A Descriptive Study to Assess the Washing and Swapping Habits (WASH) during Menstruation among adolescent girls in selected school

 

S. Annalakshmi¹, Nazia Meeran²

¹Principal, NPR College of Nursing and Research Institute, Natham, Tamil Nadu.

²Associate Professor, Government Nursing College, Kavaratti, Lakshadweep.

 

ABSTRACT:

Menstrual hygiene is a subject which is as old as humanity but has gained recent importance due to the readiness of the society to accept its challenges¹. Adolescent girls face a gamut of problems of which the menstrual problems are the most common. Descriptive survey-based study aimed to assess the WASH- Washing and Swapping habits during Menstruation among adolescent girls in the selected schools. 100 adolescents’ girls were recruited by convenience sampling method. Self-devised tool used to collect the data and simple descriptive statistics such as mean and percentage were used to analyse the data. This study revealed that 98% of the girls using only the sanitary pads, 60% of the girls do the perineal wash during their urination only, 82% of the girls do the perineal wash with the water in room temperature, 56% girls use cleansing agents for perineal wash: in which 30% of them were using soap as a cleansing agent, 74% of the girls absent during menstruation, only 40% of them were using the wash room whenever its necessary,  62% of the girls were having regular menstruation, 78% of the girls were discussing about their menstrual problems with their mother, 70% of the girls knew about menstruation only at the time of menarche and 63.26% of the girls using napkins for 3-4 hours per day. Only one student was using cloth wrappers during menstruation and washing and drying it inside her room.

 

 

 

INTRODUCTION:

Menstruation is an important physiological transition from childhood to womanhood. The menstruation is one of the most important challenges of the girls during the adolescent years. The first menstruation (menarche) occurs between 11 and 15 years with a mean age of 13 years⁴. Menstruation and menstrual practices are still clouded by taboos and socio-cultural restrictions resulting in adolescent girls remaining ignorant of the scientific facts and hygienic health practices, which sometimes result into adverse health outcomes⁹. Despite the fact that menstruation is a natural and healthy biological process, it is approached with hesitance and misinformation because of deeply rooted silence and cultural taboos surrounding it⁶.

 

Women and girls miss out education, work and other opportunities in their life when they cannot manage their menstruation with normalcy and dignity.

 

OBJECTIVES:

1.     To assess the washing and swapping habits (WASH) during Menstruation among adolescent girls in the selected schools

 

OPERATIONAL DEFINITION:

1.     Washing and Swapping Habits (WASH):

Washing and cleaning the perineal area during the menstrual period with water, soap or with antiseptic lotion.

 

2.     Swapping:

Refers to the practices of changing the napkins during the menstrual period which include the various aspects such as the frequency, agent used, type of napkin, timing and interval etc.

3.     Habits:

Any action that performed regularly as a part of our routine and settled or regular tendency or practice.

 

4.     Menstruation:

It refers to the periodical and regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina.

 

5.     Adolescent Girls:

The school going girls in the age group of 10 to 18 years those who are in 6^th grade to 12^th grade.

 

METHODOLOGY:

Research Approach: 

Quantitative approach used for this study

 

Study Design: 

Descriptive Survey method used for this study

 

Population:

All the adolescent girls in the age group of 10-18 years were the population.

 

Sample:

The adolescent girls in the age group of 10-18 years, studying in the selected school and fulfilled the inclusive criteria were selected as the study samples.

 

Criteria for sample selection:

Inclusion criteria:

·       Students those who were willing to participate in the study

·       Only the Female students were selected as the sample

·       Students those who are studying 9^th standard to 11^th standard were included in this study.

 

Exclusion Criteria:

Students those who were not available at the time of data collection.

 

Sample Size: 

100 students were selected as the study samples to participate in the study

 

Sampling Technique:

Convenience sampling technique was used in the study

 

Data collection tool:

Self devised structured questionnaire was used to collect the data. It has two parts

Part I: Consisted of selected demographical variables such as age, educational status, Religion, Age of Menarche, Educational Status of the Mother, Mothers Occupation, Monthly income of the family, Fathers occupation, Type of family and Dysmenorrhoea

 

Part II:  Consisted of the items to assess the washing and swapping habits (WASH) during Menstruation among adolescent girls in the selected schools

 

Data Analysis:

Descriptive statistics such as mean and percentage used to analyse the data.

 

Ethical Consideration:

Formal Permission obtained from the institutional authorities

Informed Consent obtained from participants

Confidentiality, Anonymity and Privacy ensured

Data only used for research purpose.

 

RESULTS AND DISCUSSION:

PART A

Table I: Description of Demographic variables

 

PART B:  Washing and Swapping Habits

1. Perineal wash/ Day:

 

2. Napkin Used:

 

Majority of the girls 60% do the perineal wash whenever urinating, 36% of the girls do the perineal wash whenever they feel wet, 2% of the girls wash two and three times per day.

 

Majority 98% of the students use sanitary napkins and only 2% were using the cloth during the menstruation

 

3. Water Used for Perineal Wash:

 

4. Using Cleansing Agent

 

Majority of the girls 82% were using room temperature water for perineal wash, 18% of them were using either cold or hot water for perineal wash and none of them were using either hot water or cold water exclusively.56% of the girls were using cleaning agent during perineal wash, 44% of them were not using any sort of cleansing agent for perineal wash.

 

5. Cleansing Agent:

 

6. Absenteeism during Menstruation:

 

Majority of the girls 30% were using soap as a cleansing agent 10%of them were using antiseptic lotion for cleaning, 2% of them were using soap liquid and body wash respectively. 74% of them were absent during menstruation, 26% were present at school during menstruation.

7. Using Wash room in the School:

 

8. Carrying Sanitary Napkins

 

The majority of 46% of the girls were never using rest room at school during menstruation, 40% of the girls were using the rest room whenever needed, and 10% of the girls were using the restroom during their break time and only 4% were using the rest room frequently.78% of the girls were not carrying the sanitary napkin every day, 14% of girls were having the napkins with them during their menstruation, only 8% of them were carrying the sanitary napkins every day.

 

9. Rugularity of Menstruation:

 

10. Discussion about Menstruation

 

The majority of the girls 62% were having regular menstrual cycle, 38% of the girls were having irregular menstrual period. Majority of the girls 78% of them were discussing with their mother about Menstruation, 22% of them were discussing with their friends on Menstruation. None of them were discussing with their teacher or neighbours about menstruation.

 

11. Previous Knowledge on Menstruation

 

12. Napkin change Per Day:

 

The majority 70% of the girls knew about menstruation only at the time of their Menarche. 30% of them were known before to their Menarche. The majority 46.9% of them were changing more than 3 sanitary napkins per day, 24.48% were changing 2 and 3 napkins per day, 4% of the girls were changing only 1 napkin per day.

 

13. Place of Disposal:

 

14.Process of Disposal:

 

Majority of the girls 81.63% were disposing their napkins only at their home, 24.48% were disposing the napkins at school, 12.24% were disposing the napkins either in school or their home, and 2.04% of them were disposing the napkins in the street bins. The majority of them 87.75% were wrapped the napkins with the paper, 10.23% of them were wrapping the napkins with plastic cover, 2.04% of them were discarding the napkins without any wrapping, none of them were wrapped the napkins with the clothes.

 

15. Method of Disposal

 

16. Duration of keeping napkins per day

 

The majority of the girls 90% of them were disposing the napkins by burning, 6% of them were disposing by dumping, 4% of them were disposing by burying and none of them were throwing in the sea. The majority 63.26% were using the sanitary napkins for 3-4 hours, 26.53% were using the napkins for 5-6 hours, 6.12% were using the napkins for 1-2 hours, and only 4.08% were using the napkins more than 6 hours

 

17. Changing of clothes per day:

 

Only one student was using cloth pad during the menstruation. She was used 3 cloth wrappers per day (2%). She was cleaning the wrappers by washing with antiseptic solution, drying the cloth pad inside her room only. Student was discarding the cloth by burying. She was using the cloth more than 6 hours.

 

CONCLUSION:

Menstrual practices are very important during the adolescent period which determines the successful motherhood in the future. School going adolescent girls are having more physical, physiological, personal and academic challenges comparing with other age group when they need to shape their reproductive health practices.  As per the UNICEF, access to safe and dignified menstruation is a fundamental need for women and girls. It recommends that every girl can learn, play, and safeguard her own health without experiencing stress, shame, or unnecessary barriers to information or supplies during menstruation. Meeting the hygiene needs of all adolescent girls and women in all settings is enables human rights, dignity, and public health¹⁰.

 

IMPLICATIONS OF THE STUDY:

Nursing Practice:

Since menstrual hygiene is a fundamental right of every adolescent girls the nurse practitioner should ensure that quality menstrual care and guidance received by all the adolescent girls during their tenure of practice.

 

Nursing Education:

Incorporate the education on safety practices during menstrual periods along with other educational propagations. Alleviate myths, misconceptions and false beliefs on menstrual habits by organizing educational campaigns.

 

Nursing Research:

Even though it’s well-known and familiar topic, still there are practical constraints and wrong ideas on menstrual practices. So there is a tremendous need to do lot of researches to establish evidence based practice and decision making to overcome the constraints.

 

Nursing Administration:

Nursing administrators should collaborate with the school authorities to ensure that the provision of sanitary napkins, clean water and the cleanliness of the bathrooms in the school environment. Helps to create the friendly ambience to the school girls to discuss the problems related to menstrual care.

 

LIMITATION OF THE STUDY:

·       No experimentation was done.

·       Only descriptive statistics was used: No hypothesis testing

·       Limited period of Data collection

·       No comparison group

 

REFERENCES:

1.      Rajasri G. Yaliwal et al. Menstrual Morbidities, Menstrual Hygiene, Cultural Practices during Menstruation, and WASH Practices at Schools in Adolescent Girls of North Karnataka, India: A Cross-Sectional Prospective Study., Obstetrics and Gynecology International, vol. 2020, Article ID 6238193, Pg 1-8.

2.      Mohammed S, Larsen-Reindorf RE. Menstrual knowledge, sociocultural restrictions, and barriers to menstrual hygiene management in Ghana: Evidence from a multi methodm survey among adolescent schoolgirls and schoolboys. PLOS ONE. 2020. 15(10): Pg 1-19

3.      Rajanbir Kaur et al. Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries.  Journal of Environmental and Public Health. 2018. Pg 1-9

4.      Deshpande TN et al. Menstrual hygiene among adolescent girls - A study from urban slum area. J Family Med Prim Care. 2018 Nov-Dec; 7(6):1439-1445

5.      Rama Ravi et al, Prevalence of Menstrual Problems among Adolescent School Girls in Rural Tamil Nadu. Journal of Paediatrics and Adolescent Gynaecology.  Dec2016; 29(6):571-576.

6.      A Dasgupta and M Sarkar. Menstrual Hygiene: How Hygienic is the Adolescent Girl? Indian Journal of Community Medicine. April 2008; 33(2): 77–80

7.      https://shramikbharti.org.in/improving-water-sanitation-hygiene-of-communities/

8.      https://www.hindawi.com/journals/ogi/2020/6238193/?utm_source=google&utm_medium=cpc&utm_campaign=HDW_MRKT_GBL_SUB_ADWO_PAI_DYNA_JOUR_X&gclid=CjwKCAiAm7OMBhAQEiwArvGi3CMV49ld2y3_tivoLQEWq-uXdWNqnEF2qccO8xrXpJ_N6Kh_9XRrFBoCVPAQAvD_BwE

9.      https://doi.org/10.1155/2018/1730964

10.   https://www.unicef.org/documents/guide-menstrual-hygiene-materials

 

Received on 07.04.2022         Modified on 03.05.2022

Accepted on 20.05.2022       ©A&V Publications All right reserved