Background: Menstrual hygiene management (MHM) and practices by adolescent females of low and middle-income countries (LMICs) are a severe public health issue. The current systematic review and meta-analysis aimed to estimate the pooled proportion of the hygiene practices, menstrual problems with their associated factors, and the effectiveness of educational interventions on menstrual hygiene among adolescent school girls in India.
Methods: PRISMA checklist and PICO guidelines were used to screen the scientific literature from 2011 to 2021. The Newcastle-Ottawa Scale was used to assess the quality of studies. Four themes were developed for data analysis, including hygiene practices, type of absorbent used, menstruation associated morbidities and interventions performed regarding menstruation. Eighty-four relevant studies were included and a meta-analysis, including subgroup analysis, was performed.
Results: Pooled data revealed a statistically significant increase in sanitary pad usage "(SMD = 48.83, 95% CI = 41.38-57.62, p < 0.00001)" and increased perineum practices during menstruation "(SMD = 55.77, 95% CI = 44.27-70.26, p < 0.00001)". Results also reported that most prevalent disorders are dysmenorrhea "(SMD = 60.24, 95% CI = 50.41-70.06, p < 0.0001)", Pre-menstrual symptoms "(SMD = 62.67, 95% CI = 46.83-78.50, p < 0.00001)", Oligomenorrhea "(SMD = 23.57, CI = 18.05-29.10, p < 0.00001), Menorrhagia "(SMD = 25.67, CI = 3.86-47.47, p < 0.00001)", PCOS "(SMD = 5.50, CI = 0.60-10.40, p < 0.00001)", and Polymenorrhea "(SMD = 4.90, CI = 1.87-12.81, p < 0.0001)". A statistically significant improvement in knowledge "(SMD = 2.06, 95% CI = 0.75-3.36, p < 0.00001)" and practice "(SMD = 1.26, 95% CI = 0.13-2.65, p < 0.00001)" on menstruation was observed. Infections of the reproductive system and their repercussions can be avoided with better awareness and safe menstruation practices.
Conclusions: Learning about menstrual hygiene and health is essential for adolescent girls' health education to continue working and maintaining hygienic habits. Infections of the reproductive system and their repercussions can be avoided with better awareness and safe menstruation practices.
Keywords: Abnormalities; Association; Disease; Hygiene; Intervention; Menstrual hygiene management; Menstruation; Morbidity.
Menstrual hygiene management (MHM) and practices by adolescent females of low and middle-income countries (LMICs) are severe problems for girls, parents, society, and policymakers. Menstrual-related problems are widespread among adolescent girls in India. Different menstrual abnormalities are found in different populations, suggesting socio-cultural and regional variation. Menstrual abnormalities and disorders are frequently linked to physical, mental, social, psychological, and reproductive issues, affecting adolescents' daily lives and their families lives by various psychosocial problems such as anxiety. We have the intention to compile, summarise, and critically analyse peer-reviewed and published scientific evidence from 2011 to 2021 on menstrual hygiene management methods used, most typical menstrual morbidities and their associated factors among Indian adolescent girls, and to evaluate the evidence for existing interventions like educational programs and absorbent distribution. Program planners and policymakers could use the findings of this study to build relevant initiatives to incorporate safe MHM in the country so that interventions can be designed taking into account the current needs of adolescent girls to reduce menstrual morbidities and improve their quality of life. A statistically significant improvement in knowledge and practice on menstruation was observed. Learning about menstrual hygiene and health is an essential aspect of adolescent girls’ health education to continue working and maintaining hygienic habits. Infections of the reproductive system and their repercussions can be avoided with better awareness and safe menstruation practices.
© 2022. The Author(s).