Abstract
Introduction
Menstruation hygiene management (MHM) among girls aged 13 to 15 years remains a public health concern in some parts of the world (1), including Cambodia (2). Lack of menstrual materials and limited school hygiene facilities makes girls struggle to come to school during their menstruation and may result in school absence or poor school performance and it could inhibit their daily living (3). To date, there are limited studies in Cambodia to explain how MHM may have impacted girls' physical, mental, and school performance. This study aimed to explore the experience of school girls aged 13-15 with menstruation hygiene management and how it impacts their daily performance and school activities.
Methods
A qualitative method was conducted in schools in Samraong Tong District in Kampong Speu Province The study included Focus group discussion (FGD) and in-depth interview (IDI). FGDs were conducted among girls aged 13 to 15 years old to explore their perceptions and knowledge of menstruation and their experience with their MHM. The IDIs were conducted with school principals, teachers, and mothers to explore their perceptions related to MHM, the support, and the challenges they encountered to support girls during menstruation. IDIs were also conducted with selected girls to explore their life experiences related to MHM. 4 FGDs with 32 girls, and 30 IDIs with 2 school principals, 6 teachers, 6 mothers, and 16 girls were conducted for this study.
Results
The study found that young girls in rural Cambodia experienced challenges with their MHM. Those challenges were: (a) a limited understanding of menstruation. Most girls did not understand what is menstruation, where it comes from, and why it happens. They know that having menstruation signifies that they are reaching adulthood; they considered that menstruation blood is poisonous; and they regarded period time as the time when their physical and mental health is down. (b) the girl had limited access to information about menstruation with unpreparedness for menarche. Girls usually learned about menstruation through their mothers when they were reaching menstruation time. Usually, the mothers would teach girls how to take care of themselves and what activities they should restrict during menstruation. Girls got information about menstruation when they reached the aged of 13 when they will study biology courses including the topic of menstruation. (c) unfavorable menstrual hygiene management with lack of school hygiene facilities, such as lack of separate toilets for boys and girls, poor hygiene condition of toilet facilities, lack of bins for disposal of sanitary pads, and lack of clean water is a major obstacle for MHM at schools. Factors described above (d) impact of MHM on girls’ health and school performance. Girls experience physical health such as itch in the genital areas, pain, cramp, and feeling fear and distress due to difficulties to change their sanitary napkins at school, they usually keep their period time as a secret to their friends and peers, and most girls would ask for absent from school during the menstruation
Conclusion
To ensure MHM for girls during menstruation is a priority for schools and families in order to support the physical and mental well-being of girls and to ensure their potential performance. Based on the finding it is recommended as follow:
- Education about menstruation for girls especially at the pre-menstruation age is crucial, education should be from mothers and schools. Mother-daughter communication should be encouraged and mothers should be given accurate information about menstruation to communicate with their daughters. Education from school is very crucial for girls in rural areas whose mothers may also have limited access to information. Schools should especially rearrange of the content about health in the book, and they should start teaching girls from primary school before they reach menstruation.
- Supporting from school facilities is also needed to be considered by separating toilets for the boys and the girls, improving the hygiene of the facilities, and water supply, and placing trash bins in toilets for schoolgirls to manage their menstruation properly. Female teachers should be assigned to provide counseling and support to young girls during their menstruation.