Abstract

Background: Although menstruation turns out to be an often-heard topic, Lack of adequate knowledge and guide before menarche and during menstruation breeds misconceptions and harmful attitudes that encourage, among other things, bullying, humiliation, and even gender-based violence. It also results in several misconceptions that limit proper menstrual health and hygiene.

Objective: This study was performed to assess the knowledge, attitudes and practices menstrual health and hygiene among secondary school girls in Limbe health district south west region Cameroon. This study will help impact knowledge about menstrual hygiene and add to the health education of secondary school girls in order to prevent poor menstrual practices.

Methods: Participants in this study were chosen based on their readiness and willingness to participate. Semi-structured questionnaires were used to collect information from the adolescent girls. The data were entered and cleaned using Ms Excel and analysed using IBM SPSS Statistics software version 25.

Results: In the survey, 1,034 participants completed the self-administered questionnaire. The comprehensive knowledge of menstruation was found to be low as 545 (53%) of the participants had inadequate knowledge. The attitudes towards menstruation were greatly influenced by their class (p-value 0.034), income per month (p-value 0.033) and parents’ level of education (p-value 0.002). Overall, 636 (62%) of our participants portrayed negative attitudes towards menstruation. Practice on menstrual hygiene was relatively poor among a majority 535 (52%) of the participants and this was influenced by factors such as their specialty (p-value 0.011) where the science students showed a level of good practice on menstrual hygiene, lack of adequate WASH facilities and family types (p-value 0.000).

Conclusion: Although school girls have some amount of information about managing menstrual health and hygiene, attitudes and practices also need to be improved. Findings point to the necessity of frequent reinforcement of school health education programs together with behaviour change communication initiatives.

CHAPTER ONE

INTRODUCTION

 1.1 Background of the Study

Menstruation, sometimes known as “period,” is a woman’s monthly bleeding. The body eliminates the monthly accumulation of uterine lining when you menstruate. Through the little opening in the cervix, menstrual blood and tissues are expelled from the body through the vagina. The uterus lining thickens during the monthly menstrual cycle to get ready for pregnancy. Hormone levels of oestrogen and progesterone start to decline if you don’t get pregnant. Progesterone and oestrogen at extremely low levels instructs the body to start menstruating [1].

The sequence of events that take place within the body as it gets ready each month for the likelihood of pregnancy is known as the menstrual cycle. The first day of a period is regarded as the start of a menstrual cycle. Although a cycle can be anywhere from 21 and 35 days in length, the typical cycle is 28 days long. The peaks and valleys of hormone-related substances in the body cause the phases of the menstrual cycle. During your menstrual cycle, your ovaries and pituitary gland produce and release specific hormones at specific intervals that affect how your reproductive tract’s organs react [2].

The first menstrual period a female adolescent experience is known as menarche. Menarche usually begins between the ages of 10 and 16, with a 12-year average age of onset. Menarche age factors are still being investigated, but socioeconomic position, genetics, general health, dietary status, physical activity, seasonality, and family size are likely to be important factors   [3]. Menarche typically happens suddenly and without pain. Usually anovulatory, the first cycles can vary in length and flow. Menarche, which marks the onset of reproductive capacity, is tightly linked to the continuing development of secondary sexual characteristics [4].

Given that most women menstruate between menarche and menopause and that menstruation can have a substantial impact on one’s physical, emotional, and social well-being, menstrual health is a crucial component of women’s overall health [5].

“Health” is “a condition of total physical, mental, and social well-being and not only the absence of disease or disability,” according to the World Health Organization [6]. Given that most women menstruate between menarche and menopause and that menstruation can have a substantial impact on one’s physical, emotional, and social well-being, menstrual health is a crucial component of women’s overall health [7].

The cyclic bleeding from the uterine corpus that takes place between menarche and menopause is currently considered to be a normal menstrual cycle. It can be stated in terms of four straightforward domains: how frequently the woman experiences bleeding episodes, how regularly or predictably these episodes occur, how long these episodes last, and how much bleeding occurs during an episode [8].

In regard to the monthly cycle, menstrual health is a condition of whole physical, mental, and social well-being rather than only the absence of illness or infirmity. Achieving menstrual health requires access to accurate, timely, age-appropriate information about the menstrual cycle, menstruation, changes experienced throughout the life-course, as well as related self-care and hygiene practices for women, girls, and all other people who experience a menstrual cycle throughout their life-course.

Menstruating women should take care of their bodies in a way that respects their choices, hygiene, comfort, privacy, and safety. It also entails having supportive facilities and services, such as water, sanitation, and hygiene services, for washing one’s body and hands, changing one’s menstrual supplies, and cleaning and/or discarding used materials, in addition to having access to and using efficient and reasonably priced menstrual products, seek prompt diagnosis, treatment, and care for discomforts and problems associated with the menstrual cycle, including appropriate health services and resources, pain management, and self-care techniques experience a positive and respectful environment in relation to the menstrual cycle, free from stigma and psychological distress, including the resources and support they need to confidently care for their bodies and make informed decisions about self-care throughout their menstrual cycle, decide whether and how to participate in all spheres of life, including civil, cultural, economic, social, and political, during all phases of the menstrual cycle, free from menstrual-related exclusion, restriction, discrimination, coercion, and/or violence [9, 10].

Menstrual hygiene management (MHM) refers to the specific health care needs and requirements that women have during their monthly cycle of menstruation. A crucial component of the health and dignity of women and girls around the world is the management of menstrual hygiene (MHM). Menstrual Hygiene Management (MHM) is the term used to describe the practices of “women and adolescent girls using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as necessary, and having access to facilities to dispose of used menstrual management materials”[11].

1.2 Problem statement

While most women and girls see menstruation as a natural and healthy phase of life, in many communities, menstruators’ experiences are nevertheless limited by social stigmas and discriminatory cultural taboos.

Although menstruation turns out to be an often-heard topic, Lack of adequate knowledge and guide before menarche and during menstruation breeds misconceptions and harmful attitudes that encourage, among other things, bullying, humiliation, and even gender-based violence. It also results in several misconceptions that limit proper menstrual health and hygiene.

Poor menstrual hygiene practices can result in major potential health risks such reproductive and urinary tract infections, which can cause infertility in the future and complicate labor and delivery. Yet, many girls are not aware of the severity of the dangers of not practicing proper menstrual hygiene

After changing menstruation products, it’s important to wash your hands to prevent the spread of diseases including hepatitis B and thrush and also ease chronic pelvic pain, dysmenorrhea (painful periods). However, many school facilities do not meet up with proper WASH amenities to fill in the gap. [12] .

1.3 Research questions

1. What proportion of secondary school girls in Limbe health district Have Adequate knowledge on proper menstrual hygiene?
2. What are attitudes portrayed by secondary school girls in Limbe health district during menstruation?
3. What are factors that influence or associated with good menstrual hygiene practice among secondary school girls in Limbe health district?

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