assess the level of awareness about menstrual hygiene practices among adolescent girls

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1 SCHOOL OF HEALTH SYSTEM STUDIES Individual Study Report of Urban Internship To study the level of awareness about menstrual hygiene and the relationship between menstrual hygiene and UTIs and RTIs and the social factors associated with practice of Menstrual Hygiene Under the guidance of: Presented by: Dr. Anil Kumar Dr. Akanksha Verma Professor, M2014PHSE0002 Centre for Health and Social Sciences, School of Health Systems Studies

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1

SCHOOL OF HEALTH SYSTEM STUDIES

Individual Study Report of Urban Internship

To study the level of awareness about menstrual hygiene and the

relationship between menstrual hygiene and UTIs and RTIs and the social

factors associated with practice of Menstrual Hygiene

Under the guidance of: Presented by:

Dr. Anil Kumar Dr. Akanksha Verma

Professor, M2014PHSE0002

Centre for Health and Social Sciences,

School of Health Systems Studies

2

INDEX

1. Summary

2. Literature Review

3. Rationale

4. Aims and objectives

5. Methodology

6. Observation

7. Results and analysis

8. Limitation

9. Conclusion

10. Recommendation

11. Acknowledgement

12.References

13.Appendix

3

SUMMARY

Objectives:

To study the level of awareness about Menstrual Hygiene among Adolescent

Girls and also their level of awareness about the relation between Menstrual

Hygiene and UTI and RTI and the social factors associated.

Methodology:

It was a cross-sectional study conducted in Shastri Nagar , Gopinath colony ,

Indira Qureshi Nagar and Mukund Nagar between feb 2015 and march 2015.a

two staged sampling was used i.e consecutive sampling in the first stage and a

convenient sampling in the second stage. A total sample of 140 adolescent girls

in the age group between 13 to 19 yrs was selected.

Results:

The analysis shows that majority of the respondents were in the agr group of 13

to 15 yrs. Majority of the respondents are in high school education.93% of the

respondents are hindu.it showed that majority of the respondents had a basic

knowledge about the basic changes which occur in the body and the association

of them with reproductive health. Further they had some idea about the special

hygiene which is required to be maintained during menstruation. But the

awareness between the relationship between menstrual hygiene and UTI and

RTI was comparatively low. Many social factors like economic cost , personal

beliefs , lack of privacy were responsible for the low level of practice of

menstrual hygiene among the respondents.

Discussion:

Results show that although there is awareness among the adolescents about

menstrual hygiene but awareness about its importance and its relationship

between UTI and RTI is very low. Also there are various social factors which

impede the practice of menstrual hygiene.

4

Conclusion:

Though there is a good level of awareness among the respondent population

about menstrual hygiene but practicing it is relatively low. Further there is low

level of knowledge about its importance.

5

LITERATURE REVIEW:

Menarche constitutes a very important milestone in the life of a girl. It is not only the start of her reproductive life but also accompanies various other things

with it.

Various studies have been conducted on the level of awareness about menstrual hygiene and the menstrual hygiene practices followed among adolescent girls.

One study (Dasgupta. A and Sarkar M) done in West Bengal showed that

around 64% of the girls were aware of menstruation prior to its initiation and the source of this information was mainly from the school and the teachers.

Also it was found that level of education of the mother had a positive

correlation between increased awareness about menstrual hygiene and

practicing it.

Another study done in Nagpur, Maharashtra , to compare the level of

knowledge about menstrual hygiene and the practices followed showed that awareness regarding menstruation was more in urban adolescent girls (63.38%)

as compared to rural (47.57%).

Further another study done in Uttrakhand (Sen and Sen) to elicit the knowledge and source of information regarding menstruation among adolescent girls and

also to find out the practices followed by them during menstruation also showed

that there is low level of awareness among the respondents Awareness among rural girls was significantly more as compared to urban girls. Friends were the

first informant in about 31.8 % girls. But the correct reason and source of

bleeding during menstruation was not known to most of the respondents.

Overall 38.4 % adolescent girls (48.1% Rural and 27.6% Urban) were using sanitary napkins as menstrual absorbent, while 30 % were using a new cloth/rag

every time.

Another study on Menstrual health and Reproductive Health in Rajasthan(

Anoop Khanna and R.S.Goyal)indicates that a significantly large proportion

of girls were not aware of menstruation when they first experienced it. Mothers,

sisters and friends were found to be the major source of information. Much of this information imparted to a young girl is in the form of restrictions on her

movements and behaviour.

6

RATIONALE OF THE STUDY:

Adolescents comprise 20% of the world's total population.Out of 1.2 billion

adolescents worldwide, about 85% live in developing countries. In India, there

are 190 million adolescents comprising 21% of India's total populationand

amongst it the adolescent girl is a doubly burdened section.

It is an irony that the society wants a BLEEDING GIRL,but still menstruation

as a health issue is not discussed frequently and openly in the society.Menstruation and the hygienic practices are still clouded by taboos and

sociocultural restrictions resulting in adolescent girls remaining ignorant of the

scientific facts and hygienic health practices, which sometimes result into

adverse health outcomes. The worst sufferers of this taboo is the most vulnerable section of the society ie the adolescent girls.Menstrual hygiene, a

very important risk factor for reproductive tract infections, is a vital aspect of

health education for adolescent girls.

Adolescent girls constitute a vulnerable group, particularly in India where

female child is neglected one. Menstruation is still regarded as something

unclean or dirty in Indian society. The reaction to menstruation depends upon awareness andknowledge about the subject. Although menstruation is a natural

process, it is linked with several misconceptions and practices, which

sometimes result into adverse health outcomes.

Hygiene-related practices of women during menstruation are of considerable

importance, as it has a health impact in terms of increased vulnerability to

reproductive tract infections (RTI). The interplay of socio-economic status, m -

enstrual hygiene practices and RTI are noticeable.

Today millions of women are sufferers of RTI and its complications and often

the infection is transmitted to the offspring of the pregnant mother.Issues

associated with menstruation are never discussed openly and the silence

surrounding menstruation burdens young girls by keeping them ignorant of this

biological function. Even after the attainment of menarche, very little

information is given to young girls about the physiological processes involved

and the hygienic practices to be followed.

Thus knowledge and awareness about the maintenance of menstrual hygiene

and the various consequences on the health status of the adolescent girls is an

important component.

7

Further during my internship at CORP India organisation in Shastri Nagar ,

Dharavi , I found that there are many gaps which are prevalent in the level of

knowledge and awareness and the practices and also the social beliefs of the

adolescent girls in the area.

AIM OF THE STUDY:

Therefore,I intend to study the level of awareness among the adolescent girls

about the menstrual hygiene and also its relation to the prevention of UTI and

RTI and also the various social factors which play a role in preventing the

acceptance and following of the menstrual hygiene practices among the

respondent population.

Verbal consent from the respondents was obtained. Confidentiality of the

respondent was maintained.

8

OBJECTIVES:

1. To elicit the beliefs, conception and source of information regarding

menstruation among adolescent girls.

2. To study the awareness about menstrual hygiene in adolescent girls.

3. To find out the status of menstrual hygiene among adolescent girls.

4. To study the awareness about the relation between menstrual hygiene and

the UTI and reproductive health.

5. To study the impact of social factors on the menstrual hygiene practices.

9

METHODOLOGY:

UNIVERSE OF STUDY:

Four areas in Dharavi i.e, Shastri Nagar, Indira Qureshi Nagar, Gopinath colony

and Mukund Nagar were selected. These areas were selected as two of these areas i.e Shastri Nagar and Gopinath Colony are comparatively well developed

with respect to the socio-economic profile whereas other two areas, Indira

Qureshi Nagar and Mukund Nagar are less developed and therefore the sample would be representative.

STUDY DESIGN: Cross sectional quantitative study.

SAMPLING:

Sampling was done in two stages. In the first stage consecutive sampling was

done in which the respondents were taken from the vocational training centre

run by the organisation. From this around 80 respondents were taken. In the second stage, Convenient sampling was done in which the sample was taken

from the community. From this around 60 respondents were taken from the four

areas of Shastri Nagar, Indira Qureshi Nagar, Mukund Nagar and Gopinath

Colony.

SAMPLE SIZE:140

INCLUSION CRITERIA: Adolescent girls in the age group of 11 to 19 yrs is taken.

EXCLUSION CRITERIA: Girls above the age of 19 are excluded.

TOOLS USED: Semi structured questionnaire

ANALYSIS WAS DONE USING SPSSv22

10

RESULT AND ANALYSIS

DEMOGRAPHIC PROFILE OF THE RESPONDENTS:

1. Age of the respondent:

The age of the respondent varied from 11 to 19 yrs . the majority of the sample

was from the age group 13 to 15 yrs and the second major chunk was from the

are group of 15 and above

2. Religion of the respondent:

Majority of the respondents were Hindus, around 64.6% followed by 29.2%

which were muslims and the rest 5% were christians.

11

3. Educational status of the respondent:

Majority of the respondents have completed their high school ie 52.8% followed

by those who are studying in higher secondary ie 32.6%

4. Age of menarche:

For the maximum respondents the age of menarche was 12 yrs (47.9%) , for

another 26.4% it was 13 yrs . Only 4.9% had their menarche started at the age of 14 yrs.

12

Basic knowledge about menstruation and menstrual

hygiene:

The above table shows about the % of the respondents who had some awareness

about the changes which take place at some stage in life. 95.8% were aware of these changes occuring at some point in their lives.

On the awareness about why these changes occur about 50.7% responded that it is a natural phenomenon and there is no specific reason for these changes.

Further 27.1% said that these changes occur for a specific reason .on the other

hand 18.1% said that they were not aware of the reason for these changes to

occur and finally only a small proportion said that it is because of God’s curse. Another important finding is that amongst the respondants the muslim

respondants ,majority of them feel that menstruation is bec of God’s curse and

not because of any specific reason

13

KNOWLEDGE ABOUT MENSTRUATION AND ITS

IMPORTANCE:

Out of all the responents there was 100% result when it came to knowledge

about what is menstruation. Further 97.2% said that it is the blood discharge

from the private parts (vagina).

Around 65.3% of the respondents were aware of the relationship between the menstrual bleeding and reproductive health and reproduction . they were aware

that menstruation is important for reproduction.another 24.3% were not aware

of the relation between the two, but this is a significant figure.

14

Out of the total respondents , 72.9% considered menstrual discharge as something good and which was important and necessary for the over all health

and reproductive health of the body . Whereas the rest considered that it was

something bad.

15

Prior knowledge about menstruation and source of the

knowledge:

Out of the total respondants ,66% had some form of prior knowledge ABOUT MENSTRUATION AND menstrual discharge and also about the practices to be

followed.

From the various sources who provided the prior knowledge about menstruation and menstruation practices , the mother of the respondent was the most

important source. It was observed that in 31.9% cases mother was the prime

source of information. In other 23.6% cases teacher was the prime source of information

16

Knowledge about menstrual hygiene and methods practiced:

97.2% of the respondents had some awareness that some special hygiene is

required during menstruation and special care is necessary during this period.

Frther , 71.5% of the respondents were aware of the benefial effects of using a

sanitary anpkins more than that of the cloth and they said that they felt much

more hygenic when usiing a sanitary napkin and also they felt it was easy to use and dispose , and also felt that it was very important to maintain personal

hygiene during menstruation.

For the things used to maintain personal hygiene , 41.7% used only water to clean their private parts in order to maintain hygiene during menstruation, while

17

around 32.6% used soap and water and about 22.9% used antiseptic and water

to clean their private parts to amintain hygiene.

18

Difficulty faced in maintaining menstrual hygiene:

Table 1

Table 2

Table 3

Table 4

19

Although a large section of the respondents are aware about the menstrual

hygiene and its importance , still a very small section only practices it and various reasons have been sighted for this.

Out of the total respondents of 140, 63.2% said that they faced some form of the

difficulty in practicing menstrual hygiene. Some of the reasons sighted were lack of privacy due to lack of space in the

area ,another important reason which was sighted was the lack of proper

infrastructure in homes , colony, school for the proper disposal of the sanitary napkin and also to dry the cloth or to dispose it properly. The third most

important factor was the economic cost associated with the buying of the

sanitary napkins.

About 52% said that they faced difficulty due to lack of proper infrastructure , 53% said they faced problem due to lack of privacy and 49% said that economic

cost was the most important factor.

20

Personal beliefs and perception about menstrual hygiene

Table 5

Table 6

Almost 100% of the respondents were aware that it is necessary to take bath during periods and in order to maintain personal hygiene. Also 52.1% of the

respondents were aware that that there is a positive relation between menstrual

hygiene and a healthy reproductive tract and a healthy reproductive life.

21

Awareness about the relation of menstrual hygiene and UTI and

the its symptoms

Table 7

Table 8

Table 9

Table 10

22

Table 7 , 8 , 9 , 10 shows the knowledge about the relationship of menstrual

hygiene and its role in preventing urinary tract infections .also it shows the percentage of the respondents who are aware about UTI and its symptoms.

Out of the total no. of respondants only half of the respondents were aware

about what is UTI .

Only a very small fraction of the respondents were aware about the relationship between UTI and menstrual hygiene (23%).

Out of those who were aware about UTI only 44% were aware about the

symptoms of UTI and the most important symptoms which were explained by the respondants included redness of the vagina ( 9.7% ) , itching sensation (

29%) , burning sensation in the urine ( 52.8%)

BELIEFS ABOUT SEVERITY AND SUSCEPTIBILITY OF DISEASE

DUE TO NON MAINTENANCE OF PERSONAL HYGIENE

Around 44% of the respondents believe that they can be susceptible for reproductive problems if they don’t maintain menstrual hygiene

23

When the respondents were asked about other people’s susceptibility for RTI if they don’t maintain menstrual hygiene ,they showed a positive optimism

towards their being less susceptible than others

Also in case of UTI they again showed an unrealistic optimism towards

themselves than other of being less susceptible towards UTI in the absence of

maintaining menstrual hygiene than other

24

SOCIAL FACTORS

25

88% of the respondents agreed that there are many social factors which impede them from following them proper menstrual hygiene and thus make them

vulnerable .

Various social factors were given, of which economic cost , personal beliefs ,

religion , were the most important factors which were posted by the respondents.

26

Discussion:

From the above results and analysis it can be observed that most of the respondents were of the age group 131 and above and most of them have

completed. Further the majority of the respondents are hindus.

It can also be seen that majority of the respondents were aware about the changes which take place in the body and around 22 % consider these changes

to happen because of some specific reason.

For the maximum respondents the age of menarche was 12 yrs (47.9%) , for

another 26.4% it was 13 yrs . Only 4.9% had their menarche started at the age of 14 yrs. Around 50.7% responded that it is a natural phenomenon and there is

no specific reason for these changes. Further 27.1% said that these changes

occur for a specific reason .on the othhand 18.1% said that they were not aware

of the reason for these changes to occur and finally only a small proportion said that it is because of God’s curse.

Another important finding is that amongst the respondants the muslim

respondants ,majority of them feel that menstruation is bec of God’s curse and not because of any specific reason

Out of all the responents there was 100% result when it came to knowledge

about what is menstruation. Further 97.2% said that it is the blood discharge

from the private parts (vagina). Around 65.3% of the respondents were aware of the relationship between the

menstrual bleeding and reproductive health and reproduction . they were aware

that menstruation is important for reproduction.another 24.3% were not aware of the relation between the two, but this is a significant figure.

Of the total respondents , 72.9% considered menstrual discharge as something

good and which was important and necessary for the over all health and

reproductive health of the body . Whereas the rest considered that it was something bad.Out of the total respondants ,66% had some form of prior

knowledge ABOUT MENSTRUATION AND menstrual discharge and also

about the practices to be followed. From the various sources who provided the prior knowledge about menstruation

and menstruation practices , the mother of the respondent was the most

important source. It was observed that in 31.9% cases mother was the prime

source of information. In other 23.6% cases teacher was the prime source of information Although a large section of the respondents are aware about the

menstrual hygiene and its importance , still a very small section only practices it

and various reasons have been sighted for this. Out of the total respondents of 140, 63.2% said that they faced some form of the

difficulty in practicing menstrual hygiene.

Some of the reasons sighted were lack of privacy due to lack of space in the

area ,another important reason which was sighted was the lack of proper

27

infrastructure in homes , colony, school for the proper disposal of the sanitary

napkin and also to dry the cloth or to dispose it properly. The third most important factor was the economic cost associated with the buying of the

sanitary napkins.

About 52% said that they faced difficulty. lack of proper infrastructure, lack of

privacy, economic cost was the most important factor. All the respondents were aware that it is necessary to take bath during periods

and in order to maintain personal hygiene. Majority of the respondents were

aware that that there is a positive relation between menstrual hygiene and a healthy reproductive tract and a healthy reproductive life.Aboutthe knowledge

about the relationship of menstrual hygiene and its role in preventing urinary

tract infections a small percentage of the respondents who are aware about UTI

and its symptoms. Out of the total no. of respondants only half of the respondents were aware

about what is UTI .

Only a very small fraction of the respondents were aware about the relationship between UTI and menstrual hygiene (23%).

Out of those who were aware about UTI only 44% were aware about the

symptoms of UTI and the most important symptoms which were explained by

the respondants included redness of the vagina ( 9.7% ) , itching sensation ( 29%) , burning sensation in the urine ( 52.8%)

88% of the respondents agreed that there are many social factors which impede

them from following them proper menstrual hygiene and thus make them

vulnerable . Various social factors were given, of which economic cost , personal beliefs ,

religion , were the most important factors which were posted by the

respondents.

Conclusion:

Although a good % of the respondents were aware about the basics of menstrual hygiene and menstruation , but still adequate knowledge is still lacking among

the respondents. Further lack of privacy , economic cost are the two main

important factors preventing adequate practice of these practices.

28

Limitation :

1. Due to a smaller sample size a holistic sample representative of whole of

Dharavi couldn’t be take.

2. Further due to lack of time some more aspect of the study couldn’t be

studied.

29

PROPOSAL FOR INTERVENTION:

Literature review:

One study conducted in in Udupi Taluk, Karnataka which was a school based

intervention study. In the study, awareness sessions were taken for the school going adolescents about the importance of menstrual hygiene and following this

an exam was conducted to assess the level of awaereness. It was observed that

there was a significant increase in the level of awareness among the adolescents. Another study was conducted in the south Gujarat which was an intervention

study aided by Govt. of India, where an intervention was taken in which

sanitary napkins were given to the school going adolescent girls .it was seen that

the rate of use of sanitary napkins increased to a considerable level. Another school-based educational intervention on menstrual health among adolescent

girls in Bangladesh was undertaken in Bangladesh in which awareness sessions

were taken for a period of six months by qualified practitioners for the school going adolescent girls. After the six month period the level of knowledge was

assessed and it was found that there was a considerable increase in the level of

awareness.

RATIONALE:

Menstrual hygiene is still a neglected subject in the Indian society where these

subject are still covered with many layers of religion, culture , respect and many others.

This is even a bigger problem in Indian context where the girl child is one of the

most neglected section and when this child grows into an adolescent she goes through many deliemas and confusions which she can’t discuss freely in our

male dominated society.

In such a situation the mother, the sister , the friend or the teacher comes to play

a very important role in clearing these doubts and become a ray of hope for this growing girl.

Limited access to products for sanitary hygiene, and lack of safe sanitary

facilities could prove to be barriers to increased mobility and the likelihood of

resorting to unhygienic practices to manage menstruation. Thus any intervention which tends to

improve the level of awareness about menstrual hygiene , improve access of the

30

target population towards various services available can significantly make a

difference in improving the health of the adoloscents.

Objective:

1. To develop a teaching program to provide information and spread

knowledge among the target population ie the adolescent girls and further

assess the change in level of knowledge in the recipient population.

2. To increase the level of awareness about menstrual hygiene among

adolescent girls and help them build their self –esteem and confidence.

3. To increase the access to safe sanitary napkins for the adolescent girls

4. To ensure safe disposal of sanitary napkins in the schools and in the

community

Target Group; adolescent girls in the age group of 10-19 years

Intervention strategy:

1. A comprehensive health education program can be conducted for the

adolescents in the govt. school for about 2 to 3 months by some trained professionals sponsored by either government or private and further the

level of knowledge can be assessed through a test to be included in the

curriculum. The education program can include lecture sessions followed

by interactive sessions with the students.

2. On the similar lines such interactive sessions can be undertaken for the

mothers and teachers , of the adolescent girls who become the most important source of information for the girl but are of very less help

themselves due to inadequate knowledge.

3. Further community –based health education and outreach an be done in

the target population by the AWW and USHA in order to increase

awareness.

4. Monthly meetings can be done with the target population of the mothers

,relatives, sisters of the adolescent population in order to further enhance

their knowledge

31

5. Demand generation for free or subsidized availability of sanitary napkins

can be done through USHA for the community or various self groups like

kishori-sanghs.

6. Anadditional mechanism for in-school youth would be that of theAEP through the life skills courses for Classes IX and XI.

7. Supply side intervention through ensuring a supply of aproduct (sanitary

napkin) which is reasonably priced and ofhigh quality.

These interventions can be applied on the whole in Mumbai,with the help of govt. schools and other private organisations and partners and the

effectiveness of the intervention can be assessed on the basis of a

questionnaire given in the schools to the students after ths completion of

the sessions

Also for the mothers these sessions can be taken with the help of AWW

in the semi –urban areas and community awareness programs with the

help of various groups.

32

References:

Knowledge and practices of adolescent girls regarding reproductive health with special emphasis on hygiene during menstruation. New Delhi:

National Institute of Public Cooperation and Child Development (2007)

,Paul.D.

Awareness and practices of menstruation and 55pubertal changes amongst

unmarried female adolescents in a rural area of East Delhi. Indian J

Community Med. 2007; Nair P, Grover VL, Kannan A.

Knowledge and practices related to menstruation among tribal (gujjar)

adolescent girls. Ethno-Med. 2009; Dhingra R, Kumar A, Kaur M.

Awareness about reproduction and adolescent changes among school girls

of different socioeconomic status., 2006; .Gupta S, Sinha A.

Adolescence and menstruation. J Family Welfare. 2001; .Gupta J, Gupta H

Perception and practices regarding menstruation: A comparative study in

urban and rural adolescent girls. Indian J Community Med. 2005; .Deo DS,

Chattargi CH

Kathmandu.Is menstrual hygiene and management an issue for adolescent

school girls- A comparative study of four schools in different settings of

Nepal. Report Water-Aid in Nepal Publication. 2009. WaterAid &#8211

Narayan KA, Srinivasa DK, Pelto PJ. Puberty rituals, reproductive knowledge and health of adolescent school girls in South India. Asia Pac

Popul J. 2001; 16(2):225-38.

Place of menstruation in the reproductive lives of women of rural north

India. Indian J Community Med. 2006; .Singh AJ

Dasgupta A, Sarkar M. Menstrual hygiene: how hygienic is the adolescent

girl? Indian J Community Med. 2008;

Gupta S, Sinha A. Awareness about reproduction and adolescent changes

among school girls of different socioeconomic status. J Obstet Gynecol India. 2006

Dasgupta A, Sarkar M. Menstrual hygiene: How hygienic is the adolescent girl

33

Water Aid. Is menstrual hygiene and management an issue for adolescent

school girls

Perceptions and practices regarding menstruation: a comparative study in urban

and rural adolescent girls. Indian J Community Med. 2005; Deo DS, Ghattargi

CH

Menstrual hygiene among adolescent schoolgirls in Mansoura, Egypt. Reprod

Health Matters. 2005; El-Gilany AH, Badawi K.

Indian Medical Gazette Effectiveness of Planned Teaching Programme onReproductive Health Among Adolescent Girls(Gouri Kumari Padhy)

Promotion of Menstrual Hygiene among AdolescentGirls (10-19 Years) in

Rural Areas.

34

APPENDIX

1. Name

2. Age

3. Education status

a. non-educated b. 10

th

4.Religion

a.hindu

b.muslim

c.christian

d.others

5. Do you know that some body changes takes place at certain age.

1-YES

2-NO

8. Why do these changes occur?

1-natural physiological process

2-for some specific reason

3-God’s curse

9. At what age do these changes occur?

1-below 10yrs 2-11 to 13 yrs

3- 13 TO 16 YRS

10. AGE OF MENARCHE? 1-11yrs

2-12yrs

3-13yrs 4-14yrs

11. AWARNESS ABOUT BODY CHANGES?

1-yes 2-no

35

12. WHY CHANGES OCCUR?

1-natural phenomenon 2-specific reason

3-God’s curse

4-others

13. What is menstruation?

1-discharge of blood from vagina

2-discharge of white fluid from vagina

3-other

14. Is discharge in menstrual cycle is bad?

1-yes 2-no

15. Does menstrual cycle is related to pregnancy?

1-yes 2-no

16. Do you have any knowledge about it before its start?

1-yes 2-no

17. If yes ,who provided this ? 1-mother

2-sister

3-friend

4-teacher 5-other

18. Do you know that some special hygiene is required during this time? 1-yes

2-no

19. What did you use as an absorbent? 1-sanitary pads

2-cloth

3-others

36

20. Do you think it is important to wash your private parts regularly?

1-yes 2-no

20. What do you use for it? 1-only water

2-soap and water

3-Antiseptic and water

21. It is difficult to manage menstrual hygiene because of

1- lack of infrastructure to dispose of used cloths in school

2-lack of privacy to dry washed ones at home 3-economic cost

4-specify

22. is Bath during a menstrual cycle necessary?

1-yes

2-No

23. Do you know about common prevalence of urinary tract infection in

females and its association with lack of or poor menstrual hygiene?

1-Yes 2-No

24. Do you know what are the common symptoms of urinary tract

infection?

1-Swelling of the vagina

2-Itching of the vagina 3-White discharge

4-others

25. Does any of your social practices prevent you from maintain

menstrual hygiene?

1-yes

2-no

26. Elaborate the social practices.?

37

27. What do you think are the difficulties faced during mensuration, if

any?

28. What are the factors which prevent you from following proper menstrual

hygiene?

1. lack of proper places for disposal 2-lack of spaces in the houses

3-Improper toilet facilities

4-Cost. 5-Others.Elaborate. 29. MENSTRUATION IMPORTANT FOR REPRODUCTIVE CYCLE?

1-yes

2-no

30. IS IT IMPORTANT TO MAINTAIN PERSONAL HYGIENE?

1-yes

2-no

31. RELATIONSHIP BETWEEN REPRODUCTIVE AND MENSTRUAL HYGIENE

AWARNESS?

1-yes

2-no

32. RELATIONSHIP BETWEEN MENSTRUAL HYGIENE AND UTI?

1-yes

2-no

33. You CAN BE SUSCEPTIBL TO UTI PROBLEMS IF U DONT MAINTAIN MH?

1-yes

2-no

34. OTHERS CAN BE SUSCEPTIBLE FOR UTI IF YOU DON'T MAINTAIN

PERSONAL HYGIENE?

1.yes

2.no

34. LACK OF MENSTRUAL HYGIENE CAN LEAD TO OTHER HEALTH

PROBLEMS IN OTHERS?

1-yes

2-no

38

ACKNOWLEDGEMENT:

I would like to thank the Institute for giving us the opportunity to gain such

valuable experience. I would also like to thank the organisation CORP India which we were placed in for helping us throughout the two months of

internship. I would also like to specially thank my internship supervisor Dr.

Anil Kumar for constantly guiding me throughout the internship. Last but not the least I would like to thank all the people who took timeout of their busy

schedules to answer questions for my group as well as individual study.