar (2016): “A Cross sectional study to assess awareness about menstruation in adolescent girls of an urban slum in western Maharashtra”,International Journal of Adolescent Medicine Health. Ghai, OP, Paul VK, Bagga A., (2009): “Essential Pediatrics”, 7the ed. New Delhi, CBS Publishers and Distributors Pvt. Ltd. Gultie T, Hailu, D, Workineh Y (2014): “Age of Menarche and Knowldege about menstrual hygiene management among adolescent school girls in Amraha Province, Ethiopia”, Implication to health care workers and school teachers. PlOS, 9, E-108644
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Juyal R, Kandpal S, Semwal, J. (2014): “Menstrual Hygiene and Reproductive Morbidity in Adolescent Girls in Dehradun, India”, Bangladesh Journal of Medical Science, Vol 13 (02), pp. 170-74 KaribeeranSathyamurthiedt. (2014): “Community Health”, Today Publication, Chennai, India Khanna A, Goyal RS, Bhawsar R. (2005): “Menstrual practices and reproductive problems: a study of adolescent girls in Rajasthan”,Journal of Health Management, Vol-7, 2005, pp 91-107 Kumar, D, Goel NK, Puri S. (2013): “Menstrual Pattern among unmarried women from northern India”, Journal of Clinical Diagnosis Research, Vol 7 (9), 2013 National Rural Health Mission (20110: “Training Module for ASHA on Menstrual Hygiene”, Ministry of Health and Family Welfare, Government of India, 2011:101-21 Sharanya, T. (2014): “Reproductive Health Status and Life Skills of Adolescent Girls dwelling in Slums in Chennai”Natl Medical Journal India, 27, pp 305-10 Sharma Shantanu et al (2017): “Menstrual hygiene practices among adolescent girls in a resettlement colony of Delhi: a cross-sectional study”,International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Vol-6 No.5 Sommer, M, Sahin, M. (2013): „Overcoming the Taboo: Advancing the Global Agenda for Menstrual Hygiene Management for School Girls‟ AMJ Public Health, p.103 World Health Organization (WHO) (1984): „WHO Technical Report Series‟, The use and Interpretation of Anthropometry, pp. 263-311.
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