Abstract

Introduction: Menstruation is the natural biological process that occurs among adolescent girls, women and other people of reproductive age who were assign females from birth (UNICEF, 2019).  an extensive part of the woman in developing countries does not have the financial ability to buy and use commercial and hygienic menstruations.

Objective: Main objective of the study was to assess the knowledge, challenges and management of menstrual problems among adolescent girls, Specific Objectives includes to assess the knowledge on menstrual problems among adolescent girls’ community, to identify the challenges during menstrual problems among adolescent girls, to assess the management of menstrual problems among adolescent girls in the Bombe Bakundu community.

Method: Method: qualitative and quantitative based cross sectional study design approach was employed, include adolescence who have started menstruating from 10-19 years from the Bombe Bakundu community a simple random sampling method was used, well-structured questionnaires were used to gather information. Microsoft excel 2010 and results presented on pie chart, histogram and frequency, table base on the demographic data and specific objectives on pie chart, histogram and frequency, table base on the demographic data and specific objectives.

Results. results revealed that, menstruation is the flow of blood from the virginal and it is also a biological process that occurs among adolescent girls, the study further found that to manage menstrual problem they will take herbs said and take over the counter medications, with regards to challenges of the menstrual problem,

Conclusion: most of the participant agreed that FP reduce the rate of unwanted pregnancy and unsafe abortion, ensures women empowerment, reduce poverty, is importance for both men and women.

Recommendations: Community campaign should be launched to educate the population on menstrual problems, the challenges and how to manage it.

CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background of Study

Menstruation is the natural biological process that occurs among adolescent girls, women and other people of reproductive age who were assign females from birth (UNICEF, 2019). It is common and natural biological process, with an estimated 800 million women, girls or gender diverse people globally experiencing a menstrual period on any given day (UNICEF, 2019). Menstrual cycle length (the number of days between the first days of menstrual bleeding until the day before the next menstrual period), duration of menstrual bleeding, amount of blood flow and other symptoms vary among those who menstruate (Critchley et al., 2020).

Menstrual disorders are problems that affect a woman’s normal menstrual cycle (American college of Obstetrician and Gynaecologists. 2010). They include Dysmenorrhea which is defined as painful menstruation. It is one of the most common gynaecologic disorders. It is the greatest single cause of lost of work and school days among young women (lacovides, et al., 2015). Amenorrhea which is the absence of menstruation (Elsevier; 2017). Other menstrual problems include oligomenorrhea (infrequent menstrual period), painful menstruation, adenomyosis (abnormal cell growth in the uterine muscle wall), and endometriosis (growth of endometrial tissue outside the uterus) (Healthdirect, 2020).

In the world, more than a quarter (26%) of the world’s population is female and of reproductive age and most of them will menstruate monthly for between 2 and 7 days. (Greek physician Hippocrates) Prior to first menstruation (menarche), each of these girls and women will have undergone puberty.

Over the years however, a few theories have emerged from scientific findings. Some think that women created their own, ‘menstrous rags’ as they are refer to in the bible and these can be found in varying form depending on the country of origin. While this theory is still disputed, the ancient (Greek physician Hippocrates) supposedly refers to small wooden sticks wrapped with soft lint thought to be inserted into the vagina as a sort of early tampon-like device.

In the United State culture, menstruation is a taboo even though menstruation is a biological function of a woman’s body, and the medial reinforce menstruation as a taboo (Delaney, Lupton, & Toth, 2012). Discussing and hiding menstruation is a burden for many women: they use euphemisms to avoid blatantly discussing menstruation and hide feminine hygiene products in male-dominated jobs (Massey, 2015).

Today, women have the option to suppress menstruation with contraceptive devices, such as intrauterine device (IUD’s) and birth control pills to avoid the physical and emotional symptoms associated with menstruation (Massey, 2015). Gynaecologists have said that skipping menstrual cycle using prescribed contraceptive have no short-or-long –term consequences, but the debate continues if suppressing menstruation is unnatural or not (Massey, 2015).

According to (Livoti & Topp, 2011), most of the world’s population will at some point in their life be affected by menstruation even if it is only the females that are affected directly. Throughout a lifespan a female in agrarian regions will have her period about 150 times and each time the period will last for 2-7days (Livoti & Topp, 2011). (House, et al, 2012) stated in a compilation that women protect themselves with variety of different products and materials such as napkins, tampons, cloths, rags or even mud and leaves. The way of protecting cloths against bloodstain, and avoid embarrassment varies from continents and countries (House, et al, 2012). (Finley, 1999) states that menstruation and female hygiene is a taboo in many cultures.

According to Biriwasha (2008); an extensive part of the woman in developing countries does not have the financial ability to buy and use commercial and hygienic menstruations. Due to this, severe infections because of lack in hygiene can occur and it also make some of the girls miss out in school or women not being able to take a job. For example; if a girl would miss school for four days each month due to her cycle she would lose 156 learning days in the four years period of high school, this is equivalent to 24weeks (Biriwasha, 2008).

In Africa, it is estimated that one in the ten young women in Africa miss school during their     menstruation period, mainly because they lack the means to obtain disposable sanitary pad. This repeated absence can have serious ramification for their career and ultimately access to the labour market. Women and girls in low-income setting have low awareness on hygienic practices and lack culturally appropriate materials for menstrual hygiene management (MHM) practices (Sumpter C, et al 2011; Arumugam et al, 2014).

Menstruation, though a natural process, has been, and still is, dealt with secrecy (Warenius, et al 2007; Patkar et al, 2004; Mahon et al 2010). In Ethiopia bathing during menstruation was believed to lead to heavier menstrual bleeding. Egyptian women are said to have make tampon from using soft cotton (Cohen, 2020). The underlying basis for this myth is also the cultural beliefs of impurity associated with menstruation. According to study by Kumar and Srivastava in (2011); participating women also reported that during menstruation the body emits some specific smell or ray, which turns to preserved food bad.

Formerly, menstruating women and girls in western Uganda were prohibited from drinking milk because it was believed to affect milk production from cows. Studies report the use of unsanitary reusable absorbents for managing menstruation, along with inadequate washing and drying methods, as highly common in low-income countries (Sumpter and Torondel, 2013).

This is particularly evident amongst girls and women in lower socio-economic groups in rural areas.  Among Tanzanian women, the most common menstrual hygiene management is the use of cloths for menstrual protection, in addition toilet paper or cotton wool have been reported being used (Baisley et al, 2009). In Papua New Guinea, for instances, menarche initiate the ‘making of a strong woman’, whereby young girls are supported by their male and female relatives to undertake mandatory isolation, initiation, and cleansing rituals to attain adult status (Maulingin-Gumbaketi et al., 2021).

In Cameroon, still today young girl maybe told not to cook when she has her period because the dishes will be ruined says (Olivia Mvondo), one of the founders of Kmarpad a company manufacturing reusable sanitary pads and winner of the Grand (prix de la finance solidaire 2019), a prize for solidarity base continue to hang over menstruation in central and west Africa and in many other parts of the world. For many girls and young women, proper sanitary protection continues to be too costly making safe menstruation difficult.

Women and girls in low-income settings have low awareness on menstrual hygiene practices and lack culturally appropriate materials for menstrual hygiene management (MHM) practices (Sumpter C, et al, 2011; Arumugam et al, 2014). Menstruation, though a natural process, has been and still is a dealt with in secrecy (Warenius, et al 2007; Patkar et al, 2004 Mahon et al 2010). Mainly this is due to cultural taboos related to sexuality and reproductive health. This demonstrates a poor knowledge and information about reproductive functions and reproductive health and associated problems amongst adolescents (Warenius et al, 2007, Mohan et al et al, 2010).

1.2 Statement of Problem

It is recommended that a woman is supposed to menstruate without any issues. The walls of the endometrium is involved in shedding of blood (usually3-5days) every month (Lundgren et al; 2017).During my community practicum , I observed women (adolescent) who menstruate even for one week of regular flow of blood and some having sporting menses, without knowing their consequences such as Dysmenorrhea (painful bleeding), Amenorrhea (absence of menses), Oligomenorrhea (light or infrequent periods), Menstrual cramps, Menorrhagia (excessive or very heavy and prolong bleeding) causing them to miss classes and low self-estimate having during their menstruation.

Also, most of the girls get infected at the end of their period because they carryout poor hygiene in order to manage their menses (Orringer and Gahagan, 2010). Addressing this problem will create an awareness and will help to assess the knowledge, challenges and management of menstruation problems among adolescent.

1.3 Research Objective.

1.3.1 General Objective

To assess the knowledge, challenges and management of menstrual problems among adolescent girls in the Bombe Bakundu community.

1.3.2 Specific Objective

1. To assess the knowledge of menstrual problems among adolescent girls in the Bombe Bakundu community.
2. To identify the challenges in managing menstrual problems among the Bombe Bakundu community adolescent girls.
3. To examine managing menstrual problems among adolescent girls in the Bombe Bakundu community.

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