The research paper written by Dr. Farhana Salim, Assistant Professor at the Department of Community Medicine, Shaheed Monsur Ali Medical College, Dhaka and Dr. Nasreen Begum, Assistant Professor of Community Medicine at Northern International Medical College, Dhaka revealed that half of the respondent girls in the research got information about menstruation from their family members. Economic constraints and access were other causes of not using sanitary napkins: 36.7% of the respondents said they did not use sanitary napkins because it was too costly; 8.8% did not use sanitary napkins because they were not available in their area. As a result, the girls suffered major health problems due to poor sanitary practices during menstruation, and also lost significant numbers of school hours due to poor hygiene management during menstruation. Poor facilities in school were the main causes for skipping the school. Only 11% of the schools had separate toilets for girls with water facilities, and only 3% of the schools had facilities to dispose of sanitary napkins. Not surprisingly, even among the girls using sanitary napkins, the majority of them (68.7%) could not change napkins at school due to lack of privacy and proper sanitary facilities; 45% complained about lack of water.

Girls buying sanitary napkins on menstrual hygiene day on 28 May 2016

Poor menstrual hygienic practices were found despite good knowledge among girls about issues like minimum age at marriage (18 years, 85.8%), minimum age of child birth (20 years, 89%) and the need for extra nutrition during pregnancy (99%). Implementation of school health programmes for adolescents should emphasize menstrual hygiene management. In parallel, the education ministry of Bangladesh recently issued a circular asking schools to improve and maintain the sanitation of school toilets. "The circular emphasizes the menstrual health and hygiene of female students to prevent absenteeism during menstruation," says Dr Farhana Salim, lead author of the article. "The toilets should be gender friendly; there must be proper systems of disposal of sanitary pads; sanitary napkins must be available (if needed, on payment) in school; a female teacher should be appointed to make students aware of menstrual health and hygiene; and schools should be visited regularly to identify problems regarding availability of water, cleanliness and other issues."

The research was conducted with 438 adolescent girls in the age group of 15 to 20 from 15 schools in the Kishoreganj, Lakshmipur, Barguna and Sirajganj districts of Bangladesh to assess the hygienic practices during menstruation among adolescent school girls in selected secondary rural schools. The article "Hygienic practices during menstruation among adolescent school girls" appears in the latest issue (Vol. 7 No 2, 2016) of Northern International Medical College Journal, pages 139-142. The article is made available online via Bangladesh Journals Online (BanglaJOL) platform, which is part of the JOL Project supported by INASP.

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