Awareness of Menstrual Hygiene Management Rights and Perception of Risks, Self-Efficacy, and Behavior.

ABSTRACT

BACKGROUND: Menstrual Hygiene Management stands as a critical health concern for girls entering reproductive age on a global scale. This transition often induces fear and anxiety due to inadequate knowledge about menstruation and a lack of resources to comprehend bodily changes. Notably, school-aged girls in marginalized communities face formidable barriers to MHM, given the insufficient facilities, supplies, and awareness in educational institutions. METHODS: A Mixed method study was conducted adopting a mixed-methods approach. It engaged 562 respondents across five local levels of Bajura district, including three municipalities (Badimalika, Budhiganga, and Tribeni) and two rural municipalities (Gaumul and Khaptad Chhedaha). RESULTS: The study unveiled over 90% awareness on on five out of seven MHM rights related statements and over 85% self-efficacy on 5 out of 8 statements regarding MHM among female adolescent respondents. However, their actual practices fell short of expectations, marked by the prevalence of restrictive norms and perceived risks pertinent to MHM. Notably, 27% (N=154) expressed fear of divine consequences for not adhering to menstrual customs. Malpractices were observed, including 66% using cloth during menstruation, inadequate pad changing frequencies, and some girls staying in Chhaugoth during menstruation. Despite a high awareness (97%) of menstrual rights, behavioral practices did not consistently align with this awareness. CONCLUSIONS: The study highlights high awareness and self-efficacy in menstrual hygiene management among female adolescents, yet challenges persist due to cultural norms, perceived risks, and insufficient infrastructure, necessitating multifaceted solutions for behavioral change and access to resources.