|Year : 2015 | Volume
| Issue : 6 | Page : 719-723
Knowledge and practices related to reproductive health amongst adolescent girls
Jayashree S Gothankar, Reshma S Patil, Sonali H Plkar
Department of Community Medicine, Bharati Vidyapeeth University Medicine College, Pune, Maharashtra, India
|Date of Web Publication||19-Nov-2015|
Jayashree S Gothankar
Manik, 31 Meghana Soc., Sahakar Nagar No. 2, Pune - 411 009, Maharashtra
Source of Support: None, Conflict of Interest: None
Objective: To assess knowledge and practices related to menstruation and reproductive health amongst college going adolescent girls. Materials and Methods: Cross-sectional study done on 323 adolescent girls admitted in the year 2012 to professional colleges belonging to the health sciences faculty of a private university in Pune, India, using self-administered proforma. Results: Mean age of onset of menarche was 13.35 years. Many girls (86.65%) had knowledge of menstruation prior to menarche. For 68% of girls, mother was a source of menstrual information. Half of the girls reported some form of restriction in activities during menstruation due to religious reasons. 11% girls suffered from some form of reproductive tract infections (RTIs). Practices related to menstruation revealed that cloth piece is used for menstrual protection by 3% of girls. Soaked sanitary pads were disposed sanitarily by 96% of girls. Adolescent of medical faculty had significantly more knowledge than nursing faculty adolescents regarding emergency contraceptives (P < 0.05). Only four girls reported a history of sexual contact, of these, three were aware of emergency contraceptives, while one used them to prevent pregnancy. Conclusions: Adolescent girls received knowledge of menstruation prior to menarche from their mothers. Restriction in activity during menstruation due to religious reasons is practiced by many girls. Sanitary pad was used by almost all girls, and all disposed the same in a sanitary manner. More than half of the girls were aware about emergency contraceptives. Prevalence of RTI was found to be low and very few girls reported history of sexual exposure.
Keywords: Adolescent girls, knowledge and practices, menstruation, reproductive health
|How to cite this article:|
Gothankar JS, Patil RS, Plkar SH. Knowledge and practices related to reproductive health amongst adolescent girls. Med J DY Patil Univ 2015;8:719-23
| Introduction|| |
The transition from childhood to adulthood occurs during adolescence period, which is characterized by major biological changes such as physical growth, sexual maturation, and psychosocial development. During this phase of growth, the girls first experience menstruation and related problems, these problems deserve careful evaluation, as uncorrected menstrual problems may adversely affect the daily routine and quality of life.  The knowledge and practices related to use of sanitary protection during menstruation is a vital aspect of health education.  Data on reproductive and general health concerns of this young population are scarce, without which, meaningful programs cannot be implemented. , Although menstruation is a natural process, it is linked with several misconceptions and practices, which sometimes result in adverse health outcomes.  Understanding the knowledge, practices, and problems related to menstruation and reproductive health, will help in planning programs for this vulnerable group.
The present study was carried out to assess knowledge and practices related to menstruation and reproductive health amongst college going adolescent girls.
| Materials and Methods|| |
- Study design: Cross-sectional study design
- Study period: August to October 2012 including 1-month of data collection
- Study area: Professional colleges of health sciences faculty of a private university in Pune, Maharashtra, India
- Study participants: All adolescent girls admitted in the year 2012 to professional colleges belonging to health sciences faculty, namely medical, dental, ayurved, homeopathy, biotechnology, nursing, optometry, audiology, and speech language therapy under a private university
- Variables: Source of information, menstrual related problems, symptoms related to reproductive tract infections (RTIs), awareness about emergency contraceptives
- Sample size: 323
- Inclusion criteria: All newly admitted adolescent girls to various health sciences faculties.
- Girls who could not be contacted on two contacts
- Unwillingness for participation
- Married adolescents.
Tool for data collection
A pretested and semi-close ended proforma was self-administered for obtaining information such as personal particulars (without identifying details), knowledge related to menstruation, practices related to menstruation, including menstruation protection material, frequency of change, and disposal of sanitary pads, symptoms suggestive of RTIs, knowledge and practices related to emergency contraception.
The study was approved by the institutional ethical committee. Permission from Principals of professional colleges was obtained prior to the onset of the study.
The study was conducted on newly admitted girls within 15 days of admission to the professional colleges. Number of girls admitted for the year 2012 was obtained from each college. Suitable time slot was taken from the designated teaching faculty of that particular college. Purpose of the study was explained, and informed consent was obtained from adolescent girls and proforma was then handed to them for self-administration. Privacy was maintained while filling up the proforma. Second attempt was done to contact girls who could not be contacted on first contact due to absenteeism.
Simple proportions and Chi-square test. A level of P < 0.05 was considered as statistically significant.
Adolescence  - definition as given by World Health Organization, the period of adolescence ranges from 10 to 19 years.
Reproductive tract infection
As subjects were unmarried, per vaginal examination had not been done. So, the operational definition of RTI was framed based on self-reported symptoms such as soreness, itching, swollen glands, pain when urinating, unusual discharge, and abdominal pain.
Are the methods that are used as emergency procedures to prevent pregnancy following unprotected intercourse? 
| Results|| |
Maximum girls (29%) were from medical college followed by dental (19%) and Ayurved College (18%) [Table 1]. All the girls included in the study represented 20 different states from India.
Mean age of girls was 17.78 (±0.75) years, and the mean age of onset of menarche amongst girls was 13.35 (±1.29) years. Many girls that is, 279 (86%) in the current study reported to have knowledge of menstruation prior to menarche. For 67% of girls mother was a source for this knowledge [Table 2] while only 17% of girls received the knowledge from school.
Out of total 323 girls, [Table 3] the most common menstrual related problem for 38% of girls was dysmenorrhea. The study noted that for 70 (35%) girls menstruation related problems led to the loss of school or college days.
[Table 4] reveals that half of the girls, that is, 50% of girls reported some form of restriction in activities during menstruation, most common and only reason for restriction in activity was for religious reason with or without other reasons.
[Table 5] reveals that 60% of girls belonging to medical faculty did not follow any restrictions in the activity during menstruation as compared with girls belonging to other faculties. This difference was found to be statistically significant (P < 0.05).
|Table 5: Faculty of adolescent girls and restriction in activities|
Click here to view
Out of total 323 girls, 35 girls (11%) reported to be suffering from symptoms suggestive of RTIs [Table 6]. Out of these 35 girls, the most common symptom reported by 21 girls was itching followed by unusual vaginal discharge with or without lower abdominal pain reported by 8 girls.
Responses to questions on practices related to menstruation revealed that cloth piece was still used for menstrual protection by 3% of girls while remaining 97% used sanitary napkins. Maximum, that is, 286 (89%) girls changed the napkins twice or thrice in a day. Soaked sanitary pads were disposed sanitarily by 96% of girls.
More than half girls (52%) were aware about emergency contraceptives [Table 7] and for 82.35% of these girls; television was a major source of information. [Table 8] reveals that the 75% of the girls of medical faculty had knowledge of emergency contraceptives while only 19% of the adolescents of nursing faculty had knowledge of emergency contraceptives. The difference was found to be statistically significant (P < 0.05).
Only four girls out of 323 (1.24%) reported a history of sexual contact and of these, three were aware of emergency contraceptives, while one used them at four occasions to prevent pregnancy.
| Discussion|| |
Singh et al.  in their study done on rural girls reported the mean age at menarche of the girls to be 13.6 ± 0.83 years. The average age of menarche is similar to the current study.
Udgiri et al.  reported that only 63 (18.42%) of 342 adolescent girls had knowledge about menstruation prior to attainment of menarche in contrast to the findings of current study where majority of girls had prior knowledge about menstruation (86%). Traditionally, mother is the main source of such information to the majority of girls as found in the current study and by many authors in their studies. However, possibility of receiving scientific information about menstruation is more if received in schools than given by mother, but as seen in the current study very less number of girls received such information from schools (17%). Udgiri et al.  reported that the main source of information about menstruation was mother for 195 (57.01%) girls. Mittal and Goel  also reported that mothers were the most important source of knowledge (47.4%) regarding menstruation among the study subjects followed by friends/peers (23.8%), teachers (4.9%), and mass media (4.8%). In a community-based door-to-door survey by Nair et al.  conducted through interviewing 251 unmarried girls between the ages of 10 and 19 years, found that out of 251 girls, 127 (50%) had attained menarche and 45.7% of the girls who had attained menarche had prior knowledge about menstruation. Dasgupta and Sarkar  reported that 67.5% of girls were aware about menstruation prior to the attainment of menarche and mother was the first informant regarding menstruation in case of 60 (37.5%) girls. Nair et al.  noted that 45.5% of the girls had knowledge of menstruation prior to menarche, this figure is less than the figures quoted in the current study.
Dasgupta and Sarkar  found higher number of girls i.e., 136 (85%) practiced restrictions due to various reasons during menstruation. While in current study only 50% reported such restrictions and of these, all girls followed such restrictions for a religious reason. Similarly, Nair et al.  found that 92% of the adolescent girls were restricted from worshipping during menstruation.
Dasgupta and Sarkar  reported that only 18 (11.25%) girls used sanitary pads during menstruation while in the current study almost all adolescents (97%) used sanitary pads for menstrual protection.
Dysmenorrhea is an important menstrual disorder in adolescence, and common in young women with ovulatory cycles. It has become an important public health problem among the female population. Current study revealed that out of total 323 girls, 61% girls reported some form of menstrual disorder and lower figures were quoted by Singh et al.  they reported that 44.6% of girls suffered from various menstrual problems, most common being dysmenorrhea among 40.7% of girls and 2.3% suffered from irregular menses. Sharma et al.  in his study on adolescent reported that dysmenorrhea (67.2%) was the most common problem faced and that 17.24% had to miss a class and 25% had to abstain from work. While Nair et al.  noted that dysmenorrhea was prevalent in 63.75% of adolescent girls. Similar number of adolescent girls, that is, 121 (37%) in the current study reported to be suffering from dysmenorrhea.
Adolescents are parents of tomorrow. A large number of them suffer due to RTIs and sexually transmitted diseases, which are recognized to be an important health problem in India. RTIs, which are preventable and treatable, are responsible for causing serious consequences of infertility, ectopic pregnancy, pregnancy wastage, low birth weight, etc.  In the current study, only 11% were suffering from symptoms suggestive of RTIs. In contrast to the study by Ram et al.,  observed that 64% of the girls were suffering from RTI.
Purohit et al.  in their study on urban unmarried women reported that emergency contraceptives were known to about 87% of the respondents. These figures are higher than the current study where only 52% of the girls had knowledge. However, in the current study, this knowledge varied significantly as per the faculty of adolescents. Higher number of adolescent of Medical faculty (75%) had knowledge about emergency contraceptives followed by dental (52%), ayurved and homeopathy (50% each) (P < 0.05).
Purohit et al.  also reported that almost 92% of the respondents had received the knowledge of emergency contraceptives from the television advertisement almost similar to current study where 82.5% received this knowledge from television. Jahnavi and Patra  in their cross-sectional survey found that 94.4% of respondents were aware of contraceptives. Puri et al.  noted that only 7.3% of college-going undergraduate and graduate female students of Punjab University had knowledge about emergency contraceptive pills. National Family Health Survey-3 (NFHS-3) data reveals that only 4.9% of adolescent girls were aware of emergency contraceptives.
In a study done in Delhi and Lucknow by Kumar and Tiwari  found 18% of adolescents respondents as having sex at least once. In the current study, 1.24% of adolescent reported to have sex. While NFHS-3 data reveals that about 0.6% of never married adolescent girls have already experienced sex.
| Conclusions|| |
Many girls received knowledge of menstruation prior to menarche from their mothers. Restriction in activity during menstruation due to religious reasons is still practiced by many girls. Sanitary pad was used by almost all girls and all disposed the same in a sanitary manner. More than half of the girls have heard about emergency contraception, but this knowledge was significantly less amongst nursing faculty adolescents than medical faculty. Prevalence of RTI was found to be low and very less number of girls reported a history of sexual exposure.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]
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