Challenges Associated with Menstrual Hygiene among Adolescent Girls Attending Bocharia Primary School in Nyamira County, Kenya

Background: Approximately, half a million of adolescent girls in the world feel frustrated during their monthly period due to poor menstrual hygiene practices. In the low-and-middle income countries, about three-quarters of girls do not have access to clean sanitary materials, and use low-quality products. In the Sub-Saharan African countries, menstruation among school-age girls is a neglected issue. Poor menstrual hygiene practices expose adolescent girls to reproductive organ infections, psychosocial stress, and poor school attendance. However, the available data concerning challenges associated with menstrual hygiene among school girls in the remote areas of Kenya remains unknown. Aim: To assess challenges associated with menstrual hygiene among adolescent girls attending Bocharia Primary School in Nyamira County, Kenya. Methods: The target population was grade 4 to 8 adolescent girls (n = 111) aged 10 - 19 years. Hence, census method of sampling was used to include all the girls in grade 4 - 8. Raw data was obtained using a Semi-structured questionnaire which was tested by a representation of 11 girls (10% of the sample size) who had the same characteristics. Data was analyzed using SPSS version 21 with both descriptive and inferential statistics. In descriptive statistics, frequency and percentage were generated. The chi-square test of independence was used to determine associations between some socio-demographic variables of the girls and menstrual hygiene practice. A p-value of less than 0.05 was considered to be significant. Results: The study found that majority (57%) of the respondents had poor menstrual hygiene practices associated with lack of accessibility and affordability to sanitary products, functional and safe latrines, shortage of soap and water supply, and sanitation facilities. Approximately half (47.8%) of the respondents reported that menstrual hygiene practices are highly influenced by taboo from cultural beliefs and societal norms. Girls who live with both parents were more likely (73.3%) to wash their body with water and soap during monthly bleeding as compared to those girls from single mother (64.7%) and those who live or grand Mothers (42.9%). The toilets or latrines that were allocated to the girls were unlockable, which threatens privacy and safety of the girls. Conclusions: Most of the school girls had poor menstrual hygiene practices associated with lack of sanitary products, safe and functional latrines, adequate water supply, soaps and sanitation facilities. Adequate attention to menstrual hygiene management should be given by the water, sanitation, and hygiene (WASH) program, education sectors, and sexual and reproductive health programs.

Facilities and Misconceptions Concerning Menstrual Health and Menstrual Hygiene Management among Young People in Jos, Plateau State, Nigeria

Background: Globally, women constitute 49.6% of the world population and at least 500 million women and girls lack adequate facilities for menstrual hygiene management. In Nigeria, a quarter of women lack adequate privacy for defecation and menstrual hygiene management. Absence of facilities needed for menstrual hygiene can pose as obstacle to women and girls practicing menstrual hygiene effectively. This study aims to identify the facilities and misconceptions concerning menstrual health and menstrual hygiene management. Methods: This was a descriptive cross-sectional study among 169 young males and females of Evangelical Church Winning All (ECWA) Theological Seminary, Jos North, Plateau State. This study sought to identify the facilities and misconceptions concerning menstrual health and menstrual hygiene management among young people in Jos, Plateau State. Nigeria. Simple random sampling technique was used in this study and data was collected using interviewer-administered structured questionnaire to measure availability of facilities/programs for menstrual hygiene management and misconceptions about menstruation. Data analysis was done using the Statistical Package for the Social Science (SPSS) version 20.0 with descriptive statistics, proportions, tables and diagrams used to illustrate findings from the data collected. Results: Majority 139 (82.2%) of the female respondents had access to adequate water supply, while 30 (17.8%) did not have access to the adequate water supply. About half, 53.8% had bathrooms with doors and safe locks, 19.5% had a school clinic where menstrual absorbents can be gotten, 10 (5.9%) had Girl’s Club/Peer Education teams, 24 (14.2%) had guidance and counselling classes. Programmes available to female respondents for menstrual health and hygiene management were girls club and guidance and counselling sessions. Majority 94 (97.9) of females have access to some form of menstrual adsorbent material, and 50 (52.1%) had no access to Sanitary pads. Most females 80 (80.3%) have access to soap, 46 (47.9%) do not have access to privacy at home when faced with changing their pads or menstrual adsorbent, while 84 (87.5%) had access to privacy while in school, 46.7% of respondents were aware of misconceptions/taboos, which included that women should not cook when menstruating (19.5% of respondents), and women should stay away from public activities during menstruation (13.6%). Conclusion: A sixth of the women had no access to adequate water, half had bathrooms without locks, over half had no access to sanitary pads, there were misconceptions that can be dispelled using health education and enlightenment on proper menstrual health and hygiene.

Development and application of a novel method to assess exposure levels of sensitizing and irritating substances leaching from menstrual hygiene products

Menstrual hygiene products(MHPs)like tampons,sanitary towels and panty liners are widely used by women and come in close contact with the intimate parts of the human body,which consist of mucosae that lack the important barrier function of normal skin.Hence,substances leaching from MHP can easily penetrate and become systemically available.This study aims to develop a new in chemico methodology that allows to identify and measure realistic consumer exposure levels of several skin sensitizers and irritants leaching from MHPs under simulated use conditions.To assess the leaching of chemicals from MHPs,a menstrual fluid simulant(MFS)simulating pH,osmolarity and protein binding was first established.Subsequently,an analytical methodology was developed for nine well-known skin sensitizers and skin irritants.In short,the MFS samples underwent salting-out assisted liquid-liquid extraction before ultra-high performance liquid chromatography coupled with a triple-quadrupole mass spectrometry analysis.Validation was performed according to the total error approach with acceptability limits of±15%regarding the total analytical error(including systematic and random bias).Fifteen commercially available MHPs were assessed.Six products were found to leach at least one of the following five sensitizing and irritating compounds:a-isomethyl ionone,benzyl salicylate,hexyl cinnamaldehyde,linalool and piperonal.Piperonal was the most abundant compound leaching from the MHPs,with leaching concentration levels measured to 28.22 mg/g.In addition,the leaching level of benzyl salicylate was found to be 11.03 mg/g.The latter fragrance concentration is above 10 mg/g and would trigger mandatory labelling if the Cosmetic Regulation would apply for MHPs.However,none of the identified and quantified skin sensitizers were mentioned on the packaging.In conclusion,this novel methodology makes it possible to estimate realistic human exposure levels to skin sensitizers and irritants through the use of MHPs.Availability of these exposure estimates is vital to carry out a quantitative health risk assessment of these substances.

Knowledge and Practice of Menstrual Health and Hygiene among Young People in Jos, Plateau State, Nigeria

Background: The periodic shedding of the lining of a woman’s uterus is referred to as Menstruation, or a menstrual period. Over a period of three to five days, the uterine lining breaks down into a bloody substance. It then passes down through the cervix and exits through the vagina. Menstrual health knowledge is regarded as having knowledge of what menstruation is and the need for effective management of health during menstruation and proper menstrual hygiene management. This study seeks to assess the knowledge and practice of menstrual health and hygiene and availability of resources for effective menstrual hygiene management among young people in Jos, Plateau State, Nigeria. Methodology: This was a descriptive cross-sectional study carried out among 169 young males and females of Evangelical Church Winning All (ECWA) Theological Seminary, Jos, North, Plateau State, Nigeria. Simple random sampling technique was used in this study and data was collected using an interviewer-administered structured questionnaire. Data analysis was done using the Statistical Package for the Social Science (SPSS) version 20.0. Findings: Majority of 70 (41.4%) respondents fall within the age range of 20 - 24 years old, 64 (37.9%) were within 25 - 29 years. There were more females (96, 56.8%) than males (73, 43.2%). Twenty (11.8%) were married, 149 (88.2%) were single. More than three quarters (78.1%) had good knowledge of Menstrual Hygiene. Of this, 64.4% are males and 88.5% are females. 18.3% of respondents had fair knowledge. Of this, 30.1% are males and 9 (9.4%) are females. 6 (3.6%) of respondent’s had poor knowledge of menstrual hygiene (4 (5.5%) of males and 2 (92.1%)) of females). Two-thirds of the female respondents had good practice of menstrual hygiene, while a third of the respondents had the poor practice of menstrual hygiene. Conclusion: There was good knowledge and practice of menstruation and menstrual hygiene among young people. Knowledge influences practice and the perception of young people to sensitive concepts like menstrual health and hygiene management. Reproductive health programs that reflect this should be taught in schools and communities.

Socio-Demographic, Clinical, and Hygiene Profile of Syndromically Managed Sexually Transmitted Diseases: A Cross Sectional Study in a Tertiary Care Center in India

Background: Sexually transmitted diseases are one of the several major public health concerns, the burden of which is borne by low- and middle-income countries like India. Purpose: The purpose is to evaluate the relationship between menstrual and sanitary hygiene and sexually transmitted diseases (STD) based on syndromic diagnosis Methods: An out-patient department (OPD) based cross sectional survey to determine these associations, if any exist, which would help critically analyze syndromic management. STD was reported by the presence of vaginal/cervical/urethral discharge with or without irritation and itching, lower abdominal pain and ulcer. Results: The prevalence of STD was 66.84% with the most commonly reported symptoms being discharged (31.18%), followed by abdominal pain (17.92%) and itching/irritation (12.90%), with ulcer (4.83%) being the least reported symptom. Perimenopausal age ((AOR: 0.420 [CI: 0.189 - 0.915];p = 0.030), higher grades of education ((AOR: 0.228 [CI: 0.119 - 0.424];p < 0.001) for secondary), urban residency (AOR: 0.435 [CI: 0.686 - 2.733];p < 0.001), and contraception use (AOR: 0.531 [CI: 0.308 - 0.887];p = 0.018) were associated with lesser odds of presenting with an STD symptom. Belonging to a minority religious community (AOR: 7.20 [CI: 1.866 - 48.251];p < 0.012) or backward castes (AOR: 3.753 [CI: 1.587 - 10.144];p < 0.001), having similar illness (AOR: 4.205 [CI: 2.795 - 6.439];p < 0.001) or having an invasive gynecological procedure done in the past one year (AOR: 1.953 [CI: 1.184 - 3.295];p = 0.010) and washing the reusable sanitary material only with water (AOR: 4.900 [CI: 2.701 - 9.116];p < 0.001) as compared to washing it with water and soap, had a higher association with presenting with STD symptoms. Stratified analysis also showed that women presenting discharge (AOR: 2.049 [CI: 1.343 - 3.146] for vaginal and cervical;AOR: 1.426 [CI: 0.826 - 2.482] for urethral) were more likely to not have a toilet facility in an accessible condition. Women with sanitary napkin use had lesser odds (AOR: 0.780 [CI: 0.516 - 1.180];p = 0.293) of presentation for STD in OPD than women who used other material. Conclusion: To better manage the group of diseases that may present with symptoms of STD under syndromic approach, we propose interventions such as menstrual hygiene education and promotion of the use of sanitary napkins among women especially those belonging to lower socio-economic sections of the society.

Exploratory systematic review and meta-analysis on period poverty

BACKGROUNDPeriod poverty is a global health and social issue that needs to be addressed.It has been reported that many females compromise their education,employment,and social commitments during their menstruation days due to a number of reasons,including lack of access to toilets or menstrual products.AIM To provide a comprehensive understanding on period poverty,including outcomes associated with menstruation.METHODS All observational and randomised clinical trials reporting menstruation challenges,menstrual poverty and menstrual products were included.Our search strategy included multiple electronic databases of PubMed,Web of Science,ScienceDirect,ProQuest and EMBASE.Studies published in a peer review journal in English between the 30th of April 1980 and the 30th of April 2022 were included.The Newcastle-Ottawa Scale was used to assess the risk of bias of the systematic included studies.Pooled odds ratios(ORs)together with 95%confidence intervals(CIs)are reported overall and for sub-groups.RESULTS A total of 80 studies were systematically selected,where 38 were included in the meta-analysis.Of the 38 studies,28 focused on children and young girls(i.e.,10-24 years old)and 10 included participants with a wider age range of 15-49 years.The prevalence of using disposable sanitary pads was 45%(95%CI:0.35-0.58).The prevalence of menstrual education pre-menarche was 68%(95%CI:0.56-0.82).The prevalence of good menstrual hygiene management(MHM)was 39%(95%CI:0.25-0.61).Women in rural areas(OR=0.30,95%CI:0.13-0.69)were 0.70 times less likely to have good MHM practices than those living in urban areas.CONCLUSION There was a lack of evidence,especially from low-and middle-income countries.Further research to better understand the scope and prevalence of period poverty should be considered.This will enable the development of improved policies to increase access to menstrual products and medical support where necessary.