Indian Journal of Health Social Work
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EXPERIENCE OF SCHOOL-GOING GIRLS IN PUBERTY STAGE
REGARDING MENSTRUAL HEALTH AND HYGIENE MANAGEMENT: A
STUDY IN COAL-FIELD-AREAS OF RANIGANJ
Soham Hazra1 & Moumee Jesmin2
1Program Coordinator, EHSAAS Feel the Desire of Nature and Society (NGO), Asansol,
2Development Practitioner, EHSAAS Feel the Desire of Nature and Society, Asansol, WB, India
Correspondence: Soham Hazra, e-mail: hazra.soham95@gmail.com
ABSTRACT
Background: This study is not regional or specific to any country, but according to previous
studies, these challenges are being faced by school-going girls all over the world. This study is
conducted in Raniganj Coalfield area, primarily located in the Asansol and Durgapur subdivisions
of Paschim Bardhaman, West Bengal (India). Aim: The study focuses on three basic indicators
to analyze the experience of school going girls in the puberty stage, especially in terms of
menstrual health and hygiene management. Methods & Materials: In the present study 50
school-going girls are being selected for the study and participated in the Focus Group Discussions
(FGDs), conducted by the trained social work interns in the coalfield areas of Ranigan. Results:
The three basic challenges they face primarily on lack of awareness of menstrual health hygiene,
social exclusion, and the impact on school attendance. In this study, it is found that the reasons
behind those issues were lack of awareness about the importance of hygiene among them and
parents also, lack of awareness of products to be used during menstruation, negligence, and
lastly, taboos and rituals. The study also illustrates various complications and issues occur due
to lack of awareness and proper intervention. The role of government programs, NGOs and
other civil society organizations in this concern is also discussed in the study. Conclusion: Healthy
practices during menstruation can lead to a healthy lifestyle and can prevent many infections
and diseases which will helps to stay comfortable during menstruation. As the numbers of
respondents are less in terms of the total population, the result can’t be generalized, but the
experiences may be common for most of the school-going-girls and suggested solutions may
help to reduce the problem worldwide.
Keywords: Awareness, Menstrual health & hygiene, Puberty, School-going-girl, Social exclusion
Keywords: Awareness, Menstrual health & hygiene, Puberty, School-going-girl, Social exclusion
INTRODUCTION
This study is based on Raniganj Coalfield area, primarily located in the Asansol and Durgapur subdivisions of Paschim Bardhaman, West Bengal (India).There are many Health hazards in coalfield areas. Poor air quality, noise, and mental health issues also contribute to health risks. School-going Girls may face various problems in puberty stage due to limited access to hygiene products, clean facilities, and menstrual education hinders their well-being and attendance.The term puberty refers to the biological process by which an individual undergoes physical, physiological, and psychological changes that lead to sexual maturity and reproductive capabilities. Girl children experience puberty between the ages of 8 and 13. In this stage, various emotional and psychological changes occur, which may lead to mood swings, self awareness, and maturation. Additionally, there are visible changes in body composition, growth in height, and development of reproductive organs. In this study school going-girls who are in puberty stage are taken for the study. The term school-going-girls’ are those female students who are currently enrolled in an educational institution. The study describes the Experience of Menstruation faced by school-going girls in the puberty stage. The term menstruation is derived from the Latin word “mensis”, which means month. Menstruation is usually the discharge of blood and tissue from the uterus through the vagina. The average length of the menstrual cycle is 28 days and usually lasts for about 5-7 days, though sometimes it also varies. According to WHO’s definition (2022) menstrual health is”a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity in relation to the menstrual cycle”. Numerous studies have documented the menstrual health issues faced by school-going girls during puberty. Adolescents often face challenges related to awareness, inadequate access to menstrual hygiene products, and stigma. A study by Sommer et al. (2015) highlighted the prevalence of absenteeism due to menstruation-related issues among girls, affecting their academic performance and overall well-being. Another research by Mason et al. (2013) emphasized the significance of comprehensive menstrual education to dispel myths and misconceptions. Moreover, a study conducted by UNICEF (2019) emphasized the importance of providing accessible and private sanitation facilities in schools to address girls’ hygiene needs. Research by Hennegan et al. (2017) stressed the role of menstrual hygiene management interventions in promoting girls’ confidence and dignity. However, a review by van Eijk et al. (2016) identified gaps in research and interventions, indicating the need for context-specific programs tailored to girls’ diverse needs. In the present study 50 school-going girls are being selected for the study and participated in the Focus Group Discussions (FGDs), conducted by the trained social work interns in the coalfield areas of Raniganj. The findings of the study not only focused on the challenges faced by the school going girls in terms of mental health and hygiene management, but also introduced possible solutions that NGOs and other civil society-organizations can adopt and implement in these fields.
This study is based on Raniganj Coalfield area, primarily located in the Asansol and Durgapur subdivisions of Paschim Bardhaman, West Bengal (India).There are many Health hazards in coalfield areas. Poor air quality, noise, and mental health issues also contribute to health risks. School-going Girls may face various problems in puberty stage due to limited access to hygiene products, clean facilities, and menstrual education hinders their well-being and attendance.The term puberty refers to the biological process by which an individual undergoes physical, physiological, and psychological changes that lead to sexual maturity and reproductive capabilities. Girl children experience puberty between the ages of 8 and 13. In this stage, various emotional and psychological changes occur, which may lead to mood swings, self awareness, and maturation. Additionally, there are visible changes in body composition, growth in height, and development of reproductive organs. In this study school going-girls who are in puberty stage are taken for the study. The term school-going-girls’ are those female students who are currently enrolled in an educational institution. The study describes the Experience of Menstruation faced by school-going girls in the puberty stage. The term menstruation is derived from the Latin word “mensis”, which means month. Menstruation is usually the discharge of blood and tissue from the uterus through the vagina. The average length of the menstrual cycle is 28 days and usually lasts for about 5-7 days, though sometimes it also varies. According to WHO’s definition (2022) menstrual health is”a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity in relation to the menstrual cycle”. Numerous studies have documented the menstrual health issues faced by school-going girls during puberty. Adolescents often face challenges related to awareness, inadequate access to menstrual hygiene products, and stigma. A study by Sommer et al. (2015) highlighted the prevalence of absenteeism due to menstruation-related issues among girls, affecting their academic performance and overall well-being. Another research by Mason et al. (2013) emphasized the significance of comprehensive menstrual education to dispel myths and misconceptions. Moreover, a study conducted by UNICEF (2019) emphasized the importance of providing accessible and private sanitation facilities in schools to address girls’ hygiene needs. Research by Hennegan et al. (2017) stressed the role of menstrual hygiene management interventions in promoting girls’ confidence and dignity. However, a review by van Eijk et al. (2016) identified gaps in research and interventions, indicating the need for context-specific programs tailored to girls’ diverse needs. In the present study 50 school-going girls are being selected for the study and participated in the Focus Group Discussions (FGDs), conducted by the trained social work interns in the coalfield areas of Raniganj. The findings of the study not only focused on the challenges faced by the school going girls in terms of mental health and hygiene management, but also introduced possible solutions that NGOs and other civil society-organizations can adopt and implement in these fields.
OBJECTIVES
1. Understanding the challenges faced by the school-going girls during the puberty stage.
2. To introduce the possible solutions for school-going girls like programs and strategies by NGOs and other civil society organizations.
1. Understanding the challenges faced by the school-going girls during the puberty stage.
2. To introduce the possible solutions for school-going girls like programs and strategies by NGOs and other civil society organizations.
METHODS & MATERIALS
The study employs in-depth interviews to explore participants’ perceptions and experiences. In this study 50 school-going girls are identified from the coal-field areas of Raniganj. Five Focus-Group-Discussions (FGDs) ware being done with self administrated Questionnaires with those 50 School-going-Girls aged between 10 to 13 years. Each FGD has taken 30 minutes time and only the school-going-girls, who have experienced menstruation for at least 1 year, are chosen for the study. 2 Interns of EHSAAS Feel the Desire of Nature and Society (NGO) who are MSW (social work) students were being conducted the FGDs in those areas and data was analysed by MS Excel. Findings will contribute to a rich understanding of the phenomenon and inform future research directions.
The study employs in-depth interviews to explore participants’ perceptions and experiences. In this study 50 school-going girls are identified from the coal-field areas of Raniganj. Five Focus-Group-Discussions (FGDs) ware being done with self administrated Questionnaires with those 50 School-going-Girls aged between 10 to 13 years. Each FGD has taken 30 minutes time and only the school-going-girls, who have experienced menstruation for at least 1 year, are chosen for the study. 2 Interns of EHSAAS Feel the Desire of Nature and Society (NGO) who are MSW (social work) students were being conducted the FGDs in those areas and data was analysed by MS Excel. Findings will contribute to a rich understanding of the phenomenon and inform future research directions.
RESULTS
The study aimed to understand the challenges faced by 50 school-going girls during the puberty stage in terms of menstrual health and hygiene management, and also tried to explore the impact of school attendance on that. Findings revealed multifaceted concerns.
The study aimed to understand the challenges faced by 50 school-going girls during the puberty stage in terms of menstrual health and hygiene management, and also tried to explore the impact of school attendance on that. Findings revealed multifaceted concerns.
The Diagram 1 is showing the various physical
health issues faced by the school-going-girls
during Mensuration. Among the 50
respondents, 22% experienced excessive
bleedings, 13% experienced very little
bleeding during the periods, 5% said they
always get delayed in periods, almost in 2-3
months gap, 31% said its unbearable pain
during those 3-4 days, 15% gets acne in faces
during or before periods, also itching in
vagina, 14% said vomiting or feeling of
vomiting is very common on those days.
Diagram 2 representing the data on use of
napkins, clothes and both (Sanitary Pads &
Clothes) during menstruation.Among the 50
respondents, 50% said they use Sanitary
Napkins and have knowledge of using it, 33%
said they use old rejected cloths, 17% said
that they use both Sanitary Napkins and old
cloths which is totally based on the
availability.
Diagram 3 is showing the school attendance
indicator in percentage. Among the 50
respondents 64% of the respondents said that
they goes to school regularly without much
difficulties whereas, 36% of the respondents
said they are irregular to go to school as they
face difficulties.
The percentage of school-going girls who are
Feeling of Impurity during menstruation to
visit any religious places among school-going
girls is shown in Diagram 4.Among the 50
respondents, 76% said that they do not visit
to any religious institution as they feel
hesitated, whereas 24% said they visit
religious institution without any such
hesitation
Awareness on Menstrual health, Hygiene
among School-going Girls:
At the cbeginning of the FGD, a few basic, open ended questions have been asked, like: “What do you understand by the term menstrual health?”, “Have you ever faced menstrual health issues?”, “Have you ever discussed all these with anybody in your family or other?”, also a few questions like those who use clothes, do they re-use it or not? If yes, how they maintain the hygiene? What is menstrual hygiene management? Do they attend any Government or NGOs programs where mental health and hygiene management discussed etc.? As per the questions, it was recorded and understood that the school-going girls are more familiar with the word “period” than menstruation and they understand that menstruation is a natural process for girls. It is the process, for which the female got the ability to conceive, but rarely they understands about the menstrual health, its link with malnutrition and anaemia, also the mental health consequences like mood swing etc. Nether they understand and nor they asked to anyone mostly. Even they don’t know what to ask on that. Same as menstrual hygiene management is also a new term for most of them. There are very few girls who reuse the clothes during menstruation, but they don’t use any hot water to use it, don’t have any such places where the clothes can dry in the Sun. They keep these clothes in a secret place. There is very little scope for them to discuss all those topics, even if they feel uncomfortable during periods. Mothers or those, who have Sisters, they discuss, but to discuss about this with a father or male members of the family is almost nil. The ASHA (Accredited Social Health Activist) workers do conduct adolescent meetings, which is the only source, where they gain new knowledge’s on it.
At the cbeginning of the FGD, a few basic, open ended questions have been asked, like: “What do you understand by the term menstrual health?”, “Have you ever faced menstrual health issues?”, “Have you ever discussed all these with anybody in your family or other?”, also a few questions like those who use clothes, do they re-use it or not? If yes, how they maintain the hygiene? What is menstrual hygiene management? Do they attend any Government or NGOs programs where mental health and hygiene management discussed etc.? As per the questions, it was recorded and understood that the school-going girls are more familiar with the word “period” than menstruation and they understand that menstruation is a natural process for girls. It is the process, for which the female got the ability to conceive, but rarely they understands about the menstrual health, its link with malnutrition and anaemia, also the mental health consequences like mood swing etc. Nether they understand and nor they asked to anyone mostly. Even they don’t know what to ask on that. Same as menstrual hygiene management is also a new term for most of them. There are very few girls who reuse the clothes during menstruation, but they don’t use any hot water to use it, don’t have any such places where the clothes can dry in the Sun. They keep these clothes in a secret place. There is very little scope for them to discuss all those topics, even if they feel uncomfortable during periods. Mothers or those, who have Sisters, they discuss, but to discuss about this with a father or male members of the family is almost nil. The ASHA (Accredited Social Health Activist) workers do conduct adolescent meetings, which is the only source, where they gain new knowledge’s on it.
DISCUSSION
From the study, it is understood that school going girls in the puberty stage experience many challenges that affect not only their physical health but also their psychological health as well and due to many misconceptions and taboos, social exclusion occur. As a result, they can’t enjoy festivals or have permission to visit religious places, and sometimes they even face persecution. Most of the physical consequences due to menstrual health also affect their school attendance resulting in absenteeism and obstruct girl’s education. Awareness regarding menstrual health and hygiene among school going girls attaining puberty is essential for their self-development and empowerment, which may lead to better mental and physical health and improve their health and hygiene management. A lack of information regarding menstrual hygiene may lead to serious health problems among girls. It is found that due to the unavailability of Sanitary Napkin, the girl child is forced to use old rejected clothes, which sometimes leads to rashes and irritation in their genital parts. It is also found that a sense of shyness and hesitation is found among the girls during menstruation. Lack of openness to talk regarding menstruation, like delay periods, excessive bleeding, excessive cramps, little bleeding, irritation, etc., with their parents has also been noticed among the school-going girls. The girl child faces various cultural and societal beliefs regarding the menstrual stigma of not participating in religious activities or not being allowed to enter any religious institution. Moreover, she faces the same treatment in her home, as she is not allowed to enter into the kitchen or any worship place inside the home as it is considered forbidden. Policies regarding menstrual health and hygiene play a vital role in alleviating menstrual stigma, improving physical and mental health, and ensuring self development and empowerment. According to the Menstrual Hygiene Scheme (MHS) under the National Health Mission (NHM), it generates awareness among adolescent girls about menstrual health and increases the access to good-quality sanitary napkins for rural girls. The government also provides subsidized menstrual products like sanitary napkins for girls living in rural areas. The ASHA (Accredited Social Health Activist) worker also plays an important role in promoting menstrual health and hygiene among girls, like awareness generation regarding menstrual hygiene, promotion of hygiene practices, referral services, and most importantly, collaboration with other health care agencies. Thus, the girl child could get proper knowledge and guidance from the ASHA worker regarding menstrual health and hygiene. Moreover, various non-governmental organizations also play a subsequent role in the promotion of menstrual health and hygiene among the school-going girls attaining puberty t hrough awareness generation, the distribution of sanitary products, counselling assistance, and other menstrual health related services. Therefore, promoting menstrual health and hygiene among school-going girls who are attaining puberty requires proper knowledge and information, breaking taboos, and the utilization of necessary resources to be able to promote their menstrual health, empowerment, and dignity.
From the study, it is understood that school going girls in the puberty stage experience many challenges that affect not only their physical health but also their psychological health as well and due to many misconceptions and taboos, social exclusion occur. As a result, they can’t enjoy festivals or have permission to visit religious places, and sometimes they even face persecution. Most of the physical consequences due to menstrual health also affect their school attendance resulting in absenteeism and obstruct girl’s education. Awareness regarding menstrual health and hygiene among school going girls attaining puberty is essential for their self-development and empowerment, which may lead to better mental and physical health and improve their health and hygiene management. A lack of information regarding menstrual hygiene may lead to serious health problems among girls. It is found that due to the unavailability of Sanitary Napkin, the girl child is forced to use old rejected clothes, which sometimes leads to rashes and irritation in their genital parts. It is also found that a sense of shyness and hesitation is found among the girls during menstruation. Lack of openness to talk regarding menstruation, like delay periods, excessive bleeding, excessive cramps, little bleeding, irritation, etc., with their parents has also been noticed among the school-going girls. The girl child faces various cultural and societal beliefs regarding the menstrual stigma of not participating in religious activities or not being allowed to enter any religious institution. Moreover, she faces the same treatment in her home, as she is not allowed to enter into the kitchen or any worship place inside the home as it is considered forbidden. Policies regarding menstrual health and hygiene play a vital role in alleviating menstrual stigma, improving physical and mental health, and ensuring self development and empowerment. According to the Menstrual Hygiene Scheme (MHS) under the National Health Mission (NHM), it generates awareness among adolescent girls about menstrual health and increases the access to good-quality sanitary napkins for rural girls. The government also provides subsidized menstrual products like sanitary napkins for girls living in rural areas. The ASHA (Accredited Social Health Activist) worker also plays an important role in promoting menstrual health and hygiene among girls, like awareness generation regarding menstrual hygiene, promotion of hygiene practices, referral services, and most importantly, collaboration with other health care agencies. Thus, the girl child could get proper knowledge and guidance from the ASHA worker regarding menstrual health and hygiene. Moreover, various non-governmental organizations also play a subsequent role in the promotion of menstrual health and hygiene among the school-going girls attaining puberty t hrough awareness generation, the distribution of sanitary products, counselling assistance, and other menstrual health related services. Therefore, promoting menstrual health and hygiene among school-going girls who are attaining puberty requires proper knowledge and information, breaking taboos, and the utilization of necessary resources to be able to promote their menstrual health, empowerment, and dignity.
CONCLUSION
Healthy practices during menstruation can lead to a healthy lifestyle and can prevent many infections and diseases which will helps to stay comfortable during menstruation. Poor menstrual health can lead to many problems, like reproductive tract infection, and that can also affect the School Attendance of a school going girl with many other causes. During puberty stage, Girl and Boy experience different things. That stage of life is very much amazing and risky as well. In this stage of life a child becomes more curious about Sexuality, as they become mature sexually. It is really important to make them aware appropriately. In this Study we found that there are many knowledge gaps among the school-going girls. They are experiencing menstruation, but they are not aware of the ways to manage menstrual health and hygiene, and how the nutrition and anaemia is related to that. Such lack of awareness generally results to polycystic ovary syndrome (PCOS), polycystic ovarian disease (PCOD) also with many other consequences. There are a few Governments and NGOs also running programs, but more awareness programs with proper strategic intervention can prevent the issues faced by them, thus their fear of school going during Menstruation also can be stopped. Sessions, programs, menstrual health and hygiene related workshops also can be organised in schools. Programs for Girls are not the only solution, parents should be knowledgeable too. As the numbers of respondents are less in terms of the total population, the result can’t be generalized, but the experiences may be common for most of the school-going-girls and suggested solutions may help to reduce the problem worldwide.
Healthy practices during menstruation can lead to a healthy lifestyle and can prevent many infections and diseases which will helps to stay comfortable during menstruation. Poor menstrual health can lead to many problems, like reproductive tract infection, and that can also affect the School Attendance of a school going girl with many other causes. During puberty stage, Girl and Boy experience different things. That stage of life is very much amazing and risky as well. In this stage of life a child becomes more curious about Sexuality, as they become mature sexually. It is really important to make them aware appropriately. In this Study we found that there are many knowledge gaps among the school-going girls. They are experiencing menstruation, but they are not aware of the ways to manage menstrual health and hygiene, and how the nutrition and anaemia is related to that. Such lack of awareness generally results to polycystic ovary syndrome (PCOS), polycystic ovarian disease (PCOD) also with many other consequences. There are a few Governments and NGOs also running programs, but more awareness programs with proper strategic intervention can prevent the issues faced by them, thus their fear of school going during Menstruation also can be stopped. Sessions, programs, menstrual health and hygiene related workshops also can be organised in schools. Programs for Girls are not the only solution, parents should be knowledgeable too. As the numbers of respondents are less in terms of the total population, the result can’t be generalized, but the experiences may be common for most of the school-going-girls and suggested solutions may help to reduce the problem worldwide.
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Conflict of interest: None
Role of funding source: None
ISSN: 2582-1393 (Online)