Prevalence and factors associated with menstruation-related school absenteeism among adolescent girls in rural northern Ghana

Maxwell Tii Kumbeni1, Florence Assibi Ziba2, Joana Apenkwa3, Easmon Otupiri3
1Ghana Health Service, Nabdam District Health Directorate, Nangodi, Ghana
2School of Nursing, University for Development Studies, Tamale, Ghana
3School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Tóm tắt

Abstract Background Although menstruation is a normal physiological process that begins in girls during adolescence, it has the potential to negatively impact on the self-esteem and education of girls particularly those from low- and middle-income countries. We investigated the prevalence and factors associated with menstruation-related school absenteeism among adolescent girls in the Talensi district of rural northern Ghana. Methods We conducted a cross-sectional survey among 705 adolescent girls aged 12–19 years who had attained menarche. The sample size was estimated using Epi Info version 6 at 95% confidence interval and a 5% margin of error. A two-stage sampling technique was employed to recruit participants. We conducted univariate and multivariate logistic regression models to determine factors associated with menstruation-related school absenteeism which was defined as “being absent from school due to menstruation-related issues during the last menstruation.” Results The prevalence of menstruation-related school absenteeism was 27.5%. School absenteeism ranged from one to seven days during the menstrual period. Older adolescent girls, (aOR = 2.38, 95% CI 1.29–4.40), use of cloth as a sanitary material at the last menstruation, (aOR = 3.21, 95% CI 2.22–4.63), and cultural restriction, (aOR = 2.54, 95% CI 1.76–3.67) were associated with higher odds of menstruation-related school absenteeism. Meanwhile, girls from moderate income parent(s), [aOR = 0.57 95% CI 0.34–0.94] had lower odds of menstruation-related school absenteeism. Mother’s education and privacy in school were only significant at the univariate level. Conclusions The prevalence of menstruation-related school absenteeism highlights the need for interventions aimed at improving the availability of sanitary pads for girls, eliminating cultural restrictions associated with menstruation, and also improving parent(s) income level.

Từ khóa


Tài liệu tham khảo

UNICEF. Adolescent demographics. 2019. Available from: https://data.unicef.org/topic/adolescents/demographics/. Accessed 20 Dec 2020

Plourde KF, Fischer S, Cunningham J, Brady K, McCarraher DR. Improving the paradigm of approaches to adolescent sexual and reproductive health. Reprod Health. 2016;13:72.

Santhya KG, Jejeebhoy SJ. Sexual and reproductive health and rights of adolescent girls: evidence from low- and middle-income countries. Glob Public Health. 2015;10(2):189–221.

Woog V, Kågesten A. The sexual and reproductive health needs of very young adolescents in developing countries. Guttmarcher Institute. 2017. Available from: https://www.guttmacher.org/fact-sheet/srh-needs-very-young-adolescents-in-developing-countries

Davis J, Macintyre A, Odagiri M, Suriastini W, Cordova A, Huggett C, et al. Menstrual hygiene management and school absenteeism among adolescent students in Indonesia: evidence from a cross-sectional school-based survey. Trop Med Int Heal. 2018;23(12):1350–63.

Hennegan J, Dolan C, Wu M, Scott L, Montgomery P. Measuring the prevalence and impact of poor menstrual hygiene management: A quantitative survey of schoolgirls in rural Uganda. BMJ Open. 2016;6:e012596.

Vashisht A, Pathak R, Agarwalla R, Patavegar B, Panda M. School absenteeism during menstruationamongst adolescent girls in Delhi. India J Family Community Med. 2018;25:163–8.

Miiro G, Rutakumwa R, Nakiyingi-Miiro J, Nakuya K, Musoke S, Namakula J, et al. Menstrual health and school absenteeism among adolescent girls in Uganda (MENISCUS): A feasibility study. BMC Womens Health. 2018;18:4.

Mohammed S, Larsen-Reindorf RE, Awal I. Menstrual hygiene management and school absenteeism among adolescents in Ghana: results from a school-based cross-sectional study in a rural community. Int J Reprod Med. 2020;2020.

Montgomery P, Ryus CR, Dolan CS, Dopson S, Scott LM. Sanitary pad interventions for girls ’ education in Ghana : A Pilot Study. PLoS One. 2012;7(10).

Grant M, Lloyd C, Mensch B. Menstruation and school absenteeism: Evidence from rural Malawi. Comp Educ Rev. 2013;57(2):260–84.

Sommer M, Caruso BA, Sahin M, Calderon T, Cavill S. A time for global action : addressing girls ’ menstrual hygiene management needs in schools. PLOS Med. 2016;13(2):e1001962.

Ssewanyana D, Kiiza B, Bitanihirwe Y. Menstrual hygiene management among adolescent girls in sub-Saharan Africa. Glob Health Promot. 2017;0(0):1757–9759.

Boosey R, Georgina P, Deave T. Menstrual hygiene management amongst schoolgirls in the Rukungiri district of Uganda and the impact on their education: a cross-sectional study. Pan Afr Med J. 2014;4(3).

Tegegne TK, Sisay MM. Menstrual hygiene management and school absenteeism among female adolescent students in Northeast Ethiopia. BMC Public Heealth. 2014;14.

Mohammed S, Emil Larsen-Reindorf R. Menstrual knowledge, sociocultural restrictions, and barriers to menstrual hygiene management in Ghana: Evidence from a multi-method survey among adolescent schoolgirls and schoolboys. PLoS One. 2020;15(10):e0241106.

Acheampong K, Baffour-Awuah D, Ganu D, Appiah S, Pan X, Kaminga A, et al. Prevalence and predictors of dysmenorrhea, its effect, and coping mechanisms among adolescents in Shai Osudoku district, Ghana. Obstet Gynecol Int. 2019;2019.

Gumanga SK, Kwame-Aryee RA. Menstrual characteristics in some adolescent girls in accra, ghana. GHANA Med J. 2012;46(1):3–7.

World Health Organization. Issues in adolescent health and development. Geneva; 2004. http://whqlibdoc.who.int/publications/2004/9241591447_eng.pdf. Accessed 21 Dec 2020

Montgomery P, Hennegan J, Dolan C, Wu M, Steinfield L, Scott L. Menstruation and the cycle of poverty: a cluster quasi-randomised control trial of sanitary pad and puberty education provision in Uganda. PLoS One. 2016;11(12):e0166122.

Hennegan J, Dolan C, Steinfield L, Montgomery P. A qualitative understanding of the effects of reusable sanitary pads and puberty education: implications for future research and practice. Reprod Health. 2017;14:78.

Sivakami M, van Eijk AM, Thakur H, Kakade N, Patil C, Shinde S, et al. Effect of menstruation on girls and their schooling, and facilitators of menstrual hygiene management in schools: Surveys in government schools in three states in India, 2015. J Glob Health. 2019;9(1).

UNICEF. Knowledge, Attitude and Practices of Menstrual Hygiene Management by Adolescent school-going girls and nuns in Bhutan [Internet]. 2018. https://www.unicef.org/bhutan/media/211/file

House S, Mahon T, Cavill S. Menstrual hygiene matters; A resource for improving menstrual hygiene around the world. 1st ed. London: WaterAid; 2012. p. 22–354.

WaterAid. Is Menstrual Hygiene And Management An Issue For Adolescent Girls? A Comparative Study Of Four Schools In Different Settings Of Nepal. 2009. Available from: http://www.wssinfo.org/fileadmin/user_upload/resources/MENSTRUAL-HYGIENE-MANAGEMENT-Paper-for-END-group-1.pdf. Accessed 16 Dec 2020

Thakre SB, Thakre SS, Reddy M, Rathi N, Pathak K, Ughade S. Menstrual hygiene: knowledge and practice among adolescent school girls of Saoner, Nagpur District. J Clin DIAGNOSTIC Res. 2011;5(5):1027–33.

Kumar A, Srivastava K. Cultural and social practices regarding menstruation among adolescent girls. Soc Work Public Health. 2011;26(6):594–604.