Factors Influencing Rural Teenage Girls' Menstrual Hygiene Management

Volume 8, Issue 4, April 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Factors Influencing Rural Teenage Girls’

Menstrual Hygiene Management
Case study: ST. PAUL’S HIGH SCHOOL MUNYONYI,
KAGONGI SUB COUNTY, MBARARADISTRICT
BANKUNDA PAULA, Student

2016-BSCPH-FT-012
MATAZE WINFRED, Supervisor
AN UNDERGRADUATE DISSERTATION SUBMITTED IN PARTIAL COMPLETION OF THE

REQUIREMENTS FOR THE AWARD OF A BACHELOR IN PUBLIC HEALTH, SUBMITTED
TO THE INSTITUTE OF PUBLIC HEALTH AND MANAGEMENTOF CLARKE
INTERNATIONALUNIVERSITY
OCTOBER 2019
IJISRT23APR922 www.ijisrt.com 2456

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ABBREVIATIONS
WHO World Health Organization
MHM Menstrual Hygiene Management
UNICEF United Nations International Children’s Emergency
PIASCY Presidential initiative on AIDS strategy for youth
MOES Ministry of Education and Sports
SACOSAN South Asian Conference on Sanitation
FGDs Focused Group Discussions
MOH Ministry of Health
LMIC low Middle-Income Countries
WASH Water and Sanitation Hygiene

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ABSTRACT
General objective: To determine the factors influencing menstrual hygiene management among rural
teenage girls in Kagongi sub-county, Mbarara district.
ResearchProblem:UNICEF approximates that at least 1in 10 of girls that menstruate skip school for
4-5 days for every 28 days cycle and others dropout completely.An increasing number of studies such
as Loughnan et al, (2016) indicate that girls who struggle at school during menstruation are high in
low-income settings. This study aimed at establishing these factors that constrained adolescent girls to
perform safe menstrual hygiene practices.
Methodology: The study adopted a descriptive cross-sectional study that involved 102 respondents.
The study used a self-administered questionnaire, a focused group guide, and an observation checklist
as the data collection tools. A simple random sampling method was usedto reduce bias and every
respondent consented to participate in the study.
Results: The findings indicated that 71.6%of the adolescent girls aged between 15-18.
74.5% of the girls used disposable menstrual pads. The majority (77.5%) of the girls believed that
menstrual blood attracts witches when not disposed of properly.53.5% practiced unsafe menstrual
hygiene management.The study also revealed that 94.1% hadhigh levels of knowledge of
menstruation.
Conclusion: The study concluded that there was a low percentage ofteenage girls practicing safe
menstrual methodsat St. Paul's high school, Kagongisub-county, Mbarara district.
Recommendations: The Ministry of Educationto incorporate menstrual hygiene management into the
school curriculum. The government should train schools on how to make reusable sanitary pads to
make them accessible to every girl. The schools should construct girls' sanitary facilities with
washrooms and private rooms for changing adolescent girls.
KEYWORDS:-
Adolescent: Transitional stage of physical and psychological human development from puberty to
adulthood.
Health: A state of complete physical, mental, and social well-being and not merely the absence of disease or
infirmity.
Menarche: The first menstruation period
Menstruation: Normal vaginal bleeding from the uterus and vagina that occurs as part of a woman's
monthly cycle.
Menstrual hygiene management: women and adolescent girls use a clean menstrual managed material to
absorb blood that can be changed in privacy as often as necessary for the duration of the cycle using soap
and water for washing the body as required and having access to facilities to dispose of the used materials.
Unsafe menstrual practices: Any menstrual practice that is unclean such as using non-recommended
menstrual materials.

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CHAPTER ONE
INTRODUCTION
A. Introduction
The topic of this study is the factors affecting menstrual hygiene management among rural adolescent
girls in St. Paul’s secondary school in Kagongi sub-county, Mbarara district. This chapter includes the
background to the study, a statement of the problem, the objectives of the study both main and specific
objectives, the research questions, the significance of the study, and the conceptual framework.
B. Background
Globally about 52% of the female population is of reproductive age, this implies that menstruation is part
of the female normal life and therefore menstrual hygiene management is an important aspect of
reproductive health that should be handled properly (House et al., 2012). Adolescents aged 10-24 years
represented a quarter of the world's population, with 90% living in low and middle-income countries.500
millionof these weregirls aged 18-19 years living in less developed countriesand most of these struggled to
find clean water for washing, private place for changing and adequate blood absorbing materials (Loughnan
et al.,2016).
According to UNICEF, Women spend many years menstruating, on average any menstruating woman
menstruates 3-5 days every month, and the age of menstruating varies by geographical region, race,
ethnicity, and diet. But usually in low-incomesettings, it occurred between 8 and 16 years (UNICEF,
2010).However, globally women and girls have developed their strategies to cope with menstruation.This
also varied from country to country and it depended on the available resources, economic status, local
traditions, cultural beliefs, and knowledge (UNICEF, 2012).This study focused on finding out how these
adolescent girls handled menstruation by identifying the menstrual materials they used.
Many studies have revealed that menstrual hygiene management at school is constrained by poor access
to water, sanitation, lack of privacy, limited knowledge and cultural restrictions about menstrual hygiene
such as ((House et al., 2012) reported the widespread use of unsanitary absorbents, inadequate washing and
drying of reused absorbents across South East Asia,Middle East and in Africa found out the use of sanitary
pads as low as 18% among Tanzanian women with the rest using cloth or toilet paper. A study carried out in
eastern Ethiopia found that 60.28% of the girls used cotton cloth which is not good hence imposing them to
infections (Gultie et al., 2014). In addition (Mahon et al., 2011) discovered menstruation caused a set of
physical, sociocultural, and economic challenges to adolescent girls that may disturb their ability to attend
school.
Studies reported that many adolescent girls lacked sufficient knowledge of menstrual hygiene
managementfor example a study from UNICEF revealed that 1 out of 3 girls in South Asia knew nothing
about menstruation before getting it while 48% of girls in Iran and 10% of girls in India believed that
menstruation was a disease (water-aid 2013, menstrual hygiene matters). In addition, a UNICEF report
estimated that 23% of adolescent girls between ages 12-18 years started experiencing menstrual periods
withinadequate menstrual materials (UNICEF, 2012). A study by Mudey et al, (2010) revealed that most
adolescent girls had incomplete and inaccurate information about menstrual hygiene. It also revealed that
mothers, television, friends, teachers, and relatives were the main sources that provided information on
menstruation to adolescent girls. Ali and Ruiz also reported that in Pakistan, less than 50% of girls
interviewed received menstruation Information before they experience it. This showed that this attributed to
poor menstrual hygiene management in this area (Ali et al., 2010).

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In developing countries like Uganda, menstruation is still dealt with in secrecy. It is considered
something unclean, a taboo and this is mainly inadequate knowledge about menstrual hygiene management,
especially among girls in rural areas this causes adolescent girls to suffer from stigma, lack of menstrual
absorbents, and lack of privacy to change while at school(Mahon et al., 2010).However, WASH United
initiated the first global menstrual hygiene day on the 28thof May aimed at breaking the silence around
menstruation.This was publicly to recognize the right of women to hygienically manage their menstruation
anywhere. WASH developed a menstrual hygiene management curriculum to educate about taboos, hygiene,
and reproductive health concerning menstruation (WaterAid, 2010).
C. Statement of the problem

An increasing number of studies such as Loughnan et al, (2016) have found that girls in low-
incomesettings struggle at school during menstruation. This is because they are unable to manage their
menstrual hygiene effectively. Another study reported 61.7% of girls in rural western Uganda schools
missed school each month because of menstrual-related reasons such as lack of access to menstrual
materials, facilities to change from, and what to use (Boosey et al., 2014).This study aimed at establishing
these factors that constrained adolescent girlsto perform safe menstrual hygiene practices.
UNICEF estimated that one in ten menstruating girls skipped school for 4-5 days for every 28 days
cycle and others dropped out completely. About 23% of adolescents (12-18) dropped out of school due to a
lack of menstrual materials (UNICEF, 2012).
Most studies in the Mbarara district were carried out in primary schools yet also in secondary schools
girlsdo not know how to manage their menstruation (Boosey et al., 2014).Therefore the reason why this
study was carried out in St.paul's secondary school Kagongisub-county.
D. Objectives of the study

 Main objective
The main objective of this study was:
To assess factors influencing menstrual hygiene management among rural adolescent girls in St. Paul’s
secondary school in Kagongi sub-county, Mbarara district.
 Specific objectives
The specific objectives of the study were;
 To determine the socio-demographic factors influencing menstrual hygiene management among rural
adolescent girls in St. Paul's secondary school in Kagongi sub-county, Mbarara district.
 To establish the socio-cultural factors influencing menstrual hygiene management among rural
adolescent girls in St. Paul's secondary school in Kagongisub-county, Mbarara district.
 To assess the knowledge level factors on menstruation influencing menstrual hygiene management
among rural adolescent girls in St .Paul's secondary school in Kagongisub-county, Mbarara district.
 The research questions were;

 What are the socio-demographic factors influencing menstrual hygiene management among rural
adolescent girls in St Paul's Secondary School in Kagongi sub-county, Mbarara district?
 What are the socio-cultural factors influencing menstrual hygiene management among rural adolescent
girls in St. Paul's secondary school in Kagongi sub-county, Mbarara district?
 What are the knowledge level factors on menstruation influencing menstrual hygiene management
among rural adolescent girls in Paul's secondary school in Kagongi sub-county, Mbarara district?

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E. Significance of the study
This study aims to inform various stakeholders on policy making such as the government, the head
teachers, teachers, and other leaders in terms of building sanitary disposals, providing menstrual pads to girls
who cannot afford them, and teaching girls about making reusable sanitary towels.
At the end of this study, the girls will be able to know that menstrual hygiene management is essential
hence improving their hygiene and knowing that menstruation is normal processing their lives therefore they
have to be comfortable when experiencing it.
The study made recommendations both at the national and local levels on how to address the problem
of the menstrual hygiene management.
The findings of this study may be used by stakeholders to design interventions to create awareness of
menstrual hygiene management among adolescent girls, especially in rural settings. The results from the
study may be used by other researchers who would wish to carry out more studies on menstrual hygiene
management. The study will provide information that strengthens preventive programs that promote
women’s sanitary health and it added to the existing research as far as menstrual hygiene management is
concerned.
F. Conceptual framework
Socio demographic factors

Age.
Disposal habits.
Level of education.
Attitude.
Economic status
Personal hygiene
Menstrual hygiene management

Socio cultural factors
Myths
Parental guidance
Perceptions of girls
Religion
Cultural beliefs
Knowledge level factors on

menstruation
Awareness about menstruation
Awareness on sanitary
disposal.
Source of information on
menstruation
Fig. 1: Conceptual framework
From the figure above, the independent variables of the study were socio-demographic factors, socio-
cultural factors, and knowledge level factors on menstruation. These were further discussed socio-
demographic factors including age, disposal habits, level of education, attitude, economic status, and
personal hygiene. Sociocultural factors included myths, perceptions, religion, and cultural beliefs.The
knowledge level factors on menstruation included awareness of menstruation, sanitary disposal, and the
source of information on menstruation. The dependent variable of the study was menstrual hygiene
management.

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CHAPTER TWO
LITERATURE REVIEW
This chapter includes other studies carried out by other researchers on the same study which is
menstrual hygiene management. It includes studies on the socio-demographic factors, sociocultural factors,
and knowledge levels on menstrual hygiene management.
A. Socio-culturalFactorsAffecting menstrual hygiene management

The following are the sociocultural factors affecting menstrual hygiene management that were reviewed:
myths, cultural beliefs, and perceptions.
 Myths
Many studies in different areas revealed some of the myths associated with menstruation such as Oche et
al, (2012) which reportedpeople believing menstrual bloodcan attract witches if not disposed off properly.
These in turn use it in black magic rituals hence the used pads must be burnt off. Another study by Kumar et
al, (2011) revealed that when girls are menstruating their mobility and character are limited and this is
because of the existing myths, misconceptions, and cultural and religious beliefs such as women being
unclean. A Roman author Pliny, (2010) in his Natural History also wrote that a menstruating woman could
turn wine sour, cause seeds to be sterile, wither grafts, cause garden plants to become parched, and fruit to
fall from a tree she sits under. A Hindu woman abstains from worship and cooking and stays away from her
family as her touch is considered impure during menstruation. As per the Jewish tradition, a woman is
regarded as ritually impure during menstruation therefore anyone or anything she touches becomes impure.
However, these studies did not clearly show how these myths affected menstrual hygiene management
therefore this study intended to find out the cultural taboos, misconceptions, and myths on menstruation in
the study area and if they were associated with menstrual hygiene management.
 Cultural Beliefs and Taboos

Studies showed that there aremany cultural beliefs on menstruation for example a study by House et
al,(2012) reported thatin some cultures, women are told during their menstrual cycle they should not bath or
will be infertile, touch a cow or it will become infertile, look in a mirror or it will lose its brightness or touch
a plant it will die and these cultural norms and religious taboos on menstruation are usually associated with
evil spirits, shame surrounding sexual reproduction such as in Tanzania some believed that if a menstrual
cloth is seen by others then the owner of the cloth become cured. In a study carried out by Kumar and
colleagues, they adopted a cross-sectional study which this study also used. In this study, some girls said that
bathing during menstruation increases the flow of menstrual blood and causes infections (Kumar et al.,
2011). Results of another study carried out in India indicated that students had substantial doubts about
menstruation and were influenced by societal beliefs and taboos concerning menstrual practices (Chothe et
al., 2014). However few studies were done in Uganda to establish the cultural beliefs that influenced
menstrual hygiene management therefore, this study intended to add to the literature available.
 Perception
Over the decades, women have been taught that having periods is shameful. They have indirectly
absorbed the messages that menstrual blood is dirty, smelly, unhygienic, and unclean. With all these
negative messages it is natural for women to want to hide their blood and throw it away as garbage (Upashe
et al., 2015). In Uganda, Menstruation is linked to maturity, and it is taken as a transition to adulthood for
girls this has led to early marriages, especially in rural areas. Women and girls recycled old clothes and used
inappropriate materials which make them feel shy and isolated. (Depio and Ntale,2018). According to
Dhingra et al, (2010), girls do hide their menstrual rags and do not dry properly because they feel it’s
embarrassing to be menstruating. Another study carried out by (Sommer,2010) found that sanitary products
are not washed or dried properly because the girls hide them under the beds and hidden cornersor fear of

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others noticing them and fear for curses, so they end up using these damp materials which are not dried
hence affecting their health. These studies identified the perceptions on menstruation but did not highlight
what should be done to break and end the perceptions therefore this study intended to find out what should
be done to end the perceptions.
B. Socio-demographic factors affecting menstrual hygiene Management
 Age
A study carried out in Entebbe among four secondary schools reported that the mean age for female
students was 15.6 years. However, both boys and girls participated in the study, and yet this study involved
only girls because the researcher assumed they had better information than boys. (Miiro et al., 2018). In a
study carried out in India, a large proportion of 58.7% of the study population was in the age group of 14 -
15 years, followed by 32.4% in the age group of 12 - 13 years andthe majority attained menarche at the age
of (13-14years) (Shanbag et al, 2012). A study in Ghana reported that the majority attained their first
menstruation at the age of 13 years (Ameada et al., 2016)
 Economic status
Studies revealed that most adolescent girls lacked access to menstrual materials such as pads because of
financial constraints for example, in a study carried out by Boosey and colleagues in 2014 in Rukungiri
district, the researcher adopted a cross-sectional study and data collection tools included a self-administered
questionnaire, focused group discussion guide which this study adopted too. In this study, 61.6% lacked
disposal pads in the last 6 months since they couldn't afford them (Boosey et al., 2014).In addition, a study
carried out in Uganda (PMA2020, 2017) indicated that 35% of women had everything they needed to
manage their menstruation.In a study in Bangladesh on factory women workers, 60% of them were using
rags from the factory floor for menstrual materials and these are highly chemically charged and often freshly
dyed therefore infections.These women had no safe place to purchase the pads or where to change from or
dispose off the used material. (WSSCC, 2013).Girls in villages from poor families cannot get or afford
sanitary pads which should be changed around two or four times during menstruation. The majority of girls
use rags which are torn old blankets, or tissue of any kind, and the rags whereby these rags are washed with
inadequate and unsafe water even without soap, and used repeatedly (FRCRC, 2010). Parental and school
support of menstrual needs is limited, Girls' physical changes prompt boys and adults to target girls as ripe
for sexual activity including marriage. Girls admitted they don’t attend school during menstruation, due to
physical symptoms or inadequate sanitary materials. They described difficulties engaging in class, due to
fear of smelling and leakage, and subsequent teasing. Sanitary pads were valued butresource constraints
resulted in prolonged use causing leakage. Others improvised alternatives such as rags and grass, which
leak, cause soreness, and were perceived as harmful. (Mason et al., 2013).
 Practices
In a study carried out in Afghanistan, 51% of the girls did not take a bath for eight days after the onset of
their period and 84% of the girls never washed their genital areas. (Nagar et al, 2010).Students practices
revealed that one-quarter of the sample avoid bathing during their bleeding period. About two-thirds of the
students stated that they use 3-8 sanitary pads per day. First-year students significantly used fewer pads than
those at higher (gultie et al., 2014). In a study (Sharma et al, 2017) it was clear from the study findings that
the majority of the girls’ practices were unhygienic only 10 girls out of 64 girls were using boiled and dried
cloth as menstrual absorbent. A study in Pakistan also reported that nearly 50% of the participants reported
that they did not take baths during menstruation (Ali et al., 2010).

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C. Levels of knowledge on menstruation hygiene management
 Awareness on menstruation
Many studies revealed that many adolescent girls were not aware of menstruation prior to it and lacked
knowledge on menstrual hygiene such as a study carried out among urban and rural adolescent girls showed
that only 37.52% were aware of menstruation prior to attainment of menarche (Paria et al., 2014).Another
study carried out in Uganda revealed that most (66.9%) of the girls had poor knowledge about menstruation
(Boosey et al., 2014).
A study carried out across LMIC revealed that the majority (70%) of the girls had limited knowledge
and understanding of menstruation prior to reaching menarche (Tarimu et al., 2015). In a study carried out in
Saoner Nagpur district, only 36.95% of the girls were aware of menstruation before menarche further more
than three fourth of the girls in the study were not aware of the cause and the source of the bleeding. (Thakre
et al., 2011). Descriptive findings from a study in Pakistan showed that 50% of the girls lacked an
understanding of the origin of menstrual blood and those with prior knowledge of menarche had gained it
primarily through conversations with their mothers (Ali et al., 2010).
However, some studies reported that adolescent girls had good knowledge of menstrual hygiene. For
example, a study (Teklemariam et al, 2014) on the knowledge about menstrual hygiene management among
adolescent school girls in Amhara province, Ethiopia found that 90.7% of the respondents had a high level
of knowledge about menstrual hygiene management. A study carried out among high school girls in western
Ethiopia assessing their knowledge and practice found that 60.9% of the respondents had good knowledge
about menstrual hygiene management( Upashe et al.,2015).The majority (99.6%) of the students had heard
of menstruation and 57.9% had acquired this knowledge before attaining menarche. Shanbaget al., 2012).
 Source of information
Most studies showed mothers as the major source of information on menstruation as a study by Thakre
et al,( 2011) revealed that (71.33%)of the respondents reported that the major source of information about
menstruation for them was found to be their mothers.
Another study by Shanbaget et al, (2012) revealed that the majority ofthe knowledge was imparted to
them by the mother (55.1%), followed by friends (17.4%) and sister (14.2%).
A study by Oche et al, (2012) carried out among adolescent girls in an urban city in Nigeria also
revealed that the majority (56.6%) had gotten information from their mothers. This study agrees with the
above studies because it’s usually the mother who is close to the girl child.
However a study by Shah et al, (2019) carried out in Gambia showed that the majority (78%) had
gotten information from the teachers while another study in western Ethiopia by Upashe et al, (2015)
showed that 67.5% of the respondents got information on menstruation from friends.

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CHAPTER THREE
METHODOLOGY
A. Introduction
This chapter is made up of the methodology which the study adopted.It includes the study area, study
design, study population, inclusion and exclusion criteria, sample size determination, source of data,
sampling procedure, study variables, data collection tools, data collection techniques, data analysis, quality
control measures, ethical considerations limitations of the study and the plan for the dissemination.
B. Study area
The study was conducted in Kagongi Sub County. It is found in Kashari county, Mbarara district. It is
made up of 6 parishes and 63 villages that is Bwengure, kibingo, KyadahiNgango, Nsiika, and Ntura.It is
bordered by Rubindi sub-county.There is only one government secondary school and 2 private secondary
schools in this sub-county. It has an estimated population density of 230.3(Census,2002).
C. Study Design
A descriptive cross-sectional study was adopted that involved the use of both quantitative and qualitative
data collection methods. This design was used because of the limited time given to collect this data and
involved collecting data at that point in time. This design also focused on obtaining data on a representative
sample of the study population at a specific time.
D. Study population
This study included all adolescent girls (13-18 years) in S1 to S4 at St Paul's secondary school in Kagongi
Sub County at the time this study was conducted.
E. Selection Criteria
 Inclusion Criteria
Only adolescent girls aged 13-18 years and were within S1 to S4 in St. Paul's secondary school in
Kagongi Sub County, Mbarara district at the time of the study.
 Exclusion Criteria
All adolescent girls above the age bracket but were in s.1 to s4
Those adolescent girls who were in the reproductive age bracket but hadn’t started menstruating
F. Sample size determination

The study adopted the Kish and Leslie (1965) formula of sample size determination.
N = Z2 (P*Q)
e2
Where N was the minimum sample size,
Z= a constant score of 1.96 at a 95% confidence interval

p= estimate of the proportion of adolescent girls not having good menstrual hygiene practices was 90%
(according to UNICEF,2013).
q=1-p
e= Error allowed at a given confidence of 95% (0.05).
N = 1.962(0.9*0.1)
0.052
N = 138.29

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Sample size, n = N/1+ N*e2
n=138.29/1+138.29*0.052
n=102.7624
n=102 respondents
G. Source of data
 Primary data:
Collected from the adolescent girls studying attending St. Paul’s secondary school in Kagongi Sub
County.
 Secondary data:
Internet sources, articles, earlier studies literature, online publications, and journals.
H. Sampling procedure
In the selection of the participating adolescent girls, this study adopteda simple random sampling method.
This was to give all the girlsan equal chance to take part in this study.Adice was used to determine the class,
to begin with by the researcher.Then also wrote Yes or No on a piece of paper and put it in a box so every
girl who met the study inclusion picked a paper and everyone who picked yes participated in the study
I. Study variables
 Dependent variable
Menstrual hygiene management among rural adolescent girls in St. Paul’s secondary school in Kagongi
Sub County was measured by a binary procedure that is safe and unsafe menstrual practices.
 Independent variables
This study included independent factors: Social-cultural factors such as cultural beliefs, religion,
perception, and parental guidance,Socio-demographic factors such as age, disposal habits, level of
education, economic status of parents/guardians, personal hygiene, and Level of knowledge factors which
included awareness about menstruation hygiene, source of information of menstrual hygiene and awareness
on sanitary disposal.
J. Data collection methods.

The researcher used an interviewing method, a Focused group Discussions method, and a non-participant
observation method.
K. Interviewing method
The adolescent girls were subjected to the interview by answering questions in the questionnaire since the
researcher assumed this would be the easiest way to collect data in the shortest time given.
L. Focus Group discussion method

The adolescent girls were divided into six groups to get clear views on menstruation since it is a sensitive
issue. The questions from the Focused group guide were discussed.
M.Observation Method
The researcher moved around the school while seeing if the items in the observation checklist were
available or not.
All these methods enabled the researcher to collect data about the study variables.
N. Data collection tools

The study used a questionnaire, a Focused group guide, and an observation checklist.

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O. Questionnaire
The study used a structured and close-ended questionnaire which was answered by the adolescent girls,
the questionnaires were self-administered since most of the study population were students so they could
read and interpret questions on their own. This was used to collect quantitative data.
P. Focused Group Guide

This had questions that were discussed among the adolescent girls in their six groups.This was used to
collect qualitative data.
Q. Observation Checklist
An observation checklist was answered by the researcher and also complimented on the data. These tools
enabled the researcher to access the factors affecting menstrual hygiene management among adolescent rural
girls in Kagongi, Mbarara district.
R. Data Analysis and Presentation

Data collected using questionnaires wasprocessed and analyzed using Microsoft Excel and statistical
package for Social Sciences (SPSS version) software and results were presented in figures such as pie charts
and Tables.
To find an association between the dependent and independent variables, Cross Tabulation was done.
Statistical significance was assessed using the Chi-square test with a P-Value of less than 0.05 considered
statically significant.
Qualitative data was presented using phrases and quotes said by certain individuals during the focused
group discussions. This was used to avoid misinterpretation of the said responses.
S. Quality control measures

The questionnaire adopted was checked thoroughly before data collection by the Researcher to ensure the
validity of the content. It was also explained in detail before handling.
Pretesting of the questionnaire was done and the filled questionnaires were checked for Completeness.
Research assistants were trained to ensure that all questions were understood.
T. Ethical Considerations
An introduction letter was gotten from Clarke International University with clearance from the Research
committee. This letter was presented to the chairman LC III of Kagongi Sub County to seek permission to
carry out the study in the area.
An acceptance letter was obtained from the head teacher of St Paul’s secondary school and all the
respondents who participated in this study had to consent before the study was carried out. Codes were used
instead of the names of the participants who were interviewed to keep their identities a secret.
U. limitation
The area was geographically inaccessible since the school was located where roads are poor and there
were physical barriers since it was under a hill. The researcher used the available means of transport to
overcome the inaccessibility problem.
V. Plan for dissemination

The findings of this research were submitted to the research and education board of Clarke international
university in partial fulfillment of the award of a bachelor's degree in public health. The school that
participated in the study also received a copy of the findings for purposes of reference.

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CHAPTER FOUR
RESULTS
A. Introduction
Analysis was done using SPSS version 20 at univariate, and bivariate levels. Univariate analysis was
typically descriptive and bivariate analysis was done for statistical inference. Statistical comparisons and
relationships were examined for the variables of this study in correspondence to the demographic and
situational variables.
Demographic factors of adolescent girls (13-18years) influencing menstrual hygiene management

attending St .Paul’s secondary school, Kagongi sub-county, Mbarara district
Table 1: Univariate analysis of demographic characteristics of respondents (n=102)

Variable Frequency (n) Percentage (%)
Age groups
13-14 28 27.5
15-18 73 71.6
Class
S1 33 32.4
S2 28 27.5
S3 34 33.3
S4 7 6.9
Age of first menstruation
<12 5 4.9
12-14 64 62.7
15-18 33 32.4
Religion
Catholic 79 77.5
Protestant 21 20.5
Muslim 1 1.0
Others 1 1.0
Mother’s education
Illiterate 13 12.7
Primary 40 39.2
Secondary 40 39.2
Tertiary 9 8.9
Source of menstrual materials
Family 96 94.1
School 1 1.0
Self 2 2.0
Others 3 2.9
Type of sanitary towel used
Old cloth 3 2.9
Knickers 9 8.9
Disposal sanitary pads 76 74.5
Reusable pads 14 13.7
Times of bathing during menstruation

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Once 2 2.0
Twice 30 30.0
Thrice 50 50.0
More than three times 13 13.0
Times of change of sanitary towel
Once 2.0 2.0
Twice 28 27.5
Thrice 59 57.8
More than three times 13 12.7
How disposal of used pads
Throw in latrine 86 84.3
Burning 15 14.7
Throw in a rubbish pit 1 1.0
Source: primary data, 2019
From the table above, the majority of the respondents were in the age group of 15-18(71.6%).
Most of the respondents were in S3 (33.3%) followed by those in S1 (32.1%) and the least were in S4
(6.9%).
The findings on the age of first menstruation majority began in the age group of 12-14(62.7%).
The majority of the respondents were Catholics (77.5%) followed by protestants (20.6%). ha
Most of the mothers had reached secondary (39.2%) and primary level of education (39.2%) and while
(12.7%) are illiterate.
The study found that the majority of girls get menstrual materials from their family members (94.1%).
According to the findings on the type of sanitary material used it was found out the majority use
disposal sanitary pads (74.5%) followed by those who use reusable pads (13.7%).
The findings on times of bathing during menstruation showed that the majority(49%) bath three times a
day and followed by those who bathed twice a day(29.4%).The study also established that most(57.8%) of
girls change their menstrual material two times a day during menstruation.
A majority (84.3) of the girls dispose off the used menstrual material by throwing it in the latrine
followed by those who burn it (14.7%).
The discussions revealed that there is inadequate resources such as money to buy sanitary pads, water to
bathe during menstruation, and the school having one bathroom for all the girls.
“Am told to use clothes such as a piece of bed sheets by my mother because she cannot afford sanitary
pads.” One of the girls from Kyandahi reported.

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B. Socio-cultural factors influencing menstrual hygiene management
Table 2: showing univariate analysis of socio-cultural factors of respondents on menstruation (n=102)

Frequency(n) Percentage (%)
Anyone talks to you about menstruation before
experiencingit
Yes 86 84.3
No 16 15.7
Belief that pain during menstruation is unhealthy
Yes 31 30.4
No 71 69.6
Belief that it's harmful to run or dance during
menstruation
True 33 32.4
False 69 67.6
The used menstrual pads can attract witches if not
disposed off properly
True 79 77.5
False 23 22.5
Source: primary data, 2019
From Table 2 above, the majority (86/102) of the girls had been talked to prior to menstruation.
The study found out that (69.6 %) of the girls did not believe that the pain during
Menstruation is unhealthy while 30.4% believed it was unhealthy.
According to the findings on the belief that it is harmful to run or dance during menstruation, 67.6% of
the respondents said it was false and 32.4% said it was true.
Majority (79/102) of the respondents believed that the used menstrual pads can attract witches if not
disposed off properly.
From all the FGDs, many cultural beliefs were raised by adolescent girls.They include: A woman
should not cook while menstruating, a woman is considered unclean during menstruation, sanitary pads
make a woman infertile and women menstruating are not supposed to go in public.
“I was told by my mother to sleep on her bed and count the iron sheet ridges when I experienced my
first menstruation to count the days I will be experiencing” as explained by one of the girls.
It was also established from the discussions that there is gender discrimination, especially at school
because boys laugh at the girls when their uniforms get stained with blood and this makes the girls miss
school even. The discrimination was also attributed to tradition such as girls are not supposed to sit with
boys when menstruating.

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C. Proportion of respondents practicing safe menstrual hygiene management
Fig. 2: A pie chart showing the proportion of respondents practicing safe menstrual hygiene management
The figure above shows that half(53.5%) of the adolescent girls in St Paul’s secondary school, Kagongi
sub county, Mbarara district practiced unsafe menstrual hygiene management.
D. Knowledge factors affecting menstrual hygiene management
Table 3: Univariate analysis of knowledge factors affecting menstrual hygiene management

Frequency(n) Percentage (%)
Menstruation is a disease
True 5 4.9
False 96 94.1
Menstrual blood contains harmful substances
True 47 46.1
False 55 53.9
Used sanitary towels should be disposed off
True 82 80.4
False 19 18.6
Know about menstruation prior to it
Yes 94 92.2
No 8 7.8
Source of information
Mother 48 47.1
Family 9 8.8
Friends 41 40.2
School 4 3.9
Source: Primary data, 2019
From the table above, majority (94.1%) of the respondents did not believe that menstruation is a
disease. The study also found out that (92/102) of the adolescent girls did not believe that pregnant women
menstruate.
The findings also revealed that 47% of the respondents believed that menstrual blood contains harmful
substances while 55% did not believe.

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80.4% of the respondents said they used sanitary towels should be disposed off.
The study also established that 92.2% of the respondents knew about menstruation prior to experiencing
it and for most (47.1%) of them the source of information was the mother followed by friends (40.2%).
Most of the respondents in the FGDs agreed that there is inadequate information on how to handle
menstrual hygiene, especially at school. This was backed up by their reactions such as most of them don’t
know how to use sanitary pads and lack of guidance and support from both the parents and teachers at
school.
“I don’t know how to use the sanitary pad.” Said one of the girls from Munyonyi.
This contradicts the results from the table above which showed that most had good information on
MHM.
Table 4: Showing a cross-tabulation and chi-square analysis of demographic factors and menstrual hygiene
management.
Menstrual hygiene
management
Variable Safe Unsafe X2(df) P-value
Times of bathing during
menstruation
Once 1 1
Twice 8 19
Thrice 24 20 8.614(3
More than three times 10 3 ) 0.035*
Age of first menstruation
<12 2 2
12-14 38 21 15.689(
15-18 6 24 2) 0.001*
* significant at 0.05
From the table above, 24 respondents who bathed three times a day practiced safe menstrual hygiene,
and 20 of them practiced unsafe menstrual hygiene.
Since the p-value 0.035 <0.05 therefore there is an association between times of bathing during
menstruation and menstrual hygiene management.
Majority (38) who experienced their first menstruation (12-14) years practiced safe menstrual hygiene
management while 24 respondents who experienced their first menstruation (15-18) years practiced unsafe
menstrual hygiene management.
There is a statistically significant association between the age of first menstruation and menstrual
hygiene management since the P-value (0.001) is less than 0.05.

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Table 5: Showing a cross-tabulation and chi-square analysis of socio-cultural factors and menstrual hygiene
management
Menstrual hygiene
management
Any of the family talk about
menstruation prior to it
Yes 43 36
No 3 11 5.182(1) 0.023*
Harmful to a woman’s body if she
runs or dances during her period
True 8 19
False 38 28 5.987(1) 0.014*
From the table above,43 respondents who had one of their family members talk to them prior to
menstruation practiced safe menstrual hygiene management while 11 of the respondents who did not have
any of the family talk to them prior to menstruation practiced unsafe menstrual hygiene management.
There is an association between menstrual hygiene management and if anyone in the family talked
about menstruation prior to it. This is because the p-value (0.014) is less than 0.05.
Table 6: Showing a cross-tabulation and chi-square analysis of knowledge factors and menstrual hygiene
management
Menstrual hygiene
management
know about menstruation before
experiencing it
Yes 45 40
No 1 7 4.784(1) 0.029*
From the bivariate analysis between knowledge factors and menstrual hygiene management, it was
found that only one factor had a significant association which is having information about menstruation
before experiencing it.The p-value is 0.029 <0.05.

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CHAPTER FIVE
DISCUSSION
A. The proportion of adolescent girls practicing safe menstrual hygiene management

This study revealed that 46.5% ofadolescent girls practiced safe menstrual hygiene.This indicates that the
majority (53.5%) practiced unsafe menstrual hygiene. These results agree with another study carried out by
Nagar et al (2011) in Afghanistan which showed that 51% of adolescent girls did not take bath for eight days
after the onset of menstruation.
Another study (Sharma et al, 2017) indicated thatmajority of the girls’ practices were unhygienic only
10 girls out of 64 girls were using boiled and dried cloth as menstrual absorbent and also a study in Pakistan
reported that nearly 50% of the participants reported that they did not take baths during menstruation (Ali et
al., 2010).Other studies carried out by Dingra et al (2010) and Sommer,(2010) also revealed that most girls
did not wash their menstrual rags and also dry them properly for fear of being embarrassed and therefore
practiced unsafe practices.The low proportion of adolescent girls practicing safe menstrual hygiene in St
Paul's secondary school may be due to inadequate information and cultural beliefs about menstruation. This
can be addressed by incorporating awareness programs within schools such that the girls can know the safe
practices to carry out during menstruation. This can be done by the NGOs and the schools.
B. Socio-cultural factors influencing menstrual hygiene management

The study demonstrated that the majority (77.5%) of the respondents believed that menstrual pads can
attract witches if not disposed off properly.This is in line with a study carried out by Oche et al,(2012) which
revealed that people believed menstrual blood attracts witches who use it in black magic rituals if not
disposed off properly. This is because menstruation has been associated with myths and taboos in most rural
areas therefore there is a need to break these taboos by creating awareness on menstruation.
From the qualitative data, the adolescent girls reported thesocio–cultural beliefs associated with
menstruation which included: women being considered unclean, women not supposed to cook while
menstruating or go in public, and menstrual pads can make a woman infertile. This is in agreement with a
study carried out by Kumar et al, (2011) which found that menstruating girls' mobility is restricted because
of the existing taboos that they are unclean. Another study by House et al,(2012) also reported thatin some
cultures, women were told during their menstrual cycle they should not bath or will be infertile, touch a cow
or it will become infertile, look in a mirror or it will lose its brightness or touch a plant it will die. There is a
need to teach adolescent girls that these beliefs are not true.
There was a significant relationship between menstrual hygiene management and if any family member
talked to the adolescent girl prior to it (p-value 0.023). This showed that those adolescent girls whose family
members talked to them practiced safe menstrual hygiene.This is probably because most of the mothers were
educated therefore they were able to pass on information to their girls on how to handle menstrual hygiene
management.
The study also demonstrated a significant association between menstrual hygiene management and the belief
that it is harmful to a woman’s body to run or dance during her period (p-value0.014).This means that
adolescent girls who believed that it was harmful to run or dance during their period were less likely to
practice safe menstrual hygiene. This is because these adolescent girls might not bathe. After all, they are in
one place. There is a need for cultural leaders to be trained on menstruation so that they can perceive
menstruation as a normal process.

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C. Socio-demographic factors influencing menstrual hygiene management
The study revealed that the majority of the respondents (71.6%) were in the age group of 15-18 years.
This is in line with a study carried out by Shanbaget et al, (2012) which showed the majority (58.7%) of the
respondents were between 15-18years.The results were similar probably because they were all carried out
among adolescents in secondary schools.
Most of the mothers had reached secondary (39.2%) and primary (39.2%) levels of education. This is
probably because of the introduction of UPE in rural areas whereby at least one can go to the primary level.
This explained why most of the adolescent girls had some knowledge on menstrual hygiene.
The qualitative data demonstrated that the adolescent girls lacked the money to buy sanitary pads
therefore they are advised by their mothers to use bedsheets. These results were similar to a study carried out
by FRCRC, (2010) where girls in the villages could not afford sanitary pads but used rags. The results are
also in line with a study carried out in Uganda by PMO 2020, (2017) which found out only 36% of women
were able to afford to buy sanitary pads. This is probably attributed to the high levels of poverty in Kagongi
Sub County. These girls should be taught how to make reusable sanitary pads to cut the costs incurred while
purchasing disposal sanitary pads.
There was a significant association between menstrual hygiene management and the age of first
menstruation (p-value 0.001).The adolescent girls who experienced their menstruation in the age bracket
(12-14) years practiced safe menstrual hygiene while those who experienced between (15-18years) practiced
unsafe menstrual hygiene. This is probably because those who experienced their menstruation earlier were
well prepared by their guardians compared to those who experienced it at a later stage.
There was a statically significant association between menstrual hygiene management and the times of
bathing during menstruation. The adolescent girls who bathed more than two times a day practiced safe
menstrual hygiene.This is probably because they have information on how to handle menstruation.
D. Knowledge factors influencing menstrual hygiene management

The study revealed that the majority (94.1%) had a high level of knowledge of menstrual hygiene. This is
in line with a study carried out in Ethiopia by Teklemariam et al, (2014) and Upashe et al, (2015) which
showed that 90.7% of the respondents had high levels of knowledge on menstruation and 60.9% of the
respondents had good knowledge about menstrual hygiene management respectively. Another study also
revealed majority (99.6%) of the students had heard of menstruation ( Shanbaget al., 2012). These results
were contracting with a study carried out in Runkungiri district by Boosey, (2014) which demonstrated that
the majority (66.7%) had low levels of knowledge about menstruation. The results of the study are
contracting with those of Boosey may be because of the different literacy levels in the districts.
Most (92.2%) of the respondents had heard of menstruation prior to experiencing it. These results are in
agreement with a study carried out by Shanbaget, (2012) which showed majority 57% had heard of
menstruation before experiencing it. However, they were in disagreement with a study carried out in LMIC
showed that 70% had limited knowledge about menstruation prior to it. This is probably because that study
was carried out in many countries yet this study was carried out in only one district so the results cannot be
applied to a larger population. Another study carried out among urban and rural adolescent girls showed that
only 37.52% were aware of menstruation prior to the attainment of menarche (Paria et al., 2014).This is also
in line with a study in Pakistan that showed that 50% of the girls lacked an understanding of the origin of
menstrual blood (Ali et al., 2010).

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Most (47.1%) of the adolescent girls had received information about menstruation from their mothers.
These results are in line with a study carried out by Shanbaget, (2012) which showed that 55.1% had
received information from their mothers prior to menstruation,and also with a study carried out in Nagpur
district which showed a majority (71.33%) had gotten information from their mothers prior to menstruation.
This could be probably in African tradition it is mothers to nurture their girl child and probably the girls feel
comfortable talking to their mothers in such matters.
There was a significant relationship between menstrual hygiene management and knowing about
menstruation before experiencing it (p-value0.029).The adolescent girls who knew about menstruation
before experiencing it were more likely to practice safe menstrual hygiene compared to those who did not
know. This is because they have learnt practices and have information on safe menstrual hygiene
management.

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CHAPTER SIX
CONCLUSION
Menstruation is an important period in a woman’s life which shows that one can give birth. The study
concluded that53.5%of the respondents practiced unsafe menstrual hygiene in St .Paul’s secondary school,
Kagongi Sub County.
Most of the respondents were aged between 15-18(71.6%).It was established that the age of first
menstruation was significant.
The study found many cultural beliefs as discussed in the FGDs such as a woman shouldn't cook while
menstruating,a woman is considered unclean,sanitary pads make one infertile, and menstruating women
should stay at home.
The study revealed knowing about menstruation before experiencing was significant.
The majority (92.2%) of the adolescent girls had good knowledge of menstrual hygiene management.
A. Recommendations to the.
 MOH
The ministry should consider on improving on sexual and adolescent health, especially regarding
gender-based violence.This can be done through sensitization and creating awareness such that women and
girls are not denied their reproductive and cultural rights.This will create an environment where women are
comfortable.
 MOES
The Ministry of Education and Sports should incorporate menstrual hygiene management into the school
curriculum. This will increase information on menstruation and decrease stigmatization in schools especially
by the opposite sex hence improving the performance of girls in schools.
The ministry should train schools on how to make reusable sanitary pads to make them accessible to
every girl. This will reduce the money spent on sanitary pads by adolescent girls.
 The school
The teachers and senior women should be trained in MHM.These will provide accurate and correct
information to adolescent girls on how to manage menstruation. The school should construct girls' sanitary
facilities with washrooms and a private room for changing for the menstruating girls. Schools should also
construct incinerators where used menstrual pads can be disposed off safely. This will offer convenience and
privacy. The school should recruit more senior women who are motivated to teach the girls about menstrual
hygiene management.
 Community members
Community leaders should influence the breaking of traditions and taboos surrounding menstruation and
make it a culturally acceptable issue that women and men can discuss freely with their families. This will
help to break the restrictions that girls face due to lack of information and some beliefs, and taboos and
hence will be able to discuss menstrual hygiene freely and understand that menstruation is a transition stage,
therefore, is normal.

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The study recommends further studies on challenges adolescent girls face while maintaining menstrual
hygiene such as gender discrimination,inadequate menstrual materials, and lack of information on menstrual
hygiene management.

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REFERENCES
[1.] Ali TS, Rizvi SN. Menstrual knowledge and practices of female adolescents in urban Karachi,
Pakistan. J Adolesc. 2010;33: 531–541. [PubMed]
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[3.] Boosey, R., Prestwich, G. and Deave, T., 2014. Menstrual hygiene management amongst schoolgirls in
the Rukungiri district of Uganda and the impact on their education: a cross-sectional study. The Pan
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[4.] Dhingra R, Kumar A. Knowledge and practices related to menstruation among tribal (Gujjar)
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Schools.http://www.unicef.org/media/files/raisingcleanhands_2010.pdf (accessed on June 2019)
[5.] Gultie, T., Hailu, D. and Workineh, Y., 2014. Age of menarche and knowledge about menstrual
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health care workers & school teachers. PloS one, 9(9), p.e108644..
[6.] House, S., Mahon, T. and Cavill, S., 2012. Menstrual hygiene matters. London: WaterAid.
[7.] Kumar, A. and Srivastava, K., 2011. Cultural and social practices regarding
menstruation among adolescent girls. Social work in public health, 26(6), pp.594-604.
[8.] McMahon SA, Winch PJ, Caruso BA, et al. ‘The girl with her period is the one to hang her head’.
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2011;11:7. [PMC free article] [PubMed].
[9.] Mason L, Nyothach E, Alexander K, Odhiambo FO, Eleveld A, Vulule J, Rheingans R, Laserson KF,
Mohammed A, Phillips-Howard PA. ‘We keep it secret so no one should know’–A qualitative study to
explore young schoolgirls’ attitudes and experiences with menstruation in rural Western Kenya. PloS
one. 2013 Nov 14;8(11):e79132.
[10.] Mudey AB, Keshwani N, Mudey GA, Goyal RC. A cross-sectional study on the awareness regarding
safe and hygienic practices amongst school-going adolescent girls in the rural areas of Wardha district.
Global Journal of Health Science 2010; 2(2):225-231
[11.] MoES and MoH Uganda .2004 .schools health policy
[12.] Miiro, G., Rutakumwa, R., Nakiyingi-Miiro, J., Nakuya, K., Musoke, S., Namakula, J., Francis, S.,
Torondel, B., Gibson, L.J., Ross, D.A. and Weiss, H.A., 2018. Menstrual health and school
absenteeism among adolescent girls in Uganda (MENISCUS): a feasibility study. BMC
Women’sHealth, 18(1), p.4.
[13.] Nagar, S. and Aimol, K.R., 2010. Knowledge of adolescent girls regarding menstruation in tribal areas
of Meghalaya. Studies of Tribes and Tribals, 8(1), pp.27-30.
[14.] Oche, M.O., Umar, A.S., Gana, G.J. and Ango, J.T., 2012. Menstrual health: the unmet needs of
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[15.] Paria, B., Bhattacharyya, A. and Das, S., 2014. A comparative study on menstrual hygiene among
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[16.] Shah, V., Nabwera, H.M., Sosseh, F., Jallow, Y., Comma, E., Keita, O. and Torondel, B., 2019. A rite
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[19.] Shanbhag, D., Shilpa, R., D'Souza, N., Josephine, P., Singh, J. and Goud, B.R., 2012. Perceptions
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impact of girls' experiences of menstruation and schooling in Tanzania. Journal of Adolescence, 33(4),
pp.521-529.
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[23.] Tamiru, S., Mamo, K., Acidria, P., Mushi, R., Ali, C.S. and Ndebele, L., 2015. Towards a sustainable
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[24.] Upashe, S.P., Tekelab, T. and Mekonnen, J., 2015. Assessment of knowledge and practice of
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[25.] UNICEF.,2012.Girls today, women tomorrow: Knowledge, practice, attitudes, and norms on menstrual
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[26.] UNICEF .,2012.Columbia University WASH in schools Empowers Girls' Education Proceeding of
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[29.] https://www.pma2020.org/sites/default/files/UGR5-MHM%20brief-v2-2017-09-08_0.pdf
[30.] WATERAID.,2009.Is Menstrual Hygiene and Management an Issue for adolescent school Girls?
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secondary school adolescents in northwest Ethiopia. BMC Women’sHealth, 9(1), p.29.

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QUESTIONNAIRE
Dear Respondent, I am Bankunda Paula a student of Clarke International University pursuing a
Bachelor of Science in Public Health.As a requirement for the course, a research study is supposed to be
carried out to fulfill the course. You are invited to participate in the study titled the factors influencing
menstrual hygiene management among rural adolescent girls in St Paul’s secondary school in Kagongi Sub
County, Mbarara District. The information you provide will be confidential and strictly used for research
purposes only. Your time and cooperation will be highly appreciated.
Socio-demographic factors
QN 1 .How old are you?
<12 years
12-14 years
15-18years
>18 years
QN 2. Which class are you in?..........
QN3.At what age did you experience your first menstruation

<12years
12-14 years
15-18years
>18years

ISSN No:-2456-2165
QN 4.What is your religion
Catholic
Protestant
Muslim
Others specify......
QN 5. Mother’s level of education

Illiterate
Primary
Secondary
Tertiary
QN 6. Who provides menstrual materials for you?

Family
School
Self
Others specify........
QN.7 What type of sanitary towels do you use

Old cloth
Knickers
Disposal sanitary pads
Reusable pads
Toilet paper
Others specify
QN.8 Does the school have a separate bathroom with water and soap for when menstruating
Yes
No
If yes, how many times do you bath during menstruation?

Once
Twice
Thrice
More than three times
QN.9 how many times do you change the sanitary towel in a day during menstruation
Once
Twice
Thrice
More than three times

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QN.10 How do you dispose off the used menstrual pads
Throw in latrine
Burning
Throw in rubbish pit
Wash and re use
Others specify.......
Socio-cultural factors
QN .11 Did any of your parents/family talk to you about menstruation before you experienced it
Yes
No
If yes, specify who she/he was........
QN .12 Do you believe that pain during menstruation means that one is unhealthy
Yes
No
QN.13.It is harmful to a woman's body if she runs or dances during her period
True
False
QN.14 The used menstrual pads can attract witches if not disposed off properly
True
False
QN.15 In the following table answer Agree, Disagree and Not sure
AGREE DISAGREE NOT SURE
Women during menstruation should not bath or will be
infertile
During menstruation you aren't supposed to touch others
Women in menstruation are unclean
The menstrual cloth shouldn't be seen by others
The knowledge level factors
QN .16 Menstruation is a disease
True
False
QN.17 Menstrual blood contains harmful substances

True
False
QN.18 Used sanitary towels should be disposed off
True
False
QN.19 Did you know about menstruation before you experienced it
Yes
No
If yes, where did you first hear it from?
Mother
Family
Friends
School
Others specify

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APPENDIX II: FOCUS GROUP DISCUSSIONS GUIDE

What are the cultural and traditional beliefs you know about menstrual hygiene management?
How do friends react to you during menstruation?
What other major factors do you think influence menstrual hygiene and management?
Have you heard about menstrual hygiene management?
Are u able to access menstrual cloth such as pads if not why?

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APPENDIX III: OBSERVATION CHECKLIST

1. Number of latrines designated for girls...............................................................................
…............................................................................................................................................
…...............................................................................................................................................
2. Presence of buckets.........................................................................................................
….............................................................................................................................................
….............................................................................................................................................
3. Waste disposal pit or incinerator..............................................................................................
…..................................................................................................................................................
…..................................................................................................................................................
3. Tap water in the school near the girls’ latrines........................................................................
…..................................................................................................................................................
…................................................................................................................................................
4. Daily cleaning schedule for girl's latrines..............................................................................
…...............................................................................................................................................
…..................................................................................................................................................
5. An office in the school with sanitary materials for girls..........................................................
….................................................................................................................................................
…..................................................................................................................................................

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Volume 8, Issue 4, April 2023 International Journal of Innovative Science and Research Technology

Factors Influencing Rural Teenage Girls’

BANKUNDA PAULA, Student

AN UNDERGRADUATE DISSERTATION SUBMITTED IN PARTIAL COMPLETION OF THE

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C. Statement of the problem

D. Objectives of the study

 The research questions were;

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Socio demographic factors

Menstrual hygiene management

Knowledge level factors on

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A. Socio-culturalFactorsAffecting menstrual hygiene management

 Cultural Beliefs and Taboos

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B. Socio-demographic factors affecting menstrual hygiene Management

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F. Sample size determination

Where N was the minimum sample size,

Z= a constant score of 1.96 at a 95% confidence interval

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J. Data collection methods.

L. Focus Group discussion method

N. Data collection tools

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P. Focused Group Guide

R. Data Analysis and Presentation

S. Quality control measures

V. Plan for dissemination

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Demographic factors of adolescent girls (13-18years) influencing menstrual hygiene management

Table 1: Univariate analysis of demographic characteristics of respondents (n=102)

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B. Socio-cultural factors influencing menstrual hygiene management

Table 2: showing univariate analysis of socio-cultural factors of respondents on menstruation (n=102)

Menstruation is unhealthy while 30.4% believed it was unhealthy.

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D. Knowledge factors affecting menstrual hygiene management

Table 3: Univariate analysis of knowledge factors affecting menstrual hygiene management

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A. The proportion of adolescent girls practicing safe menstrual hygiene management

B. Socio-cultural factors influencing menstrual hygiene management

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D. Knowledge factors influencing menstrual hygiene management

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QN 2. Which class are you in?..........

QN3.At what age did you experience your first menstruation

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QN 5. Mother’s level of education

QN 6. Who provides menstrual materials for you?