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Jahan F, Shuchi NS, Shoab AK, Alam MU, Bashar SMK, Islam K, Jahan H, Hasan M, Alam MM, Rahman M. Changes in the menstrual hygiene management facilities and usage among Bangladeshi school girls and its effect on school absenteeism from 2014 to 2018. Glob Health Action 2024; 17:2297512. [PMID: 38230656 PMCID: PMC10795776 DOI: 10.1080/16549716.2023.2297512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/12/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND The lack of menstrual hygiene management (MHM) information and facilities in schools is a major contributor to adolescent girls' school absenteeism in low- and middle-income countries like Bangladesh. OBJECTIVES This paper examines the changes over time in school MHM facilities, knowledge and perceptions among adolescent girls, in relation to school absenteeism between 2014 and 2018 in Bangladesh. METHODS We examined changes in MHM and school absenteeism among schoolgirls using nationally representative data from the Bangladesh National Hygiene Baseline Survey 2014 and National Hygiene Survey 2018. Given the repetitive nature of our data and its clustering within participants, our method included performing descriptive analysis, bivariate analysis, and multivariate Generalised Estimating Equation (GEE) modelling to analyse these changes. RESULTS Results showed that adolescent girls' menstruation-related absenteeism decreased between 2014 and 2018. Percentage of adolescents who missed school decreased from 25% to 14% (PD: -11; CI: -16 to -6.1), while the average number of missed days reduced from 2.8 to 2.5 (PD: -0.33; CI: -0.57 to -0.10). In the GEE model, we found that living in rural areas (coef: -5.6; CI: -10.06 to -1.14), parental restrictions on going outside (coef: 4.47; CI: 0.75 to 8.2), education levels of girls (coef: -9.48; CI: -14.17 to -4.79), girl's belief that menstruation affects school performance (coef: 23.32; CI: 19.71 to 26.93), and using old cloths (coef: -4.2; CI: -7.6 to -0.79) were significantly associated with higher absenteeism. However, participant's age, type of school, knowledge of menstruation before menarche, receiving information regarding MHM, separate place for changing absorbents, and separate latrine and urine facility were not significantly associated with the changes in absenteeism over time. CONCLUSION This paper emphasised the associations between changes in school absenteeism, parental restrictions on students, students' education levels, and menstruation-related misperceptions. Ongoing research, policy reviews, and targeted interventions to improve MHM perceptions among girls are required to provide long-term benefits for adolescent girls in Bangladesh.
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Affiliation(s)
- Farjana Jahan
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Noshin Sayiara Shuchi
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Abul Kasham Shoab
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mahbub-Ul Alam
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- School of Civil Engineering, University of Leeds, Leeds, UK
| | - Sk. Md. Kamrul Bashar
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Khairul Islam
- WaterAid, South Asia Region Bangladesh, Dhaka, Bangladesh
| | - Hasin Jahan
- WaterAid, South Asia Region Bangladesh, Dhaka, Bangladesh
| | - Mahadi Hasan
- WaterAid, South Asia Region Bangladesh, Dhaka, Bangladesh
| | - Md. Masud Alam
- Demography and Health Wing, Bangladesh Bureau of Statistics, Dhaka, Bangladesh
| | - Mahbubur Rahman
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Schreiber T, Solebo AL. The Experience of Menarche for Young People With Sensory and Motor Impairments: A Systematic Review. J Adolesc Health 2024; 74:223-231. [PMID: 37815768 DOI: 10.1016/j.jadohealth.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 10/11/2023]
Abstract
Young people with disabilities may face barriers to optimal management of menstrual health, including the management of menarche, a unique stage of development. This systematic review examined the barriers to and facilitators of a positive experience of menarche for young people with visual, hearing, or mobility impairments. The MEDLINE, Embase, PsychINFO bibliographic databases, and grey literature were systematically searched in February 2022 to identify relevant research. Thematic synthesis of the extracted study findings was undertaken, using a team-based approach. A total of seven primary qualitative, and 1 mixed method studies were eligible for inclusion. The themes identified through metasynthesis were: timeliness of pre-menarcheal access, with many being unaware of menarche before it occurred, leading to fear and shock at their first period; resonance, with individuals reporting positive impacts of guidance from those with similar disabilities; and frame, the impact of surrounding societal narratives on the experience of menarche. Families, and those involved in the care of children with visual, hearing, and mobility impairments should be made aware of the importance of timely and resonant menarcheal support and guidance for these individuals and of broadcasting positive surrounding narratives of menarche. This should enable a positive experience of menarche for these vulnerable young people, supporting a good trajectory for later-life menstrual health.
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Affiliation(s)
- Tamar Schreiber
- Population, Policy and Practice Research and Teaching Department, UCL GOS Institute of Child Health, London, United Kingdom
| | - Ameenat Lola Solebo
- Population, Policy and Practice Research and Teaching Department, UCL GOS Institute of Child Health, London, United Kingdom; Department of Opthamology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
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Plesons M, Torondel B, Caruso BA, Hennegan J, Sommer M, Haver J, Keiser D, van Eijk AM, Zulaika G, Mason L, Phillips-Howard PA. Research priorities for improving menstrual health across the life-course in low- and middle-income countries. Glob Health Action 2023; 16:2279396. [PMID: 38010372 PMCID: PMC10795652 DOI: 10.1080/16549716.2023.2279396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Research on menstrual health is required to understand menstrual needs and generate solutions to improve health, wellbeing, and productivity. The identification of research priorities will help inform where to invest efforts and resources. OBJECTIVES To identify research priorities for menstrual health across the life-course, in consultation with a range of stakeholder groups from a variety of geographic regions, and to identify if menstrual health research priorities varied by expertise. METHODS A modified version of the Child Health and Nutrition Research Initiative approach was utilized to reach consensus on a set of research priorities. Multisector stakeholders with menstrual health expertise, identified through networks and the literature, were invited to submit research questions through an online survey. Responses were consolidated, and individuals were invited to rank these questions based on novelty, potential for intervention, and importance/impact. Research priority scores were calculated and evaluated by participants' characteristics. RESULTS Eighty-two participants proposed 1135 research questions, which were consolidated into 94 unique research questions. The mean number of questions did not differ between low- and middle-income country (LMIC) and high-income country (HIC) participants, but significantly more questions were raised by participants with expertise in mental health and WASH. Sixty-six participants then ranked these questions. The top ten-ranked research questions included four on 'understanding the problem', four on 'designing and implementing interventions', one on 'integrating and scaling up', and one on 'measurement'. Indicators for the measurement of adequate menstrual health over time was ranked the highest priority by all stakeholders. Top ten-ranked research questions differed between academics and non-academics, and between participants from HICs and LMICs, reflecting differences in needs and knowledge gaps. CONCLUSIONS A list of ranked research priorities was generated through a consultative process with stakeholders across LMICs and HICs which can inform where to invest efforts and resources.
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Affiliation(s)
- Marina Plesons
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Belen Torondel
- Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Bethany A. Caruso
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Julie Hennegan
- Maternal, Child, and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Marni Sommer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jacquelyn Haver
- School Health and Nutrition, Department of Education and Children Protection, Save the Children US, Washington, DC, USA
| | | | - Anna M. van Eijk
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Garazi Zulaika
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Linda Mason
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Power R, Heanoy E, Das MC, Karim T, Muhit M, Badawi N, Khandaker G. The Sexual and Reproductive Health of Adolescents with Cerebral Palsy in Rural Bangladesh: A Qualitative Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1689-1700. [PMID: 36692630 PMCID: PMC10126047 DOI: 10.1007/s10508-023-02535-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Adolescents with disability in the Global South have unique sexual and reproductive health (SHR) experiences and needs; however, they are rarely included in SRH discourse. This qualitative study, conducted in rural Bangladesh, used semi-structured interviews to understand how adolescents with cerebral palsy (CP) experience their SRH. Participants were recruited from the Bangladesh Cerebral Palsy Register and included 24 adolescents with CP (n = 12 female; n = 12 male) and 76 parents (n = 56 mothers, n = 17 fathers, n = 3 other relatives). Data were analyzed using reflexive thematic analysis. Findings highlighted heterogeneity among adolescents with CP including differences for adolescent men versus women. For some adolescent men with CP, sexual maturity was viewed as bringing new opportunities, whereas for other men, adolescence affirmed exclusions and some transgressed sociocultural norms as they struggled to navigate their pubescent body alongside new privacy requirements. For adolescent women with CP, sexual maturity was associated with new domestic responsibilities, silence and secrecy regarding menstruation, and increased vulnerability to sexual violence and abuse. Adolescent men and women with CP spoke about marriage as something "everybody wants," however, was deemed "impossible" for those with more impairment-related support needs. Both adolescent men and women with CP lacked access to SRH information and support. Mothers positioned providing care to their adolescent child with CP after puberty as "shameful." Our findings suggest that disability, health, and education services in rural Bangladesh need to adopt a life-course approach that incorporates the SRH of adolescents with CP. We recommend the provision of SRH education that addresses the physical, cognitive, and social needs of adolescents with CP.
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Affiliation(s)
- Rosalie Power
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia.
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.
| | - Eamin Heanoy
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
| | - Manik Chandra Das
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
| | - Tasneem Karim
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Mohammad Muhit
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
| | - Nadia Badawi
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Gulam Khandaker
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
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Türker D, Doğan H, Coban O, Goksuluk MB, Özengin N, Ün Yıldırım N. Menstrual health and genital hygiene status in adolescent girls and young women with cerebral palsy. Women Health 2023; 63:243-250. [PMID: 36775296 DOI: 10.1080/03630242.2023.2171175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Menstrual health and genital hygiene behavior in patients with cerebral palsy (CP) is underrecognized, undertreated, and negatively affects quality of life. The aim of this case-control study is to compare menstrual health and genital hygiene behaviors in adolescent girls and young women with CP to a healthy women control group. Participants were invited to study via social media tools between August 2021 and February 2022. The study included 74 adolescent girls and young women with CP and 89 healthy women. Menstrual status with semi-structured questions, menstrual symptoms with "Menstrual Symptom Questionnaire (MSQ)," genital hygiene behavior with "Genital Hygiene Behavior Scale (GHBS)" were evaluated. The control group scored significantly higher on the MSQ sub-dimensions of "negative effects somatic complaints" (r = 0.396; p < .001), "menstrual pain" (r = 0.287; p < .001), "coping methods" (r = 0.291; p < .001), and total score (r = 0.395; p < .001), as well as the GHBS sub-dimensions of "awareness of abnormal findings" (r = 0.270; p = .001) and "menstrual hygiene" (r = 0.495; p < .001) and total score (r = 0.393; p < .001). People with CP had worse genital hygiene behavior, had less menstrual symptoms, and behaved differently about the menstruation symptoms. This study focused on adolescent girls and young women with CP who cannot easily express their own experiences and concerns, emphasized that their needs should be identified by determining their menstrual health and genital hygiene behaviors.Clinical Registration Name, Registration Number, Registration Date: Menstrual Health and Genital Hygiene Status in Cerebral Palsy and NCT04985045, August 2,2021.
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Affiliation(s)
- Duygu Türker
- Gülhane Faculty of Physiotherapy and Rehabilitation, Health Sciences University, Ankara, Türkiye
| | - Hanife Doğan
- Sarıkaya School of Physiotherapy and Rehabilitation, Bozok University, Yozgat, Türkiye
| | - Ozge Coban
- Gülhane Faculty of Physiotherapy and Rehabilitation, Health Sciences University, Ankara, Türkiye
| | - Merve Basol Goksuluk
- Faculty of Medicine, Basic Medical Sciences, Erciyes University, Kayseri, Türkiye
| | - Nuriye Özengin
- Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Bolu Abant İzzet Baysal University, Bolu, Türkiye
| | - Necmiye Ün Yıldırım
- Gülhane Faculty of Physiotherapy and Rehabilitation, Health Sciences University, Ankara, Türkiye
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Smith SE, Chowdhury MK, Doherty M, Morgan DD. Serious health-related suffering experienced by children with disability and their families living in Bangladesh: A scoping review. Palliat Med 2022; 37:602-626. [PMID: 36428280 DOI: 10.1177/02692163221136896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND In 2020, the International Association for Hospice and Palliative Care redefined palliative care to incorporate the concept of serious health-related suffering. An estimated 21 million children globally live with conditions which would benefit from a palliative approach to relieve suffering. Bangladesh is a lower-middle income country with isolated provision of palliative care. AIM To synthesise existing evidence describing serious health-related suffering of children with disability and their families living in Bangladesh and the intersection between this suffering, palliative care and rehabilitation. DESIGN Scoping review methodology. DATA SOURCES A search strategy related to serious health-related suffering and childhood disability was applied to online databases and grey literature. English language studies (1990-2021) were included. Papers pertaining to serious health-related suffering of typically developing children and those over eighteen years were excluded. Data which addressed the three domains of serious health-related suffering (physical, social and emotional/spiritual) were extracted. Palliative care interventions were assessed with a pre-existing checklist. RESULTS Forty-six studies were included, representing ten different methodologies. Sample sizes ranged from 11 to 2582 participants, with 87% of studies including children with cerebral palsy. Serious health-related suffering was described in 100% of the studies, only 14 of the studies described specific interventions to mitigate suffering. Convergence between palliative care and rehabilitation approaches was evident. CONCLUSION Findings document the extensive nature and burden of serious childhood health-related suffering that may be remediated by a palliative approach. They highlight the urgent need to prioritise service development and research in this area.
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Affiliation(s)
- Suzanne E Smith
- Master of Palliative Care student, Flinders University, Australia; Victorian Paediatric Rehabilitation Service, Australia
| | | | - Megan Doherty
- University of Ottawa, ON, Canada; Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Deidre D Morgan
- Research Centre for Palliative Care, Death and Dying (RePaDD), College of Nursing and Health Sciences, Flinders University, SA, Australia
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“The door has opened”: moving forward with menstrual health programming in Bangladesh. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2021. [DOI: 10.1108/ijhrh-11-2020-0102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
In Bangladesh, as elsewhere, menstruation is surrounded by stigma, silence, and shame. Despite being a critical part of women’s and girls’ sexual and reproductive health and rights (SRHR), it remains significantly under-researched and addressed. However, the focus on menstrual health (MH) programming is growing globally, with increased awareness of the importance of holistic and rights-based approaches. This case study aims to examine and reflect upon the MH landscape and programming in Bangladesh, assessing the progress, challenges, and potential ways forward.
Design/methodology/approach
This case study is based on a non-systematic review of recent global and national literature, eight semi-structured interviews, a review of national television adverts and the authors’ experiences of MH research and programming in Bangladesh.
Findings
Hygiene-based education delivered through schools is a common entry point for MH programming in Bangladesh, with limited activities conducted in communities (including with men and boys) and through media. The focus of MH programming has tended to be narrow, with insufficient recognition of the wider gender equality and health implications of menstruation. There are growing efforts to coordinate MH work by different agencies and to collectively advocate for increased government engagement. While significant progress has been made, this case study identifies several gaps and tensions that reflect the complexity of addressing MH.
Originality/value
This case study presents an overview of recent MH experiences and programming in Bangladesh. It recognises the different sectors, sites and stakeholders involved, and includes experiences and perspectives of practitioners, academics, and programme participants.
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