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Factors influencing hygienic practices during menses among girls from South India--a cross sectional study.

Introduction

Menstruation is a natural phenomenon among matured females who experience shedding of blood for 1-7 days every month from the age of maturity until menopause [1]. Various aspects such as physiology, pathology and psychology of menstruation have been found to associate with health and wellbeing of women; hence it is an important issue concerning morbidity and mortality of female population. On the other hand, hygiene-related practices during menstruation are of considerable importance for reproductive health, poor practices increase vulnerability to reproductive tract Infections [2].

Good hygiene, such as use of sanitary pads and adequate washing of the genital area, is essential during menstruation. Women and girls of reproductive age need access to clean and soft absorbent sanitary products, which in the long run protect their health [34]. Menstrual hygiene and management is an issue that is insufficiently acknowledged and has not received adequate attention.

Adolescent girls constitute a vulnerable group not only with respect to their social status but also in relation to health. Menstruation is regarded as unclean or dirty in Indian society. Although it is a natural process, is linked with several misconceptions and practices which sometimes results into adverse health outcomes. Never the less, reaction to menstruation depends upon awareness and knowledge about the subject. The manner in which a girl learns about menstruation and its associated changes may have an impact on her attitude to the event of menarche [2].

Primarily poor personal hygiene and unsafe sanitary conditions result in gynecological problems [5]. Infections due to lack of hygiene during menstruation are often reported [6-7]. Repeated use of unclean napkins or the improperly dried cloth napkins before its reuse results in harboring of micro-organisms causing vaginal infections [8]. Very few studies have included the detailed aspects of menstrual practices prevalent among young girls. It was therefore considered relevant to investigate menstrual related practices among females aged 15-22 years from South India.

Methods and materials

The study was conducted during the academic years 2009-2010. A cross-sectional study was carried out on 350 students recruited from educational institutions offering higher secondary education, pre-university and under graduate courses in the urban areas from a major city in South India. A purposeful sampling was done to select girls who were unmarried and in the age group of 15-22 years. Also those who volunteered to give complete and correct information were included for the study. The selected women were explained about the protocol and purpose of the study and were requested to complete the questionnaires to elicit information relating to demographic features, menarche age and menstrual hygiene and practices.

The demographic information included family details relating to family size, type, parent's education, occupation, house type, and possession of costly goods like vehicles, computer, TV, DVD, refrigerator, phones etc., and the information was used to derive the socio economic status. The chronological age and age at menarche was also elicited.

Menstrual hygiene questionnaire included quarries about type of napkins used, storage place, usage of napkins such as clean and unclean napkins, frequency of change and cleaning. Information about personal hygiene included, washing and bathing during menses, practice of wearing stained clothes etc. The research protocol was approved by the Ethical Committee, University of Mysore.

Statistical analysis

The data was analyzed using SPSS for Windows version 16. Descriptive statistics was used to determine mean and percentages. The categorical data were analyzed using Chi-sq or Fisher's exact test and regression analysis.

Results

Table 1 presents the demographic details of the selected girls. It is evident that the mean age of the subjects studied was 18.6 [+ or -] 1.7 years, while the age range was 15-22 years. Among these 42.6 % girls were in the age group of 15-19 years, and others were aged 19-22 years (57.4%). Age at menarche in the selected group ranged from 10-17 years, with a mean of 13.4 [+ or -] 1.2 years. Majority of the participants (90.9%) belonged to families practicing Hinduism, 85.4% girls were from nuclear family. The girls belonged to low (20.8%), middle (49.1%) and high (11.7%) SES.

Table 2 presents data regarding the awareness about menstruation before encompassing menarche. It is evident that 64.2% of the participants were aware and the most important source of information was mothers, while friends and television also contributed to their information.

Table 3 highlights the pattern of use of sanitary napkins by girls according to age. It can be perused that two-thirds of the selected girls (68.9%) regardless of age used disposable pads and a small proportion (7.4% and 19.1%) used cotton or cloth material, respectively. However use of both the disposable and non disposable materials by girls was also common. With respect to storage of the sanitary napkins and the pattern of use, it was found that 56.6% girls stored the clean (unused) pads in the cupboards or drawers, and 15.1 and 21.1% girls used dress cabinet and bathroom respectively. The practice of changing pads during night was mentioned by 79.1% while changing in school or college was less common (20.6%). Majority (78.3%) of the girls changed napkins 2-3 times a day and 16.6% mentioned to change once a day.

The hygienic practices were different in girls aged 19 years and above as compared to younger ages. We found significant association between type of napkin/pads used and the age (P=0.001) of the participants, higher proportion of older girls used disposable pads than the young girls. Since significant associations were also found between age and practice of storage (P= 0.002), change of pads during nights (P=0.018); number of pads used per day (P= 0.045) and reuse of pads (P= 0.014).

Table 4 presents information regarding personal hygiene. Practice of bathing (P=0.049) during menstruation, using washed napkins (P=0.009) and wearing stained dress (P=0.001) were significantly associated to age. Significantly higher percent of older girls (87.2%) practiced bathing as compared to younger age (79.3%). Nearly 83% of the girls studied regardless of age mentioned to practice washing of genital tract. Other practices such as using washed napkins and wearing stained dress were noted among younger girls in higher percentage. Majority of the participants opined the need for more information regarding menstruation and hygienic practices to be followed during these days.

Table 5 provides information about relationship between menarche age and various menstrual practices. A partial correlation that was performed by adjusting chronological age to identify the effect of menarche age, however, no significant relationship was observed for any of the practices studied.

Table 6 exhibits statistically significant association between SES and practices such as use of disposable pads (P=0.004), storage behavior (P=0.049), wearing stained dresses (P=0.004) and expressing the need for information about menstruation (P=0.027).

Table 7 the linear regression analysis revealed a significant negative effect of SES on Menarche age, Awareness about menstruation and use of non disposable pads.

Discussion

Hygiene related practices of women during menstruation are of considerable importance as it affects health by increasing vulnerability to infection especially the infections of urinary tract and perineum. Studies reported from India and other developing countries have highlighted the common practices prevailing among the young females [2,9]. The type of absorbent material used is of primary concern since reusable material could be a cause for infection if improperly cleaned and poorly stored [9]. Studies from India and Pakistan indicate use of old cloth material as a frequently used absorbent (98.5%) among both rural and urban girls [10-12].

A study from India, reported that majority of rural school girls who used old cloth, sanitize the materials by boiling and drying them before reuse. It is evident that such practices offer protection against possible infections. In our study 19.1% girls used cloth material as menstrual absorbents never the less practice of cleaning or sanitizing was not appraised. Place of storage of pads/napkins is equally important for their cleanliness, especially practice of storing in bath rooms is disturbing since it could give rise to harboring of dust and insects. The proportion of participants having bathroom as storage place was 21.1%, this practice was significantly prevalent among younger age. In other studies practice of storing in bath room was as high as 49.8%. Literature information regarding the adverse health effect due to bath room storage is meager

According to healthy practices changing pads during night and at school or college is important. Change of napkins/pads at an interval of 3-4 hours is considered as a healthy behavior for comfort and to prevent odor, regardless of the extent of staining [3]. Higher percentage of girls (80%) practiced to changing pads at night while a small proportion changed pads at school/college hours (20.6%). Age profoundly influenced the practice of changing at night, significantly higher percentage of older girls practiced to change at night (Table 3). On the other hand, the practice of continued use of pads during school hours was a common behavior across all the age groups. It is obvious to expect health risk due to such practices. The probable reason for not changing the pads could be ignorance and lack of facility. Our findings are in accordance to other studies reported from India and Arabia Saudi [12].

Further, the practice of reuse of soiled napkins was found common among girls in the present group; although the percentage was less, significantly higher proportion of younger girls used the soiled napkins. It could be because of lack of knowledge about healthy practices in young girls. Narayana et al. suggested based on his study that urban girls have better awareness about menstrual hygienic practices than their rural counterpart [11].

Studies from India indicate that, ritualistically girls take special bath at the time of menstruation, hence 83.9% practiced taking bath and this behavior was found to be associated to age. Also a higher percentage of girls were aware of washing genital tracts and perineum which is essential for health. Attitudes such as refraining from bath and poor perineum care were found common among a small percentage of the participants. Bathing was significantly associated to age. Lack of awareness regarding the menstrual hygiene could be an important influencing factor for poor practices [12-14]. Similar observations have been reported by other studies from India. On the other hand none of these behaviors were associated to age of menarche [10].

Socio economic status was the most influencing factor on the behavior of girls, it is established fact that affordability help to acquire healthful behaviors [15]. It is evident from our observations that, use of unsanitary and sub-standard menstrual absorbents was common among girls from low socio economic status. Therefore undoubtedly poverty and low social class play a major role on the choices of absorbents leading to the use of unsanitary materials. It is likely that poor financial resources has contributed to the use of 'multiple material' as menstrual absorbents; Gilany et al. working with Egyptian girls were also of similar opinion [9]. We found significant association between SES and factors such as kind of pads used, storage place and wearing stained dress. However, there was an inverse relation between SES and need for more information about menstrual practices. Other studies have shown lower socio-economic status, lack of access to information about menstruation and money to buy sanitary products for menstrual hygiene are all related factors affecting menstrual behaviors [9,16]. Evidently poverty is more than just the lack of income as it includes lack of access to services, resources and skills, vulnerability, insecurity and powerlessness [15].

Prior awareness regarding menarche and menstruation among girls is generally low in most cultures. Never the less in our study 64.5% of the participants were aware [17-19]. Mothers, teachers, friends, relatives, television and books are reported as the major source of information. Considerable percentage (54 and 35.3% )of the participants revealed mothers followed by friends to be the source of information. Prior information about menstruation has been reported to prepare the girl child mentally to accept the change in a constructive way and help her to develop better attitude [19-20].

Conclusion

Healthy practices are important for health and well being of individuals. Menstrual period is one such time when females are expected to adopt hygienic practices. A variety of factors are known to affect the behaviors. Age, culture, awareness and SES are often found to exert profound influence on the behaviors and practices. Age and SES were the most influencing factors, as they influenced the choices for menstrual absorbents and other practices such as personal hygiene, bathing and washing of genital tract was common, changing of pads at night and school hours was followed by higher percentage of girls. Further, girls are becoming conscious about the importance of adopting healthy practices during menstrual period since majority of girls opined the need for menstrual health education. It is important therefore that a sustained public health awareness program is developed to operate in population to create better awareness among women. Such initiative would make women population self sufficient to manage their health and wellbeing.

Acknowledgement: Authors are grateful to the all participants.

References:

[1.] Abera, Y., Menarche, Menstruation related Problems and Practices among Adolescent High School Girls in Addis Ababa. Thesis of Master degree Addis Ababa University 2003/04: p. 9.

[2.] Dasgupta, A. and M. Sarkar, Menstrual hygiene: How hygienic is the adolescent girl? 2008.

[3.] Gynecologists, A.C.o.O.a., Menstrual Hygiene Products. Medical Library, 1997.

[4.] Harvey P, B.S., Reed P, Emergency sanitation: assessment and programme design. Water, Engineering and Development Centre, Loughborough University, UK, 2002: p. 60.

[5.] Bhatia, J. and J. Cleland, Self-reported symptoms of gynecological morbidity and their treatment in south India. Studies in family planning, 1995. 26(4): p. 203

[6.] Mehra, E.S., Adolescent Girl: An Indian Prespective. New Delhi. Mamta Health Institute for Mother and Child. , 1995.

[7.] Margaret, E.G., Watering the Neighbours Garden. New Delhi. Population Council 1997. Working Paper. No. 7.

[8.] Paul, D., A Report of an ICMR Funded Research Project: Knowledge and Practices of Adolescent Girls Regarding Reproductive Health with special Emphasis on Hygiene during Menstruation. New Delhi. National Institute of Public Cooperation and Child Development (NIPCCD), 2007.

[9.] El-Gilany, A., K. Badawi, and S. El-Fedawy, Menstrual hygiene among adolescent schoolgirls in Mansoura, Egypt. Reproductive Health Matters, 2005. 13(26): p. 147-152.

[10.] Drakshayani, D. and R. Venkata, A study on menstrual hygiene among rural adolescent girls. Indian journal of medical sciences, 1994. 48(6): p. 139.

[11.] Narayan, K., et al., Puberty rituals, reproductive knowledge and health of adolescent schoolgirls in South India. Asia Pacific Population Journal, 2001. 16(2): p. 225-238.

[12.] Moawed, S., Indigenous practices of Saudi girls in Riyadh during their menstrual period. Eastern Mediterranean Health Journal, 2001. 7: p. 197-203.

[13.] Poureslami, M. and F. Ostati-Asliani, Attitudes of female adolescents about dysmenorrhea and menstrual hygiene in Tehran suburbs. Archives of Iranian Medicine, 2002. 5(4): p. 219.

[14.] Tazeen Saeed Ali , S.N.R., . Menstrual knowledge and practices of female adolescents in urban Karachi, Pakistan. Journal of adolescence, 2009.

[15.] Bourne PA, and Rhule J, Good Health Status of Rural Women in the Reproductive Ages. International Journal of Collaborative Research on Internal Medicine & Public Health, 2009. 1(5): p. 132-155.

[16.] Adinma, E. and J. Adinma, Perceptions and Practices on Menstruation Amongst Nigerian Secondary School Girls. African Journal of Reproductive Health, 2009. 12(1): p. 74.

[17.] Nair, P., V. Grover, and A. Kannan, Awareness and practices of menstruation and pubertal changes amongst unmarried female adolescents in a rural area of East Delhi. Indian Journal of Community Medicine, 2007. 32(2): p. 156.

[18.] Ahuja A, T.S., Awareness of pubertal changes among adolescent girls. J Fam Welfare 1995. 41: p. 46-50.

[19.] Tiwari H, O.U., Tiwari R, Knowledge, attitudes and beliefs about menarche of adolescent girls in Anand district, Gujarat. East Mediterr Health J, 2006. May-Jul;12(3-4): p. 428-33.

[20.] Rajni Dhingra, A.K.a.M.K., Knowledge and Practices Related to Menstruation among Tribal (Gujjar) Adolescent Girls. Ethno-Med 2009. 1(3): p. 43-48.

Shabnam Omidvar, Khyrunnisa Begum

DOS in Food science & Nutrition, University of Mysore, Mysore, India

Corresponding author: Shabnam Omidvar (shomidvar@yahoo.com) Correspondence concerning this article should be addressed to Shabnam Omidvar, DOS in Food Science & Nutrition University of Mysore, Manasagangotri, Mysore, India--Email: shomidvar@yahoo.com

Paper review summary:

Paper submission: October 19, 2010

Revised paper submission: December 14, 2010

Paper acceptance: December 15, 2010

Paper publication: December 17, 2010
Table 1: Demographic profile of selected girls

Participants                N        Percent

[less than or equal        149        42.6
  to] 19 Yrs
  adolescents

>19 Yrs young adults       201        57.4
  Mean age (current)    18.7 [+ or -] 1.757
  in Years

Menarche age- Mean      13.470 [+ or -] 1.234
  (in years) Range               10-17
  (in years)

Religion

Hindu                      318         90.9
Muslim                     20           5.7
Christian                   8           2.3
Others                      4           1.1
Total                      350        100.0

Family type

Nuclear                    299         85.4
Joint                      32           9.1
Extended                   14           4.0
Total                      345         98.6 *

Socio Economic
Status

Low                        73          20.8
Middle                     172         49.1
High                       41          11.7
Total                      286         81.6 *

* Differences in percentages are due to non reporting.

Table 2: Awareness about menstruation among girls
and sources of information

variable                                   N (%)

Girls aware about menses before menarche   217 (64.5)
Source for information
Mother                                     116 (54.0)
Friends                                    76 (35.3)
Television                                 30 (14.0)
Magazines                                  8 (3.7)
News paper                                 6 (2.8)
others                                     10 (4.7)

Table 3: Usage of napkins during menses: type, storage
and frequency of change

                                                Percent
                                               of girls
practice        variables                    (n=350) N(%)

Kinds of pads   Disposable      Sanitary     241 (68.9)
used                              napkins
                                Cotton        26 (7.4)

                Non disposable  Cloth         67 (19.1)
                                  material
                                Others        13 (3.7)
Storage Place   Dress cabinets                53 (15.1)
for pads        Cupboard                     198 (56.6)
                  /drawers
                Bathroom                      74 (21.1)
                Others                        12 (3.4)

Number of       One                           58 (16.6)
pads per day    2-3                          274 (78.3)
                >3                            14 (4.0)

Changing pad    No                            71 (20.3)
during night    Yes                          277 (79.1)

Changing pads   No                            78.6 (275)
at school /     Yes                           20.6 (72)
college

Reuse of pads   No                            94.0 (329)
(Unclean)       Yes                            4.3 (15)

                                                    Age in years

practice        variables                       < 19           >19

Kinds of pads   Disposable      Sanitary      86 (57.7)    155 (77.1)
used                              napkins
                                Cotton        13 (8.7)      13 (6.5)

                Non disposable  Cloth         44 (29.5)     23 (11.4)
                                  material
                                Others         5 (3.4)       8 (3.9)
Storage Place   Dress                         19 (12.8)     34 (16.9)
for pads        cabinets
                Cupboard                      76 (51.1)    122 (60.7)
                  /drawers
                Bathroom                      43 (28.8)     31 (15.4)
                Others                         5 (3.4)       7 (3.5)

Number of       One                           33 (22.1)     25 (12.4)
pads per day    2-3                          109 (73.2)    165 (82.1)
                >3                             4 (2.7)      10 (5.0)

Changing pad    No                            39 (26.2)     32 (15.9)
during night    Yes                          109 (73.2)    168 (83.6)

Changing pads   No                            79.2 (118)    78.1 (157)
at school /     Yes                           19.5 (29)     36.3 (73)
college

Reuse of pads   No                           136 (91.3%)   193 (96.1%)
(Unclean)       Yes                           11 (7.4%)      4 (1.9%)

practice        variables                       Chi-sq

Kinds of pads   Disposable      Sanitary      0.426 **
used                              napkins
                                Cotton

                Non disposable  Cloth         0.760 **
                                  material
                                Others
Storage Place   Dress cabinets                0.283 (Ns)
for pads        Cupboard
                  /drawers
                Bathroom                      0.949 **
                Others

Number of       One                           8.981 *
pads per day    2-3
                >3

Changing pad    No                            6.059 *
during night    Yes

Changing pads   No                            0.189 (Ns)
at school /     Yes
college

Reuse of pads   No                            5.353 *
(Unclean)       Yes

The difference in total percentage for each practice is due to
'no response' from subjects.

Table 4: Personal Hygienic practices during menstruation

                                                    Age in year

                                Percent of
Variables          Practice   girls (n=350)      < 19          >19

Taking bath           No      16.1 (55)       20.7 (30)    12.8 (25)
during their          Yes     83.9 (286)      79.3 (115)   87.2 (171)
periods

Washing genital       No      14.3 (50)       15.4 (23)    13.4 (27)
tract (at every       Yes     82.9 (290)      81.9 (122)   83.6 (168)
visit to toilet)

Using washed          No      51.1 (179)      42.0 (64)    57.2 (115)
napkins during        Yes     42.0 (147)      49.7 (74)    36.3 (73)
periods

Wearing stained       No      46.0 (178)      41.6 (62)    57.7 (116)
dress                 Yes     50.9 (161)      56.4 (84)    38.3 (77)

Need more             No      18.6 (65)       23.5 (35)    14.9 (30)
information           Yes     78.3 (274)      75.2 (112)   80.6 (162)
about menstrual
hygiene

Variables           Chi-Sq

Taking bath        6.713 **
during their
periods

Washing genital    0.520 (NS)
tract (at every
visit to toilet)

Using washed       8.944 **
napkins during
periods

Wearing stained    11.567 **
dress

Need more          4.646 *
information
about menstrual
hygiene

P values are obtained by chi-square test

Table 5: Influence of age and menarche age on hygienic practices
followed during menses by the selected girls  (%)

Practices                                Age at the time of study

                                                 <19 yrs

                                          Menarche age  (in yrs)

                                      10-12        13-14       15-17
                                      N (%)        N (%)       N (%)

                         Sanitary   20 (55.5)    46 (55.4)   14 (70.0)
Kind of     Disposable   napkins      3 (8.3)     7 (8.4)    2 (10.0)

pads                     Cotton

            Non          Cloth      12 (33.3)    28 (33.7)   3 (15.0)
            disposable   material

                         Other        1 (2.8)     2 (2.4)     1 (5.0)

Pad keeping behavior

Dress cabinets                       9 (25.0)     7 (8.8)    4 (20.0)
Cupboard/drawers                    18 (50.0)    42 (52.5)    12 (60)
bath room                            9 (25.0)    29 (36.2)   3 (15.0)
other                                 0 (0.0)     2 (2.5)     1 (5.0)

Number of pads/day

1                                   10 (27.8)    17 (20.4)   6 (30.0)
2-3                                 25 (69.4)    63 (76.0)   14 (70.0)
>3                                    1 (2.8)     3 (3.6)     0 (0.0)

Re-use unclear pads

Yes                                   0 (0.0)    10 (12.0)    1 (5.0)
no                                  36 (100.0)   74 (88.0)   19 (95.0)

Taking bath

Yes                                 29 (80.5)    66 (78.6)   13 (76.5)
no                                   7 (19.4)    18 (21.4)   4 (23.5)

Washing genital
tract

Yes                                 31 (91.2)    70 (83.3)   14 (73.7)
no                                    3 (8.8)    14 (16.7)   5 (26.3)

Wearing stained
dresses

Yes                                 15 (44.1)    50 (59.5)   9 (45.0)
no                                  19 (55.9)    34 (40.5)   11 (55.0)

Expressed the need
for more information

Yes                                 28 (77.8)    66 (78.6)   14 (73.7)
No                                   8 (22.2)    18 (21.4)   5 (26.3)

                                          Age at the time of study

                                                   <19 yrs

                                           Menarche age  (in yrs)

                         Sanitary     10-12        13-14       15-17
Kind of     Disposable   napkins      N (%)        N (%)       N (%)

pads                     Cotton
                                    32 (82.0)    78 (78.0)   40 (80.0)
            Non          Cloth       4 (10.2)     5 (5.0)     2 (4.0)
            disposable   material

                         Other
                                      2 (5.1)    11 (11.0)   8 (16.0)
Pad keeping behavior

Dress cabinets                        1 (2.6)     6 (6.0)     0 (0.0)
Cupboard/drawers
bath room
other
                                     8 (20.5)    16 (16.3)   7 (14.6)
Number of pads/day                  27 (69.2)    60 (61.2)   32 (66.7)
                                      1 (2.6)    19 (19.4)   9 (18.7)
1                                     3 (7.7)     3 (3.0)     0 (0.0)
2-3
>3

Re-use unclear pads                  6 (15.4)     8 (8.0)    8 (15.6)
                                    33 (84.6)    87 (86.1)   39 (76.5)
Yes                                   0 (0.0)     6 (5.9)     4 (7.9)
no

Taking bath
                                      1 (2.6)     2 (2.0)     0 (0.0)
Yes                                 37 (97.4)    97 (98.0)   50 (100.0)
no

Washing genital
tract                               33 (89.1)    93 (93.0)   40 (30.8)
                                     4 (10.9)     7 (7.0)    90 (69.2)
Yes
no

Wearing stained
dresses                             35 (92.1)    80 (82.5)   45 (90.0)
                                      3 (7.9)    17 (17.5)   5  (10.0)
Yes
no

Expressed the need
for more information                 9 (24.3)    43 (43.0)   21 (44.7)
                                    28 (75.7)    57 (57.0)   26 (55.3)
Yes
No

                                    32 (84.2)    85 (86.7)   40 (83.3)
                                     6 (15.8)    13 (13.3)   8 (16.7)

Table 6: Influence of SES on hygienic practices followed during
menses by the selected girls

Hygiene practices                               SES

                                  Low          Middle       High

                       Sanitary   40 (56.3)    125 (73)     37 (90.2)
Kind of   Disposable   napkins    3 (4.2)      14 (8.2)     2 (4.8)
pads
                       Cotton

          Non          Cloth      25 (35.2)    23 (13.4)    1 (2.4)
          disposable   Other      3 (4.2)      9 (5.2)      1 (2.4)

Pad keeping behavior

Dress cabinet                     3 (4.3)      33 (20.0)    7 (17.0)
Special cupboard                  44 (63.8)    97 (58.8)    24 (58.5)

In bathroom                       21 (30.4)    29 (17.6)    7 (17.0)
other                             1 (1.4)      6 (3.6)      3 (7.3)

Number of pads/
day

1                                 9 (12.7)     31 (18.1)    6 (14.7)
2-3                               60 (84.5)    133 (77.8)   33 (80.4)
>3                                2 (2.8)      7 (4.0)      2 (4.9)

Re-use unclear pads

Yes                               6 (8.4)      7 (4.7)      0 (0.0)
no                                65 (91.6)    163 (95.3)   41 (100.0)

Taking bath during
menstruation

Yes
no                                61 (87.1)    138 (83.1)   34 (82.9)
                                  9 (2.9)      28 (6.9)     7 (7.1)
Washing genital
tract

Yes                               61 (84.7)    147 (89.6)   33 (82.5)
no                                11 (5.3)     17 (0.4)     7 (7.5)

Wearing stained
dresses

Yes                               41 (59.4)    71 (2.8)     11 (7.5)
no                                28 (40.6)    95 (57.2)    29 (72.5)

Expressed the need
for more information

Yes                               66 (91.7)    131 (79.9)   30 (73.1)
no                                6  (8.3)     33 (21.1)    11 (6.9)

Hygiene practices

                                   Chi-Sq

                                  28.635 **

                       Sanitary
Kind of   Disposable   napkins
pads
                       Cotton

          Non          Cloth
          disposable   Other

Pad keeping behavior              15.543 *

Dress cabinet
Special cupboard

In bathroom
other

Number of pads/                   5.537 (Ns)
day

1
2-3
>3

Re-use unclear pads               4.457 (Ns)

Yes
no

Taking bath during                0.644 (Ns)
menstruation

Yes
no

Washing genital
tract
                                  2.071 (Ns)
Yes
no

Wearing stained                   11.084 **
dresses

Yes
no

Expressed the need                7.208 *
for more information

Yes
no

Table 7: Regression analysis between SES and certain variables

variables               [beta]   Adj.r (2)     P

Menarche age            -0.145     0.017     0.000
Awareness about         -0.108     0.008     0.000
  menstruation
Using non disposable    -0.288     0.080     0.000
  pads
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Author:Omidvar, Shabnam; Begum, Khyrunnisa
Publication:International Journal of Collaborative Research on Internal Medicine & Public Health (IJCRIMPH)
Article Type:Report
Geographic Code:9INDI
Date:Dec 1, 2010
Words:4434
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