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School Sanitation Facilities and Absenteeism from School During Menstruation in Adolescent Girl in Rural Area of Hapur

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School Sanitation Facilities and Absenteeism from School During Menstruation in Adolescent Girl in Rural Area of Hapur ORIGINAL RESEARCH ARTICLE pISSN 0976 3325│eISSN 2229 6816 Open Access Article www.njcmindia.org DOI: 10.5455/njcm.20200204084244 School Sanitation Facilities and Absenteeism from School during Menstruation in Adolescent Girl in Rural Area of Hapur Pankaj Kumar1 Financial Support: None declared ABSTRACT Conflict of Interest: None declared Copy Right: The Journal retains the Introduction: The menstrual related problems are one of the most copyrights of this article. However, re- common problems among adolescent girls and might have an ad- production is permissible with due ac- verse effect on their performance in academic and other activities knowledgement of the source. of daily life which may lead to school absenteeism during men- How to cite this article: strual days. School absenteeism due to menstrual problems has Kumar P. School Sanitation Facilities been reported previously among adolescent. and Absenteeism from School during Methodology: This is a cross sectional study was conducted in ru- Menstruation in Adolescent Girl in Ru- ral field practice area of RHTC (Rural Heath Training Centre) un- ral Area of Hapur. Natl J Community Med 2020;11(4):182-185 der Department of Community Medicine of a tertiary care teach- ing hospital in Pilkhuwa, Hapur, Uttar Pradesh. The study popula- Author’s Affiliation: tion included all adolescent girls in age group of 10-19 year study- 1Associate Professor, Dept. of Commu- ing in senior secondary school, Pilkhuwa. A verbal consent of the nity Medicine, ,G.S.Medical College, adolescent girls was taken before administering the questionnaires Pilkhuwa, Hapur. and assured of confidentiality. Correspondence Result: In present study as many as 229 (41.86 %) out of 547 girls Dr. Pankaj Kumar who attained menarche used to remain absent from school during [email protected] menstruation. 191 (83.4 %) of girls normally absent for just one day. However, a considerable proportion 20 (8.72%) of girls absent Date of Submission: 04-02-2020 for 2 days while 18(7.86 %) remain absent for three days. Date of Acceptance: 21-04-2020 Date of Publication: 30-04-2020 Conclusion: There is a need to improve the conditions with re- spect to basic facilities at school to cut down the absenteeism. Key Words: School sanitation, Absenteeism, menstruation, adoles- cent girl. INTRODUCTION to manage menstrual bleeding effectively. It is possible if they have access to appropriate water, World Health Organization defined a person aged sanitation and hygiene services, having some- 10–19 years is considered as an adolescent . 1 This where private to change clothes or disposable sani- adolescent period is preparation of safe mother- tary pads, facilities to dispose of used cloths and hood, physically as well as monthly also. 2 pads, and access to information to understand the About 85% of total 1.2 billion. adolescent popula- menstrual cycle and how to manage menstruation tion lives in developing countries. These adoles- hygienically. 5 Menstruation play an important role cent girls don’t have sufficient information, skills, in limiting school attendance. 6 and readiness to overcome this stressful situation Menstruation not only affects girl's attendance but makes them vulnerable. Puberty. begin early or also attention, and achievement in school in both young adolescence ages, 10 -14 years in most girls.3 rural and urban areas. The absence of clean and Puberty is the age of beginning of Menstruations private sanitation facilities that allow for menstrual called menarche and it is a part of reproductive hygiene may promote girls for absent from school cycle of female4 during their menstruation phase. In addition, a girl To live healthy, productive and dignified lives for feels embarrassment during these period due to women and girls, it is important that they are able lack of knowledge about Menstrual hygiene man- National Journal of Community Medicine│Volume 11│Issue 4│April 2020 Page 182 Open Access Journal │www.njcmindia.org pISSN 0976 3325│eISSN 2229 6816 agement (MHM), she may be forced to stay at Table-1: Menstrual problem and absenteeism home while menstruation. 7Adolescent girls expe- from school (n=547) rience different feelings including fear, shame and Menstrual Problem (%) Absenteeism Present in guilt because of lack of information about men- in school (%) school (%) strual management.8 Yes [246] (44.97) 181 (79.04) 65 (20.44) United Nations Children’s Fund (UNICEF) has No [301] (55.07) 48 (20.96) 253 (79.56) Total [547] (100) 229 (100) 318 (100) stated that school-age girl were absent at puberty P value 0.00001(df=1) Chi squire=152.584 due to lack of cleanliness and separate toilet facili- ties for female students at schools 9 Table -2: Absenteeism in and management of Dysmenorrhea also associated with school absen- menstruation (n=547) teeism and decreased academic performance, sports participation, and socialization with peers 10 Substance used Absenteeism Present in in school (%) school (%) The present study aims to assess the menstrual hy- Pad (266) 149 (42.45) 117 (60.62) giene knowledge, attitude, practice and absentee- Cloths (281) 202 (57.55) 76 (39.38) ism from school during menstruation among girl Total [547] (100) 351 (100) 193 (100) students from Hapur school. P value 0.00004979 (df=1) Chi squire=16.456 Table -3: *Reasons for missing school (n=351) METHODOLOGY Reasons for missing school Girls (%) Feel uncomfortable at school during men- 84(23.93) After ethical clearance from college ethical commit- struation tee, this cross sectional study was conducted in ru- Forbidden by guardian 67(19.08) ral field practice area of RHTC (Rural Heath Train- Remain sick 61(17.38) ing Centre) under Department of Community Heavy bleeding 55(15.67) Medicine of a tertiary care teaching hospital in No place to change rag/cloths 38(10.83) Pilkhuwa, Hapur, Uttar Pradesh. There are eight Feel uncomfortable sitting beside boys dur- 34(9.69) villages under RHTC. Out of them one village viz. ing menstruation Pilkhuwa was randomly selected. (by using ran- Unsanitary toilet 9(2.56) dom sampling method). Pilkhuwa is one of the vil- Water supply away from bath room 3(0.85) *Multiple answers lages in Hapur District in Uttar Pradesh. Pilkhuwa is 18 km far from its District main city Hapur. The study population included all adolescent girls in In present study as many as 229 (41.86 %) out of age group of 10-19 year studying in senior second- 547 girls who attained menarche used to remain ary school, Pilkhuwa. A verbal consent of the ado- absent from school during menstruation .The mean lescent girls was taken before administering the number of absent days was 1-0.8. It is noticed that questionnaires and assured of confidentiality. majority 191 (83.4 %) of girls normally absent for School records were used for getting accurate age just one day. However, a considerable proportion information. Pre-designed, pre-tested question- 20 (8.72%) of girls absent for 2 days while 18(7.86 naires (in Hindi language) were distributed. The %) remain absent for three days. data collected was compiled in Ms Excel. Statistical The prevalence of menstrual disorders among ado- significance of any association was tested using the lescent girls who had attained menarche (547) was Chi-square test. 246 (44.97%). It was revealed that out of 547, 64.05% girl who attained the menarche, 246 (44.97%) girls had one or more menstrual disord- RESULTS ers. Nearly 2 out of 3 girls suffered from the com- A cross sectional study was undertaken in the inter monly prevalent menstrual disorders like dysme- college located at Pilkhuwa village in the in Dis- norrhoea (58.1%) together with many other major trict Hapur under Rural Health Training Centre menstrual disorders. Table 1 shows that high pre- (RHTC) . Total 854 girls studying in class 6th to valence 181(79.04 %) of school absence among ru- 12th (11-19 age groups) in the school were selected ral school going girls who are suffering from men- for the study. 411 (48.13%) of girls belong to early strual disorders. The chi-square test for statistical adolescent (10-14years) phase and while majority association also supports the significant (p=.000) of girls 443 (51.87%) belong to late adolescent association of school-absence and menstrual- phase (15-19 years). It was revealed that out of 854; disorder. Like Chi-square test, the odd ratio =14.68. most of the girls 547 (64.05%) had attained the me- The most common reason reported by 84 (25.08%) narche. girls are Feel uncomfortable at school during men- struation and 67 (19.08%), and 61(17.38%) respon- National Journal of Community Medicine│Volume 11│Issue 4│April 2020 Page 183 Open Access Journal │www.njcmindia.org pISSN 0976 3325│eISSN 2229 6816 dent mentioned Forbidden by guardian, and Re- was reported by Grant et al. 17 who stated that the main sick during menstruation respectively. It level of perceived privacy in school toilets is signif- appears that social factors responsible for absentee- icantly associated with the odds that a female stu- ism in the school. dent missed at least one day of school during her last menstrual period. DISCUSSION CONCLUSIONS In the present study the, age at menarche of ado- lescent schoolgirls ranged between 10 and 15 years Since mothers are the rule makers at home for all with a mean of 13 years. Kumar et al. (13 practices during menstruation, they should be years).11also mentioned the mean age of menarche counseled to remove their inhibitions about dis- students were 12.7+1 which is consistent with cussing issues related to menstruation and ill ef- another study by Patavegar et al. 12. They observed fects of adhering to bizarre taboos with their that the mean age of menstruation phase in study daughters well before the age of menarche.
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