Status of Menstrual Health and Hygiene Management among Adolescent Girls in Nepal has been published by world vision. Menstrual taboos are common in many low- and middle-income countries (LMICs) including Nepal. Such taboos can have direct negative impacts on psychosocial/mental health contributing to poor Menstrual Health and Hygiene Management (MHM), which in turn leads to further negative health outcomes among girls and women. Studies have reported a wide range of negative effects from poor MHM, including shame, fear, anxiety, loneliness, and psychological distress. While a number of efforts to address adolescent issues have been initiated, there is a significant lack of data on adolescents in Nepal that are essential for programs to be properly targeted, be based on robust needs assessments, and for them to reach their intended beneficiaries and achieve desired outcomes.
Table of Contents
Brief description of study
A survey on Status of Menstrual Health and Hygiene Management among Adolescent Girls in Nepal was conducted in all seven provinces of Nepal. The survey assessed knowledge, attitude and practice and psychosocial well-being of adolescent girls (10-19 years) in menstrual hygiene management. The study also explored the experiences of differently abled adolescent girls with regard to menstruation. Field work and data collection was conducted in Oct-Dec 2019.
Methods
The sample size for this cross-sectional survey was calculated considering the prevalence of psychosocial problems among adolescents (P) to be 30%, allowable error (L) to be 5% and Z value to be 1.96, design effect of 1.5 and adding 5% nonresponse. This gave a sample size of 340, the sample size per province was 510 and a total sample size across the country was 3570. With a plan to consider 35 participants from each selected primary sampling unit (PSU). 15 schools per province were selected randomly which gave a total of 105 PSUs in each province. Therefore, a total sample size of 525 in each province and 3675 across the country was considered to be taken for this study. Adopted version of MR-SSS (menstrual related stress and self-efficacy) tool was used to assess the knowledge, attitude and practice and psychosocial well-being of adolescent girls. All participants were interviewed after obtaining informed consent. Ethical approval for this study was obtained from Nepal Health Research Council.
Findings
Conclusion
Adolescent girls’ knowledge around menstruation is inadequate as one quarter are unware about menstruation before menarche and one half are unaware of the link between menstruation and pregnancy. This may have direct implications on the level of reproductive health knowledge among adolescent girls and subsequent reproductive health programs.
• Adolescent girls continue to face restrictions during menstruation ranging from restrictions in religious activities, issues of touchability to food consumption. Mothers are the primary source of information and guide for menstrual management as well as major bearers to continue restrictions during menstruation.
• Chaupadi continues to be practiced in three of seven provinces with Sudurpaschim practicing most. Three fourth of adolescent girls know chaupadi is bad but cultural practice is deep rooted.
• Menstruation management among adolescent girls were found to be good: majority had access to disposable sanitary materials, half of the girls were able to change pads thrice or more per day, more than 90% had access to soap for washing and was able to dry menstrual materials, majority had a safe and private place to change. However, home was more comfortable place for menstruation management compared to schools.
• One quarter of girls missed school due to menstruation related issues.
• Menstrual needs of differently abled adolescent girls is largely neglected. Their needs are related to availability of menstrual material and disable friendly WASH beyond home. Their needs are largely fulfilled within household only.
• Majority of girls felt sacred during their first menstruation. Almost half of the girls experienced high menstrual stress, high annoyance and low self-efficacy
Full Report
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