TY - JOUR
T1 - Menstrual hygiene management and school absenteeism among adolescent students in Indonesia
T2 - evidence from a cross-sectional school-based survey
AU - Davis, Jessica
AU - Macintyre, Alison
AU - Odagiri, Mitsunori
AU - Suriastini, Wayan
AU - Cordova, Andreina
AU - Huggett, Chelsea
AU - Agius, Paul A.
AU - Faiqoh, F.
AU - Budiyani, Anissa Elok
AU - Quillet, Claire
AU - Cronin, Aidan A.
AU - Diah, Ni Made
AU - Triwahyunto, Agung
AU - Luchters, Stanley
AU - Kennedy, Elissa
N1 - Publisher Copyright:
© 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
PY - 2018/12
Y1 - 2018/12
N2 - Objective: To assess the prevalence of menstrual hygiene management (MHM) knowledge and practices among adolescent schoolgirls in Indonesia, and assess factors associated with poor MHM and school absenteeism due to menstruation. Methods: A cross-sectional survey enrolled a representative sample of urban and rural school-going girls aged 12–19 years in four provinces of Indonesia. A semi-structured, self-administered questionnaire obtained socio-demographic characteristics, knowledge, practices and attitudes related to menstruation, MHM and school absenteeism. School water, sanitation and hygiene (WASH) facilities were also assessed. Univariate weighted population prevalence was estimated and multivariable logit regression analyses applied to explore associations. Results: A total of 1159 adolescent girls with a mean age of 15 years (SD = 1.8) participated. Most girls (90.8%, 95% confidence interval (95% CI) = 79.7–96.1) had reached menarche. Over half (64.1%, 95% CI = 49.9–76.2) reported poor MHM practices, and 11.1% (95% CI = 8.1–15.2) had missed one or more days of school during their most recent menstrual period. Poor MHM practices were associated with rural residence (Adjusted odds ratio (AOR) = 1.73, 95% CI = 1.13–2.64), province (various AOR), lower school grade (AOR = 1.69, 95% CI = 1.05–2.74) and low knowledge of menstruation (AOR = 3.49, 95% CI = 1.61–7.58). Absenteeism was associated with living in rural areas (AOR = 3.96, 95% CI = 3.02–5.18), province (various AOR), higher school grade (AOR = 3.02, 95% CI = 2.08–4.38), believing menstruation should be kept secret (AOR = 1.47, 95% CI = 1.03–2.11), experiencing serious menstrual pain (AOR = 1.68, 95% CI = 1.06–2.68) and showed mixed associations with school WASH facilities. Conclusions: High prevalence of poor MHM and considerable school absenteeism due to menstruation among Indonesian girls highlight the need for improved interventions that reach girls at a young age and address knowledge, shame and secrecy, acceptability of WASH infrastructure and menstrual pain management.
AB - Objective: To assess the prevalence of menstrual hygiene management (MHM) knowledge and practices among adolescent schoolgirls in Indonesia, and assess factors associated with poor MHM and school absenteeism due to menstruation. Methods: A cross-sectional survey enrolled a representative sample of urban and rural school-going girls aged 12–19 years in four provinces of Indonesia. A semi-structured, self-administered questionnaire obtained socio-demographic characteristics, knowledge, practices and attitudes related to menstruation, MHM and school absenteeism. School water, sanitation and hygiene (WASH) facilities were also assessed. Univariate weighted population prevalence was estimated and multivariable logit regression analyses applied to explore associations. Results: A total of 1159 adolescent girls with a mean age of 15 years (SD = 1.8) participated. Most girls (90.8%, 95% confidence interval (95% CI) = 79.7–96.1) had reached menarche. Over half (64.1%, 95% CI = 49.9–76.2) reported poor MHM practices, and 11.1% (95% CI = 8.1–15.2) had missed one or more days of school during their most recent menstrual period. Poor MHM practices were associated with rural residence (Adjusted odds ratio (AOR) = 1.73, 95% CI = 1.13–2.64), province (various AOR), lower school grade (AOR = 1.69, 95% CI = 1.05–2.74) and low knowledge of menstruation (AOR = 3.49, 95% CI = 1.61–7.58). Absenteeism was associated with living in rural areas (AOR = 3.96, 95% CI = 3.02–5.18), province (various AOR), higher school grade (AOR = 3.02, 95% CI = 2.08–4.38), believing menstruation should be kept secret (AOR = 1.47, 95% CI = 1.03–2.11), experiencing serious menstrual pain (AOR = 1.68, 95% CI = 1.06–2.68) and showed mixed associations with school WASH facilities. Conclusions: High prevalence of poor MHM and considerable school absenteeism due to menstruation among Indonesian girls highlight the need for improved interventions that reach girls at a young age and address knowledge, shame and secrecy, acceptability of WASH infrastructure and menstrual pain management.
KW - Indonesia
KW - adolescent health
KW - cross-sectional design
KW - menstrual health
KW - menstrual hygiene
KW - school absenteeism
KW - school-based survey
UR - http://www.scopus.com/inward/record.url?scp=85055700015&partnerID=8YFLogxK
U2 - 10.1111/tmi.13159
DO - 10.1111/tmi.13159
M3 - Article
C2 - 30286270
AN - SCOPUS:85055700015
SN - 1360-2276
VL - 23
SP - 1350
EP - 1363
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 12
ER -
