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Cited by 187Menstrual Health and DisordersAdolescent Sexual and Reproductive HealthHypothalamic control of reproductive hormones

The effect of a school-based educational intervention on menstrual health: an intervention study among adolescent girls in Bangladesh

Open access
Haque, Syed Emdadul, Rahman, Mosiur, Itsuko, Kawashima, Mutahara, Mahmuda, Sakisaka, Kayako·2014·BMJ Open
DOI 10.1136/bmjopen-2013-004607PMC PMC4091465
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Abstract

OBJECTIVES: To assess the impact of a school-based menstrual education programme on: (1) menstrual knowledge, beliefs and practices, (2) menstrual disorders experienced, and (3) restrictions on menstruating adolescents. DESIGN: Intervention study. SETTING: Araihazar area, Bangladesh. PARTICIPANTS: 416 adolescent female students aged 11-16 years, in grade 6-8, and living with their parents. INTERVENTIONS: A school-based health education study conducted from April 2012 to April 2013. PRIMARY AND SECONDARY OUTCOME MEASURES: We randomly selected 3 of 26 high schools in the study area. We delivered 6 months of educational intervention by trained (by an obstetrician and gynaecologist) research assistants (RAs) on menstrual hygiene among school girls. RAs read the questionnaire and participants answered. The changes in knowledge, beliefs and practices regarding menstruation, menstrual disorders experienced, and the restrictions and behaviours practiced by menstruating adolescents were compared between the baseline and the follow-up assessments. RESULTS: After health education, participants reported a significant improvement (p<0.001) in 'high knowledge and beliefs' scores compared to baseline (51% vs 82.4%). Significant improvement was also observed in overall good menstrual practices (28.8% vs 88.9%), including improvements in using sanitary pads (22.4% change after the intervention), frequency of changing pads/cloths per day (68.8%), drying the used absorbent (77.6%), methods of disposing of the used absorbent (25.5%), and cleaning of genitalia (19.2%). During the follow-up, the participants reported significant improvements in the regularity of their menstrual cycle (94.5% vs 99.5%) and fewer complications during menstruation (78.6% vs 59.6%). CONCLUSIONS: The programme produced significant changes in the knowledge, beliefs and practices of menstrual hygiene, complications from lack of hygiene, and the behaviour and restrictions of the menstruating adolescents. These results demonstrate the feasibility of implementing a health education programme for adolescents on menstrual hygiene in secondary schools serving rural Bangladesh.

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  • Multiple intervention trials that have improved facilities for menstrual hygiene have measurably improved girls' attendance.

    “Multiple intervention trials that have improved facilities for menstrual hygiene have measurably improved girls’ attendance.27 31–37”

    From Menstrual hygiene management among Bangladeshi adolescent schoolgirls and risk factors affecting school absence: results from a cross-sectional survey (2017) · cites this paper as [35]

    The Results report a significant improvement in girls’ school attendance during menstruation at follow-up. But this paper describes one health-education intervention, not an intervention that improved menstrual-hygiene facilities; it cannot itself substantiate the claim about multiple facilities-focused trials. Page numbers were not provided in our copy. (LLM, conf=0.88)

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  • In Bangladesh, a 6-month educational intervention among 416 girl students aged 11-16 years from three schools demonstrated a 31% increase in students' knowledge about menstruation and a 5.1% decrease in self-reported school absence among participants from baseline.

    “In Bangladesh, a 6-month educational intervention among 416 girl students aged 11–16 years from three schools demonstrated a 31% increase in students’ knowledge about menstruation and a 5.1% decrease in self-reported school absence among participants from baseline.35”

    From Menstrual hygiene management among Bangladeshi adolescent schoolgirls and risk factors affecting school absence: results from a cross-sectional survey (2017) · cites this paper as [35]

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Research works printed but not linked: 29

  1. [2]McPherson ME Korfine L Menstruation across time: menarche, menstrual attitudes, experiences and behaviors. Womens Health Issues 2004; 14: 193– 200 15589769
  2. [5]Dasgupta A Sarkar M Menstrual hygiene: how hygienic is the adolescent girl? Indian J Comm Med 2008; 33: 77– 80 PMC2784630 19967028
  3. [6]Lawan UM, Yusuf NW, Musa AB. Menstruation and Menstrual Hygiene amongst Adolescent school Girls in Kano, Northwestern Nigeria. Afr J Reprod Health 2010;14:201–7. 21495614
  4. [7]Ayalew T Meseret Y Yeshigeta G Reproductive health knowledge and attitude among adolescents: a community based study in Jimma Town, Southwest Ethiopia. Ethiop J Health Dev 2008; 22: 243– 51
  5. [8]Suneela G Nandini S Ragini S Socio-cultural aspects of menstruation in an urban slum in Delhi, India. Reprod Health Matters 2001; 9: 16– 25 11468832
  6. [9]Olayinka OO Akinyinka OO Unmet need for sexuality education among adolescent girls in Southwest Nigeria: a qualitative analysis. Afr J Reprod Health 2004; 8: 27– 37 17348323
  7. [10]Ahuja A Tiwari S Awareness about pubertal changes among adolescent girls. J Fam Welfare 1995; 41: 46– 50
  8. [11]Chaudhari RH Socio-economic demographic and reproductive health profile of adolescents in the SAARC countries. Paper presented at the South Asia Conference on Adolescents; 21–23 July 1998; New Delhi, India
  9. [12]Khanna A Goyal RS Bhawsar R Menstrual practices and reproductive problems: a study of adolescent girls in Rajasthan. J Health Manag 2005; 7: 91– 7
  10. [13]Mudey AB Keshwani N Mudey GA A cross-sectional study on the awareness regarding safe and hygienic practices amongst school going adolescent girls in the rural areas of Wardha district. Global J Health Sci 2010; 2: 225– 31
  11. [14]Bhatia JC Cleland J Self-reported symptoms of gynecological morbidity and their treatment in south India. Stud Fam Plann 1995; 26: 491– 5 7482678
  12. [16]Ghattargi CH Deo DS Preparation and practices regarding menstruation: a comparative study in rural and urban adolescent girls. Indian J Comm Med 2005; 30: 10– 14
  13. [17]Singh AJ The place of menstruation in the reproductive lives of women of rural north India. Indian J Comm Med 2006; 31: 10– 14
  14. [20]Drakshayani Devi K Venkata Ramaiah P A study on menstrual hygiene among rural adolescent girls. Indian J Med Sci 1994; 48: 139– 43 7927585
  15. [21]Narayan KA Srinivasa DK Pelto PJ Puberty rituals, reproductive knowledge and health of adolescent school girls in South India. AP Pop Jour 2001; 16: 225– 38
  16. [25]Lawan UM Yusuf NW Musa AB Menstruation and menstrual hygiene amongst adolescent school girls in Kano, Northwestern Nigeria. Afr J Reprod Health 2010; 14: 201– 7 21495614
  17. [26]Anju A Patil R Menstrual hygiene and practices of rural adolescent girls of Raichur. Int J Biol Med Res 2013; 4: 3014– 17
  18. [27]El-Gilany AH Badawi K El-Fedawy S Menstrual hygiene among adolescent school girls in Mansoura, Egypt. Reprod Health Matters 2005; 13: 147– 52 16291496
  19. [28]Liu H Yang F Li Z Passive smoking, Cyp1A1 gene polymorphism and dysmenorrhea. Reprod Toxicol 2007; 24: 114– 19 17566695 PMC3763751
  20. [29]Kovacs M The Children's Depression Inventory. Psychopharmacol Bull 1985; 21: 995– 8 4089116
  21. [32]Cohen S Karmarck T Mermelstein R A global measure of perceived stress. J Health Soc Behav 1983; 24: 385– 96 6668417
  22. [33]Chakraborti A Ray P Sanyal D Assessing perceived stress in medical personnel: in search of an appropriate scale for the Bengali population. Indian J Psychol Med 2013; 35: 29 23833339 PMC3701356
  23. [34]Ayafi SA Factors associated with health behavior regarding menstruation among Saudi intermediate school girls in Riyadh city [ Master thesis]. Nursing College, King Saud University, 1999
  24. [35]Hassanen H Tosson M El-Elkareem EA Effect of health education and training program for secondary school students on menstruation at Assiut Governorate. Bull High Inst Public Health 2004; 34: 575– 94
  25. [37]Afzali M Allameh R Study of educational needs of 12–14 years old girls about adolescent health and determines appropriate and effective strategies for adolescent health education. Koomesh 2000; 1: 39– 47
  26. [38]Eswi A Helal H Elarousy W Menstrual attitude and knowledge among Egyptian female adolescents. J Am Sci 2012; 8: 555– 65
  27. [39]Lee K Chen Y Lee K Menstruation among adolescent girls in Malaysia: a cross-sectional school survey. Singapore Med J 2006; 47: 869– 74 16990962
  28. [40]Warren MP Rebecca JL What is the effect of exercise on primary dysmenorrheal? Products and prostaglandins as a root of menstruation. Br J Sports Med 1999; 33: 227 10450473
  29. [43]Markovic N Markovic O What every woman should know about cervical cancer. Springer, 2008

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Authors
Haque, S. E., Rahman, M., Itsuko, K., Mutahara, M., & Sakisaka, K.
Affiliations
  • University of Chicago (US)
  • Tokyo Medical and Dental University (JP)
  • Honjo International Scholarship Foundation (JP)
  • Wageningen University & Research (NL)
  • Chuo University (JP)
Corresponding author
Haque, Syed Emdadul
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2014-07
Volume
4
Issue
7
Pages
e004607
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2013-004607
PMC
PMC4091465
OpenAlex
W2143597186
Cited by
187
References
4
Citations by year
2026: 13 · 2025: 18 · 2024: 14 · 2023: 17 · 2022: 27 · 2021: 32 · 2020: 26 · 2019: 14 · 2018: 9 · 2017: 7 · 2016: 4 · 2015: 5 · 2014: 1
FWCI
5.64
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Socio-Environmental Systems Modeling (acceptedVersion)
  • UNU Collections (United Nations University) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
Honjo International Scholarship Foundation
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
  • Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
menstrual health, menstrual hygiene, school-based health education, adolescent girls, menstrual disorders, sanitary pad use, menstrual cycle regularity, rural middle school students, Bangladesh
MeSH terms
Adolescent, Bangladesh, Child, Female, Health Education, Humans, Hygiene, Menstruation, Surveys and Questionnaires, Rural Population, School Health Services, Schools, Students

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