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INTRODUCTION
The Word adolescent is derived
from the Latin word “adolescere”, which means to grow into maturity. The World
Health Organization (WHO) defines adolescents as individual between 10-19 years
of age group [1]. Adolescent population occupies 1/5th of world’s
population and in India 20.9% of the population falls into this age group [2].
Current population of India is 1.21 billion and among those people 253.2
million of population lies between 10-19 years [3]. The onset of menstruation
is called “Menarche” and it is the hallmark of female pubertal development [4].
Menstruation is generally considered as unclean in India. Social prohibitions
and strong bondage with the taboos and traditional beliefs during menstruation
and hesitation of parents not discussing the related issues openly to their
adolescent daughters has blocked the access to get the right kind of
information regarding menstrual hygiene [5]. Because of the lack of knowledge,
they end-up with repeated use of unclean menstrual absorbent results in
harboring of micro-organisms that increases susceptibility to urinary,
perineal, vaginal and pelvic infections [6]. If these infections left untreated
that will lead to several consequences like infertility, ectopic pregnancy,
prenatal infection, low birth weight babies, and toxic shock syndrome [7]. The
lack of attention to this issue is striking as still we cannot achieve several
Millennium Development Goals (MDGs), that is, 2, 3, 4, 5 and 5B. The MDG 2,
achieving universal primary education and MDG 3 on promoting gender equality
and empowering women are vital for achieving almost all the other MDGs. The best
place to translate the plans concerning menstrual hygiene is in the context of
educational institutions [8]. By giving more emphasize to the menstrual health,
a day is being celebrated on May 28th as ‘Menstrual Hygiene day’ by
WASH United [9]. By recognizing the importance of promotion of menstrual
hygiene, government of India started a scheme of making available subsidized
sanitary napkins to adolescent girls in rural part of India since August 2011
[10]. These younger generations are tomorrow’s parents. The reproductive health
decisions that they make today will affect the health and wellbeing of their
upcoming generations and their community. Even though all initiatives took
place, by government of India, a major section of the adolescent girls do not have
a prior awareness about the menstrual cycle and its hygienic practices leading
to poor menstrual hygiene.
An Indian study has reported
that young girls are generally told nothing about menstruation until their
first experience. It is even more dangerous when the source of information is
itself ignorant [11].
Menstrual hygiene is personal
hygiene during menstruation that includes bathing and washing, the use of
clean, dry sanitary material to absorb the flow and hygienic and
environmentally preparation of material for reuse or safe disposal [12].
To manage menstruation
hygienically, it is essential that women and girls have access to water and
sanitation. They need somewhere private to change sanitary cloths or pads;
clean water for washing their hands and used cloths; and facilities for safely
disposing of used materials or a place to dry them if reusable.
In a study carried out by
Nielsen in rural areas of Bihar and Jharkhand, a framework was created on the
understanding that increased communication on the subject could lead to
increased awareness. This in turn would lead to change in practices and
eventually benefit the lives of entire rural societies. Little is known in
these girls about the importance of practicing hygiene during menstruation.
They are like that because they have never been taught the do’s and do not’s
for this period [13].
CONCLUSION
It is important to educate girls regarding the need for bathing and general hygiene during this time. There are places in India where girls refrain from bathing which poses serious health and reproductive problems in later life. Menstrual hygiene management is an integral part of the Swachh Bharat Mission Guidelines (SBM-G). Through awareness programs girls should be educated about the problems associated with menstruation which are dysmenorrhea, heavy bleeding, irregular cycles, premenstrual syndrome, inter-menstrual spotting and other issues. Though these can be physiological also, most of the girls do not understand these can be associated with some underlying pathology. Approaching health care systems for such problems should be encouraged, more so in the rural settings where cultural and social beliefs overpower the logistics. An important cause of absence from school is dysmenorrhea about which young girls are shy of speaking. We need to provide girls with education as well as supply of sanitary pads which are cheap and hygienic. The awareness of menstrual hygiene needs to be spread in the society. Education can bring major changes so strong policies and political reforms are required in which teachers, village level workers, mass media and government organizations and non-government organizations can work together in spreading right information and help to eradicate age old myths and taboos. There is a need to start nationwide awareness and education programs to educate our teenagers so that they grow up into mature and healthy women.
1. World Health Organisation (2013) Fact sheet on
Adolescent health. Geneva: WHO. Available at: http://www.who.int/topics/adolescent_health/en/ (Accessed on 4 April 2017).
2. Sanyal S, Ray S (2008) Variation in the menstrual
characteristics in adolescent of West Bengal. Singapore Med J 49: 542-550.
3. Chandramouli C (2011) Release of social and cultural
tables - Age data highlights. Census of India. Mumbai: IIPS. Available at: www.censusindia.gov.in/2011.../Census_2011_Age
_data-final-12-09-2013.ppt (Accessed on 4 April 2017).
4. Dasgupta A, Sarkar M (2008) Menstrual hygiene: How
hygienic is the adolescent girl? Indian J Community Med 33: 77-80.
5. Mudey AB, Kesharwani N, Mudey GA, Goyal RC (2010) A
cross-sectional study on awareness regarding safe and hygienic practices
amongst school going adolescent girls in rural area of Wardha district, India.
Canadian Center of Science and Education 2: 225-231.
6. Garg R, Goyal S, Gupta S (2012) India moves towards
menstrual hygiene: Subsidized sanitary napkins for rural adolescent
girls-issues and challenges. Matern Child Health J 16: 767-774.
7. Ram R, Bhattacharya SK, Bhattacharya K, Baur B, Sarkar
T, et al. (2006) Reproductive tract infection among female adolescents. Indian
J Community Med 31: 32-33.
8. Ten VTA (2007) Menstrual hygiene: A neglected
condition for the achievement of several millenium development goals. Europe
External Policy Advisors, Brussels, Belgium, p: 22.
9. WASH United (2017) Menstrual hygiene management.
Berlin: WASH United. Available at: http://washunited.org/our-work/issues/menstrual-hygienemanagement/articles/our-work-issues-menstrualhygiene-management (Accessed on 4 April 2017).
10. Jogdand K, Yerpude P (2011) A community based study on
menstrual hygiene among adolescent girls. Indian J Maternal Child Health 13:
1-6.
11. Narayan KA, Srinivasa DK, Pelto PJ, Veeramal S (2001)
Puberty rituals, reproductive knowledge and health of adolescent school girls
in south. Asia Pacific Population J 16: 225-238.
12. Hema Priya S, Nandi P, Seetharaman N, Ramya MR,
Nishanthini N, et al. (2007) A study of menstrual hygiene and related personal
hygiene practices among adolescent girls in rural Puducherry. Int J Community
Med Public Health 4: 2348-2355.
13. Nilesen AC (2011) Sanitary protection: Every woman's
health right. Plan India.
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