Tag Archives: menstrual hygiene

Assessment of Beliefs and Practices Relating to Menstrual Hygiene of Adolescent Girls in Lebanon

Assessment of Beliefs and Practices Relating to Menstrual Hygiene of Adolescent Girls in Lebanon. International Journal of Health Sciences and Research (IJHSR), 2013; 3(12): 75-88.

Authors: Tania Santina, Nancy Wehbe, Fouad M. Ziade, Mona Nehme.

Introduction: Poor menstrual hygiene prevents achieving the several Millennium Development Goals. The aim of this study was to assess menstrual hygiene practices based on sociocultural beliefs of adolescent girls in Lebanon.

Methods: A community-based cross-sectional survey was conducted, in 2010, among 389 post-menarcheal adolescent girls aged 13 to 19 years, at five high schools in Sidon city and suburbs, using a cluster randomized sampling and self-completed questionnaires. Collected data was analyzed by using descriptive and inferential statistics.

Results: Of 389 participants, 89.5% did not follow all menstrual hygiene practices recommended, they adopted menstrual practices based on the dominant sociocultural beliefs found in the Lebanese society about these matters: 66.9% and 16.5%, respectively, did not shower in the first three days of menstruation or during all days of menstruation, and activity restrictions included physical (70.3%) and social (18.2%) activity and diet (35.5%).

A significant association was found between describe menstrual hygiene practices based on sociocultural beliefs and type of school, religion, both parents’ education levels, as well as family monthly income. Logistic regression analyses indicated that significant variables predicting describe menstrual hygiene practices based on sociocultural beliefs were mother level education (OR = 2.8; P < 0.001), and religion (OR = 0.7; P = 0.002).

Conclusion: Findings indicate the need for health school education programs during puberty; they also can help design appropriate intervention strategies.

May #MENSTRAVAGANZA – WASH United’s menstrual hygiene campaign

“If women can have moustaches we can all talk about menstruation”. With this message WASH United kicked off May MENSTRAVAGANZA, a 28-day campaign to raise awareness and break the silence around menstruation and menstrual hygiene.

Messages are posted on the campaign website:
wash-united-may-menstravaganza.tumblr.com and
on Twitter using hashtag #MENSTRAVAGANZA

Review of the Health and Social Effects of Menstrual Hygiene Management

A Systematic Review of the Health and Social Effects of Menstrual Hygiene Management. PLoS ONE 8(4) 2013.

Sumpter C, Torondel B

Background – Differing approaches to menstrual hygiene management (MHM) have been associated with a wide range of health and psycho-social outcomes in lower income settings. This paper systematically collates, summarizes and critically appraises the available evidence. plos

Methods – Following the PRISMA guidelines a structured search strategy was used to identify articles investigating the effects of MHM on health and psycho-social outcomes. The search was conducted in May 2012 and had no date limit. Data was extracted and quality of methodology was independently assessed by two researchers. Where no measure of effect was provided, but sufficient data were available to calculate one, this was undertaken. Meta-analysis was conducted where sufficient data were available.

Results – 14 articles were identified which looked at health outcomes, primarily reproductive tract infections (RTI). 11 articles were identified investigating associations between MHM, social restrictions and school attendance. MHM was found to be associated with RTI in 7 papers. Methodologies however varied greatly and overall quality was low. Meta-analysis of a subset of studies found no association between confirmed bacterial vaginosis and MHM (OR: 1.07, 95% CI: 0.52–2.24). No other substantial associations with health outcomes were found. Although there was good evidence that educational interventions can improve MHM practices and reduce social restrictions there was no quantitative evidence that improvements in management methods reduce school absenteeism.

Conclusion – The management of menstruation presents significant challenges for women in lower income settings; the effect of poor MHM however remains unclear. It is plausible that MHM can affect the reproductive tract but the specific infections, the strength of effect, and the route of transmission, remain unclear. There is a gap in the evidence for high quality randomised intervention studies which combine hardware and software interventions, in particular for better understanding the nuanced effect improving MHM may have on girls’ attendance at school

Global Review of Sanitation System Trends and Interactions with Menstrual Management Practices

Global Review of Sanitation System Trends and Interactions with Menstrual Management Practices, 2012.

Kjellén, M., C. Pensulo, P. Nordqvist and M. Fogde. Stockholm Environment Institute.

This review of sanitation system trends and interactions with menstrual management practices has been conducted as part of the broader project on Menstrual Management and Sanitation Systems. sei

It starts with a review of trends in the development of urban sanitation systems and then explores the interaction between menstrual management and sanitation systems, mainly relating to the issue of disposal of used menstrual blood absorption materials. Finally, it proposes a framework of interactions by positioning a range of issues of particular relevance for menstrual management into the different parts of the sanitation system.

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The Gendered Nature of Schooling in Ghana: Hurdles to Girls’ Menstrual Management in School

JENdA: Journal of Culture and African Women Studies, (20) 2012

The Gendered Nature of Schooling in Ghana: Hurdles to Girls’ Menstrual Management in School

Marni Sommer, Nana Mokoah Ackatia-Armah

Read the full article (subscription required) at: www.africaknowledgeproject.org/index.php/jenda/article/view/1578

View the table of the contents of the whole issue at:

This article explores girls’ voiced experiences of menstruation and schooling in rural and urban Ghana. The study was conducted in the Greater Accra Region (rural and urban) and the Tamale-Tolon-Kumbungu Districts of Northern Ghana. These regions are predominantly populated by the Ga-Dangme, and the Dagbani. The major aim of the study was to better understand the intersection of menarche, menstrual management and schooling for pubescent girls in Ghana, in order to adapt a Tanzania’s girl’s puberty book to the Ghana context.

The methodology included a comparative case study using participatory research with adolescent girls in and out of school. The research highlighted the significant gap in girls’ understandings around menstrual onset and overall pubertal body changes, along with aspects of the school physical and social environment that create barriers to girls’ successful attendance and participation during monthly menses. The findings highlight the importance of girl-focused approaches to developing guidance for healthy transitions through puberty.

Sanitary Pad Interventions for Girls’ Education in Ghana: A Pilot Study

PLoS ONE, Oct 2012.

Sanitary Pad Interventions for Girls’ Education in Ghana: A Pilot Study

Paul Montgomery, et al.

Background – Increased education of girls in developing contexts is associated with a number of important positive health, social, and economic outcomes for a community. The event of menarche tends to coincide with girls’ transitions from primary to secondary education and may constitute a barrier for continued school attendance and performance. Following the MRC Framework for Complex Interventions, a pilot controlled study was conducted in Ghana to assess the role of sanitary pads in girls’ education.

Methods – A sample of 120 schoolgirls between the ages of 12 and 18 from four villages in Ghana participated in a non-randomized trial of sanitary pad provision with education. The trial had three levels of treatment: provision of pads with puberty education; puberty education alone; or control (no pads or education). The primary outcome was school attendance.

Results – After 3 months, providing pads with education significantly improved attendance among participants, (lambda 0.824, F = 3.760, p<.001). After 5 months, puberty education alone improved attendance to a similar level (M = 91.26, SD = 7.82) as sites where pads were provided with puberty education (Rural M = 89.74, SD = 9.34; Periurban M = 90.54, SD = 17.37), all of which were higher than control (M = 84.48, SD = 12.39). The total improvement through pads with education intervention after 5 months was a 9% increase in attendance. After 3 months, providing pads with education significantly improved attendance among participants. The changes in attendance at the end of the trial, after 5 months, were found to be significant by site over time. With puberty education alone resulting in a similar attendance level.

Conclusion – This pilot study demonstrated promising results of a low-cost, rapid-return intervention for girls’ education in a developing context. Given the considerable development needs of poorer countries and the potential of young women there, these results suggest that a large-scale cluster randomized trial is warranted.

WaterAID – Menstrual hygiene matters

Menstrual hygiene matters is an essential resource for improving menstrual hygiene for women and girls in lower and middle-income countries. 

Nine modules and toolkits cover key aspects of menstrual hygiene in different settings, including communities, schools and emergencies.

This comprehensive resource:

  • Brings together examples of good menstrual hygiene practice from around the world
  • Provides guidance on building competence and confidence to break the silence surrounding the issue
  • Encourages increased engagement in advocacy on menstrual hygiene

In her foreword, Catarina De Albuquerque, UN Special Rapporteur on the human right to safe drinking water and sanitation, states:

This resource brings together, for the first time, accurate, straightforward, non-judgemental knowledge and practice on menstrual hygiene programming from around the world to encourage the development of comprehensive and context specific approaches to menstrual hygiene.

Download the complete report (PDF, 16.4 Mb)

Download the report introduction (PDF, 1.1 Mb)


Menstrual hygiene matters has been produced with input from a wide range of experts and organisations. It was jointly funded by WaterAid and the SHARE research consortium.