Knowledge, Hygiene Practices, and Factors Associated with Menstrual Hygiene among Adolescent School Girls in Galle, Sri Lanka

Abstract

Background: Globally, poor menstrual hygiene management remains a significant challenge, particularly in low- and middle-income countries. Studies estimate that at least 500 million women and girls lack access to adequate menstrual hygiene facilities. Further, menstrual hygiene plays a crucial role in the lives of adolescent girls by impacting their ability to participate in academic and extracurricular activities. Objectives: To assess the knowledge and hygiene practices on menstruation, and associated factors for knowledge on menstruation and menstrual hygiene practices among grade 9-10 school girls in Galle educational division Methods: A descriptive cross-sectional study was conducted with the participation of 389 girls in Galle educational division using the multi-stage cluster sampling method. A validated, modified, self-administered questionnaire including socio-demographic information, general facts about menstruation, knowledge about menstruation and its’ hygiene, practices regarding menstrual hygiene was used to collect data. Descriptive statistics, Chi-square test, independent sample t-test, one-way ANOVA were used to analyse the data. Results: Among the participants, only 37.2% (n=125) had satisfactory knowledge on menstruation and only 17.3% (n=66) had a satisfactory level of practices on menstrual hygiene. 50.5% (n=193) participants used both sanitary and cloth napkins. 28.8% (n=110) change sanitary napkins more than 3 times per day for the first two days of menstruation. Among the participants 86.9% (n=332) washed genitalia with soap and water with every change of sanitary napkins. Knowledge of menstruation was associated with menstrual hygiene practices (p=0.015), information received from the media (p=0.010), experience on menstruation (p=0.025), mother’s level of education (p<0.001) and father’s level of education (p<0.001). 76.7% (n= 293) were from nuclear families and the hygiene practices on menstruation were associated with the type of the family (p=0.023). Conclusion: The participants' overall knowledge of menstruation and menstrual hygiene practices were poor. Key factors influencing menstrual hygiene included parents' level of education, family structure, and prior experience with menstruation.