Dr. Kanika Gupta and Dr. Jasmine Pattanayak and Kirti Udayai

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MENSTRUATION: CELEBRATING VERACITY OR PRACTICING BIGOTRY

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“MENSTRUATION: CELEBRATING VERACITY OR PRACTICING BIGOTRY” Dr. Kanika Gupta International Institute of Health Management Research (IIHMR ) India

MENSTRUATION: CELEBRATING VERACITY OR PRACTICING BIGOTRY:

MENSTRUATION: CELEBRATING VERACITY OR PRACTICING BIGOTRY Dr. Kanika Gupta, Dr. Jasmine Pattanayak, Dr. Kirti Udayai ICOPH A-355

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Women’s health and issues Hygiene & Sanitation Menstruation Sustainable Development Goals (SDG) Objective of the study Methodology Findings Discussions Recommendations OUTLINE

WOMEN ISSUES GLOBALLY- WHO:

WOMEN ISSUES GLOBALLY- WHO Cancer Reproductive health Maternal health HIV Sexually Transmitted Diseases Violence against women Mental health Non-communicable diseases Being young Getting older

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Source:http :// unicef.in / Whatwedo /11/Eliminate-Open-Defecation HYGIENE STATUS

MENSTRUAL HYGIENE FACTS:

MENSTRUAL HYGIENE FACTS According to UNICEF study, “WASH in Schools Empowers Girls’ Education Proceedings of the Menstrual Hygiene Management in Schools Virtual Conference 2012”. Rajasthan In 2006, it was found that 56 per cent of girls in and out of school did not have any information about menstruation before reaching menarche. 75 per cent of girls were using cloths or rags to absorb their menstrual flow, while 27 per cent of girls out of school did not use any material at all. Uttar Pradesh 66 per cent of girls knew nothing about menstruation prior to menarche. 89 per cent of girls use cloths or rags and 11 per cent of girls share used menstrual cloths and rags with others.

BRITISH MEDICAL JOURNAL March, 2016:

BRITISH MEDICAL JOURNAL March, 2016 The objective was to assess the status of menstrual hygiene management (MHM) among adolescent girls in India to determine unmet needs . Major results Data (Meta analysis) from 138 studies involving 193 subpopulations and 97,070 girls were extracted. In 88 studies, 48% of the girls reported being informed prior to menarche. Menstruating girls experienced many restrictions, especially for religious activities 77% of the girls followed restriction. A quarter (PP 24%, n=64 ) reported missing school during periods. Approximately a third of girls changed their absorbents in school facilities (PP 37%, n=17 ). Source: http://bmjopen.bmj.com/content/6/3/e010290.short?rss=1

MENSTRUATION & NUTRITION:

MENSTRUATION & NUTRITION The study, “ Prevalence of Anemia among Adolescent Girls Studying in Selected Schools” revealed anemia to be a major health problem among the adolescent girls in rural areas. The prevalence of anemia was more among girls who were more than 14 years of age. The prevalence of anemia was high among girls who had attained menarche. There was a higher prevalence of anemia among girls who belonged to the lower socio-economic groups. There was association between prevalence of anemia with selected demographic variable. i.e. among adolescents 14 year age girls had highest prevalence of anemia [42.5 %]. 87.5 % of prevalence belonged to girls who had regular menstruation and 61.25% of prevalence was in adolescent girls who had bleeding for 5 days. N utritional anemia in adolescent girls attributes to the high maternal mortality rate, the high incidence of low birth weight babies, high perinatal mortality. Source: Volume 3 Issue 8, August 2014 , Paper ID: 02015611 www.ijsr.net

CULTURAL MYTHS :

CULTURAL MYTHS In the Hindu faith, women are prohibited from participating in normal life while menstruating. She must be “purified” before she is allowed to return to her family and day to day chores of her life.  Not entering the “puja” room, not entering the kitchen. Menstruating girls and women are also restricted from offering prayers and touching holy books. The underlying basis for this myth is also the cultural beliefs of impurity associated with menstruation. It is believed that menstruating women are unhygienic and unclean and hence the food they prepare or handle can get contaminated. According to a study, participating women also reported that during menstruation the body emits some specific smell or ray, which turns preserved food bad. And, therefore, they are not allowed to touch sour foods like pickles . Bathing can cause infertility Women in Japan are not hired as Sushi chefs as it leads to imbalance in taste. Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408698/

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Outcome of cultural myths: G irls in many less economically developed countries drop out of school when they begin menstruating. Poor protection and inadequate washing facilities may increases susceptibility to infection. Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408698| http://nepalwash.blogspot.in/2015/05/menstrual-hygiene-day-2015-time-to.html

RATIONALE & SIGNIFICANCE:

RATIONALE & SIGNIFICANCE

DEFINITION:

DEFINITION M enstrual hygiene management (MHM) Women and adolescent girls use a clean material to absorb or collect menstrual blood, and this material can be changed in privacy as often as necessary for the duration of menstruation. MHM also includes using soap and water for washing the body as required, and having access to facilities to dispose of used menstrual management materials . Source: WHO-UNICEF Joint Monitoring Programme, ‘Consultation on Draft Long List of Goal, Target and Indicator Options for Future Global Monitoring of Water, Sanitation and Hygiene’, 2012.

OBJECTIVE:

OBJECTIVE The objective of the study was to assess the knowledge and practices related to menstruation among adolescent girls of Government Girls S enior S econdary School, Haryana, India.

SPECIFIC OBJECTIVES:

SPECIFIC OBJECTIVES To assess the knowledge of the adolescent girls in relation to menstruation. To assess the hygiene practices during the menstrual phase among adolescent girls. To find any restrictions followed by the adolescent girls during menstrual phase. To analyze the overall nutritional status with their daily food intake.

METHODOLOGY:

METHODOLOGY Study design : Cross sectional study Study duration : April- May 2016 Study Site : Government Girls Senior Secondary School, Haryana, India Sample size : 210 adolescent girls in the age group of 12-18 years who have attained puberty . Sampling method : A simple random sampling was implemented to select the respondents Tool : A questionnaire was prepared in Hindi language. The informed consent was taken from the each participant before the study was conducted . Ethical clearance : Taken from research committee of the institute. Analysis : Analysis was done using Microsoft Office Excel 365 and SPSS (version 22)

FINDINGS:

FINDINGS

MENSTRUAL PATTERN :

MENSTRUAL PATTERN Mean age of Respondent : 15.05 ( SD= 1.613) Mean age at menarche: 12.79 ( SD=1.23 ) Pattern Percentages(%) Age at which menarche attained <12 12-14 >14   11% 80% 9% Duration of blood flow in days <2 2-5 >5   0% 69% 31% Length of cycle in days <28 28-32 >32   21% 59% 20%

Knowledge About Menstruation:

Knowledge About Menstruation Literacy of mothers Knowledge about menstruation before puberty Source of information Cause of bleeding Organ of bleeding

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Fig 1: Literacy of Mother

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Fig 2: Knowledge about menstruation before puberty

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Fig 3: Source of information

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Fig 4: Cause of bleeding

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Fig 5: Organ of bleeding

Hygiene Practices:

Hygiene Practices Type of absorbent used Frequency of washing genitals Measures used for washing genitals Bathing during menstruation Condition of toilet at school Provision of pad at school Change of pad during school hours

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Fig 6: Type of Absorbent Used

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Fig 7: Frequency Of Washing Genitals

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Fig 8: Measures Used For Washing Genitals

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Fig 9: Bathing During Menstruation

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Fig 10: Condition Of Toilet At School

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Fig 11: Provision of Absorbent at School

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Fig 12: Change Of Absorbent At School

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Fig 13: Types of restrictions practiced

Nutritional Assessment:

Nutritional Assessment Out of 210 respondents, 100% of the girls were consuming a diet which lacked the required amount of calories as per the age group. 87% of the respondents consumed less than 50% of the required calorie intake.

Sanitary dignity campaign helps South African girls stay in school :

Sanitary dignity campaign helps South African girls stay in school The   Serithi Campaign in Pretoria, South Africa, a project helping girls who face absenteeism because they’re unequipped for periods, will provide the menstrual cups to students at Tshegofatsong Special School in Pretoria. In South Africa, an estimated 7 million girls between the age of 13 and 19 miss up to a week of school every month because of a lack of sanitary products. High rates of absenteeism also lead some girls to drop out completely. Source: http://www.sanews.gov.za/south-africa/sanitary-dignity-campaign-changes-schoolgirls-lives MENSTRUATION CAMPAIGNS

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Mina, which means “mine” in Zulu Source: https://www.globalcitizen.org/en/content/menstrual-cup-campaign-south-africa-girls-school/

Menstrual Man: Arunachalam Muruganantham :

Menstrual Man: Arunachalam Muruganantham Muruganantham created a low-cost machine to address menstrual hygiene challenges for rural women on the subcontinent. Women can then buy these machines to make and sell the pads as alternative sources of income. Sanitary napkins from international companies sold in Indian stores cost around $1.50 (USD) for a pack of eight. The pads from Muruganantham's machine sell for only 25 cents for the same amount. The machine has been a huge success. There are now more than 1,300 machines across India and it’s been exported to 17 additional countries.

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The Journey from cloth to 'MY Pad' Goonj, did the analysis and found, the problem has three critical dimensions. The Triple A’s of menstruation Access , A ffordability and Awareness to deal with .

RECOMMENDATIONS:

RECOMMENDATIONS Introduction of “Puberty education program” focusing on the hormonal changes, education about good hygiene practices, knowledge and clarification of doubts related with menstruation among girls in school at the age of puberty by health care professionals. Improvement of the conditions of the toilet in school and modification in the behavior regarding the use of toilet. An education program in school for both students & parents with respect to importance of a well-nourished diet for the adolescent age group. As part of CSR activities, private firms can help in introducing economically sound absorbents for the weaker sections.

THANK YOU:

THANK YOU

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