Study on usage of woman hygiene kit among menstruating age group in field practice area of KIMS , Hubli

Menstruation is a physiological periodic vaginal bleeding occurring with the shedding of the uterine mucosa. It forms a sign of Puberty after 2-3years of appearance of secondary sexual characters1. A woman menstruates for 3-5 days average (Minimum of 2 days and Maximum of 7 days) each month until menopause which accounts to approximately 2,100 day, Equivalent to Six years of her life of Menstruation.


Introduction
Menstrual Hygiene is an issue that every woman has to deal with once she enters her adolescence around the age of 12 (Menarche) and until she reaches the Menopause. .
Menstruation is a physiological periodic vaginal bleeding occurring with the shedding of the uterine mucosa. It forms a sign of Puberty after 2-3years of appearance of secondary sexual characters 1 . A woman menstruates for 3-5 days average (Minimum of 2 days and Maximum of 7 days) each month until menopause which accounts to approximately 2,100 day, Equivalent to Six years of her life of Menstruation.
In many cultures and societies of Developing and Underdeveloped regions of the world believe that Menstruation is unclean and deprive the menstruating women from undergoing their daily routine work like cooking, moving out in the public etc. Menstruation is generally considered as unclean in the Indian society. Isolation of the menstruating girls and restrictions being imposed on them in the family, have reinforced a negative attitude towards this phenomenon 2 .
During menstruation period, shedding of the blood leaves the genital tract moist and lowered acidity of the vagina IJBR (2013) 04 (02) www.ssjournals.com making it vulnerable for infections by bacteria and other organisms in reproductive tract, which in turn may lead to Discomfort, Pain, Smelling and sense of embarrassment among them. 3 Hence there is a need of special Health care, Knowledge and requirements of women during monthly menstruation with proper hygienic practices like using of Sanitary Napkins, Sanitary Towels, Proper bathing of the Vulva and Vagina 4 . Menstrual hygiene and management will directly contribute to the Millennium Development Goal (MDG)-2 on Universal education and MDG-3 on Gender equality and Women Empowerment. 5 In Developing Countries like India and other third world countries it is reported that many of the menstruating women/girls do not follow healthy measures for maintaining the Menstrual Hygiene. Women belonging to low socioeconomic strata, who cannot afford to buy Sanitary napkins, use a cotton cloth which is usually a torn piece of cloth from their old sarees or other dresses (rags) and use them throughout their periods without changing. They don't change even if the cloth is totally drenched with the blood or soiled to the maximum. Sometimes scarcity of water adds up to them depriving them of washing the cloth. Such ill health menstrual practice is associated with many complications of recurrent reproductive tract infections like Toxic Shock Syndrome, Premature births, Stillbirths, Miscarriages, Infertility problems, Carcinoma cervix etc..
So it becomes an important area of study to assess the Knowledge and the Menstrual practices that the women follow and rectify them by Educating them right from their Adolescence so that the habit of healthy practices are continued in the future and prevent the complications as mentioned above. So a study was conducted on Menstruating women living in urban slums, Field Practice Area of KIMS, Hubli.

Materials and Method
A cross sectional study was conducted on the Menstrual Practices, Myths and beliefs and the experiences during menstruation in an urban slum of Hubli.

Study population:
All the menstruating women of the age group between 15-45yrs, present at the time of data collection.

Study duration:
Three months from 6th June 2012 to 5 th September 2012.

Exclusion criteria:
All the girls that had not attained Menarche, and all the women that had attained Menopause

Method used:
A community based cross sectional study was conducted among 100 women in the reproductive age group present during study period. All the required information was obtained by a well structured and pretested Questionnaire which was prepared in advance. Oral consent was taken and information by personal interview technique was collected regarding age, religion, education, marital status, age of menarche and age of menopause , questions on usage of women hygiene kit etc… 2.5 Statistical Analysis: The collected data was analyzed by SPSS version 20 software to derive significant test results using chi-square test.

Results
It was observed that majority of women (50%) belonged to age group of 25-34yrs followed by age group of 15-24 (30%). Majority of the women were Hindus (69%) followed by Muslims (29%).It was observed that majority of women were Homemakers (80%).and 82% were married .It was observed that majority of women were educated up to High School (51%) followed by Primary School (27%).
From table (1) it is observed that out of the 82 married women 68(83%) were using cloth and61% of unmarried women were using cloth .While 39% of unmarried women were using sanitary pad as compared to only 17% of married women. = 4.234 p<0.05, statistically significant. Table (2) it is observed that most of the women of different age groups have various myths attached to menstruation. It is observed that women of all religions believe menstruation to be a mythical process. It is observed that almost all the women of different education status think menstruation to be a mythical process. Infection is more in cloth users (8.9%) in contrast to women using sanitary pad (4.8%). And prevalence of Urinary Tract Infection is more in cloth user (12.7%) in contrast to women using sanitary pad (9.5%) from Table (3). 80% women used cloth stating the reason that they were comfortable with cloth. 18% did not use sanitary pad as it is costly from fig(1).

Discussion and Conclusion
It was observed that the women had attained the age of Menarche mostly at the ages of 13 and 12 with figures of 31% and 28% respectively. Prior awareness regarding menarche and menstruation among girls is generally low in most of the cultures, likewise in the present study 90.1% were not aware about menstruation before menarche.
It was observed that majority of women(75%) considered menstruation as a mythical process and only 25% believed it to be physiological. In S.B Thakare et al study it was observed , that only 18.35% of the girls believed menstruation to be physiological process, 91% of the women did not know the age of normal cessation of menstruation. Majority of women (99%) clean their external genitalia more than 2 times a day and use water and soap which is a healthy practice.
It was observed that 79% of women used Cloth during menstruation in contrast to only 21% using sanitary pad. In S.B.Thakare et al study it was found out that 79% of women used cloth as absorbent material in contrast to Sanitary pad used by only 21% of the women. Women belonging to age group 35-44 years 87.5% used cloth and age group of 15-24 years 30% used sanitary pad 1 . It was observed that 65% of women were aware that poor menstrual hygiene predisposes to infections. It was observed that 41% of women feel that they are sick during menstruation .It is observed that 50% of IJBR (2013) 04 (02) www.ssjournals.com women are aware that good nutrition is required for regular period.
It is observed that prevalence of reproductive tract infections is more in women using cloth (8.9%) in contrast to women using sanitary pad(4.8%).Likewise urinary tract problems were more in women using cloth (12.7%) in contrast to women using sanitary pad (9.5%). It was observed that women using pad disposed it by dumping it in dustbin (90.5%). It is observed that the women using cloth dry them mostly outside under sunlight (50.6%).
Hence it is obvious that there is a need for proper initiative to be taken in order to ensure healthy menstrual practices among them. Formal as well as informal channels of communication such as mothers, sisters and friends need to emphasize for the delivery of such information. This study has highlighted the need of women to have accurate and adequate information about menstruation and its appropriate management. Considering the lesser use of sanitary pads by women, there is need to mobilize them to use sanitary pads. Health education regarding the awareness about Reproductive and urinary tract infections and HIV/AIDS to be given. Women hygiene kit to be provided by government at subsidized rate and the women to be encouraged to use it.