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vanEijk, Anna 
ORCID: https://orcid.org/0000-0003-1635-1289, Sivakami, M, Thakkar, Mamita Bora, Bauman, Ashley, Laserson, Kayla F, Coates, Susanne and Phillips-Howard, Penelope ORCID: https://orcid.org/0000-0003-1018-116X
(2016)
'Menstrual hygiene management among adolescent girls in India: a systematic review and meta-analysis'. BMJ Open, Vol 6, Issue 3, e010290.
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BMJ_Open_6_e010290_Menstrual hygiene management.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
Objectives
To assess the status of menstrual hygiene management (MHM) among adolescent girls in India to determine unmet needs.
Design
Systematic review and meta-analysis. We searched PubMed, The Global Health Database, Google Scholar and references for studies published from 2000 to September 2015 on girls’ MHM.
Setting
India.
Participants
Adolescent girls.
Outcome measures
Information on menarche awareness, type of absorbent used, disposal, hygiene, restrictions and school absenteeism was extracted from eligible materials; a quality score was applied. Meta-analysis was used to estimate pooled prevalence (PP), and meta-regression to examine the effect of setting, region and time.
Results
Data from 138 studies involving 193 subpopulations and 97 070 girls were extracted. In 88 studies, half of the girls reported being informed prior to menarche (PP 48%, 95% CI 43% to 53%, I2 98.6%). Commercial pad use was more common among urban (PP 67%, 57% to 76%, I2 99.3%, n=38) than rural girls (PP 32%, 25% to 38%, I2 98.6%, n=56, p<0.0001), with use increasing over time (p<0.0001). Inappropriate disposal was common (PP 23%, 16% to 31%, I2 99.0%, n=34). Menstruating girls experienced many restrictions, especially for religious activities (PP 0.77, 0.71 to 0.83, I2 99.1%, n=67). A quarter (PP 24%, 19% to 30%, I2 98.5%, n=64) reported missing school during periods. A lower prevalence of absenteeism was associated with higher commercial pad use in univariate (p=0.023) but not in multivariate analysis when adjusted for region (p=0.232, n=53). Approximately a third of girls changed their absorbents in school facilities (PP 37%, 29% to 46%, I2 97.8%, n=17). Half of the girls’ homes had a toilet (PP 51%, 36% to 67%, I2 99.4%, n=21). The quality of studies imposed limitations on analyses and the interpretation of results (mean score 3 on a scale of 0–7).
Conclusions
Strengthening of MHM programmes in India is needed. Education on awareness, access to hygienic absorbents and disposal of MHM items need to be addressed.
| Item Type: | Article |
|---|---|
| Subjects: | W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 85 Patients. Attitude and compliance WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WS Pediatrics > By Age Groups > WS 460 Adolescence (General) |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1136/bmjopen-2015-010290 |
| Depositing User: | Jessica Jones |
| Date Deposited: | 31 Mar 2016 15:19 |
| Last Modified: | 13 Sep 2019 14:16 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/5829 |
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