Knowledge and practices related to menstruation and their relation to school absenteeism among adolescent girls attending tertiary care hospital in Ghaziabad: A cross sectional study

Manisha Gupta, Neelima Agarwal, Alpana Agrawal


Introduction: Onset of menarche is a special period when adolescent girl undergoes various social emotional and physiological changes. They often lack knowledge regarding reproductive health which can be due to socio-cultural barriers in which they grow up. Though menstruation is a natural process, it is associated with misconceptions and challenges among girls in developing countries. This has led to decrease in school attendance and increasing numbers of school dropouts. With focus on the school girls, this study examined knowledge about menstruation, determinants of menstrual management and its influence on school-attendance in Ghaziabad.

Aims and Objectives: To assess the knowledge and the practices of menstrual hygiene among adolescent girls attending Gynecology OPD of a tertiary care hospital. To find out the proportion of school absenteeism in the study group and factors related to it.

Materials and Methods: It was an observational study conducted over a period of 3 months from January 2019 to March 2019. All adolescent school going girls who presented in the Gynaecology OPD in Santosh Medical College & Hospital, Ghaziabad, were recruited in the study. They were interviewed after their informed consent using a pretested structured questionnaire which focused on socio-demographic factors, parental factors, knowledge, social restrictions and hygienic management regarding menstruation, problems associated with menstrual health practices and school attendance.

Statistical Analysis: Frequencies were calculated for different variables. Data was analyzed and p value of <0.05 was taken significant.

Results: The mean age at menarche was 13.67 (±1.17) years. About two thirds, that is 122 (61%) of girls had knowledge about menstruation and its management. Only 64 (32%) of the girls used sanitary napkins as absorbent during menstruation. About 128 (64%) girls were reported to have been absent from school during their menstruation period. Those who did not use sanitary napkins, where there were lack of facilities and restrictions on playing were more likely to be absent from school(p<0.0001). In addition, study indicated that school absenteeism was common among girls who experienced teasing and humiliation by classmates when their clothes were stained with blood.

Conclusion: Lack of basic needs like availability of sanitary napkins and their disposal, separate functional wash rooms and running water supply are the most important factors causing drop in girls’ school-attendance.


Keywords: Menstrual hygiene, Menstrual knowledge, Menarche, Sanitary napkins, Adolescent school girls, School absenteeism, School dropout.

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