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Preface Menstruation is a very normal physical changes of a female body which starts
from the adolescence period. Hygiene management is very much important especially at
the time of menarche. Many of the adolescent girls have lacking of knowledge about
the menstrual hygiene management as well as they have some wrong ideas about the
management of menstrual hygiene. Though it’s the very common physical indicator but
most of them it’s a shameful process. Even they seems that menstrual management
process has to be very top secret from all without knowing that they are undergoing
menarche.

The main aim of the study is to know about the menstrual hygiene management among
the adolescent girls in Bangladesh. And the study indicates the knowledge of the
adolescent girls about the attitudes, misconceptions, awareness as well as about the
overall notions about the menstruation as its management process. The researcher tries
her best to keep the errors of the study at very minimum level in the report. But there
may have some printing as well as other mistakes and errors. So my benevolent pray to
overlook these in adherent errors and mistakes.

ABSTRACT Menstrual health significantly associated with reproduction and sexual

well-being of a girl; therefore, ensuring proper menstrual hygiene must be on the top
priority while the real scenario is quite appalling in Bangladesh. Studies found that due
to lack of awareness, socio-cultural restriction and taboos a significant number of
adolescent girls ignore scientific facts and hygienic management during menstruation
that leads a jeopardized health condition of a whole female community. Therefore, this
paper intends to identify the nature of menstrual hygiene management among
adolescent girls at the time of menstruation in Bangladesh introducing an efficient
approach to promote sexual wellbeing of adolescent girls.
The main objective for this study was to know the menstrual hygiene management
among adolescent girls at the time of menstruation in Nalitabari Upazila of Sherpur
District. The study followed mixed method research design including both qualitative
and quantitative approach; both constructivism and objectivist perspective are
considered. Following qualitative approach, the researcher coherently conducted FGD
(Focus Group Discussion) and Face to Face Interview for collecting data from the field
while for the quantitative approach, Sample Survey was selected.

Purposive sampling was used to select the study area while simple random sampling
technique was applied to select 80 respondents for purpose of data collection. The
study indicates overweening non-hygienic management of menstruation since 37.50%
of respondents use cloths, tissues or other insalubrious materials while 77.50% girls even
unaware of the effect of using unhygienic menstrual materials. The key finding also
shows a massive incognizance regarding menstruation as 86.30% of respondents had no
idea before experiencing their first period as well as to 91.30% respondents
menstruation is a taboo in society.

The study was mainly designed to know menstrual hygiene practices and management
among adolescent girls at the time of menstruation as well as to know about the
present misconceptions and attitude about menstruation and its management among
adolescent girls in Bangladesh. EXECUTIVE SUMMARY Menstruation is a very natural
changes of a female body and it occurs regular discharge or normal bleeding from
vagina as well as mucosal tissue from the inner lining of the uterus through the vagina
in every month. At the early stages of puberty every adolescent girls have to undergo
the natural process of menstruation and it is mainly the preparation of a female for
potential pregnancy.

A female child get her first menstruation at the age of 8 to 15 years old and the average
age of getting first menstruation of an adolescent girl is 12. At the stages of adolescence
various types of physical as well as emotional or behavioral changes can occur of a
female body and menstruation is one of the inevitable physical changes for a healthy
adolescent girl. At the time of menstruation, it is very necessary to maintain menstrual
hygiene for every adolescent girls. For the management of menstrual hygiene properly it
is unavoidable to know about the process of menstrual hygiene properly.

But most of the adolescent female child in our country feel very hesitation to ask
someone about the menstrual related issues as well as most of the societies of our
country think about menstruation is a taboo and a very shameful matter to discuss
openly. In the school also, the adolescent girls does not learn properly about the
management of menstrual hygiene. Because of poor knowledge about menstruation
and menstrual hygiene management many of the adolescent girls can be affected
various types of gynecological diseases as well as infections, Reproductive Tract
Infections (RTI's) is one of them.

It is very much essential to know about the menstrual hygiene management for every
adolescent girls in our country. The study was mainly designed to know menstrual
hygiene practices and management among adolescent girls at the period of
menstruation as well as to know about the misconceptions and attitude about
menstruation and its management among adolescent girls in Bangladesh. The study had
been comprised of both the qualitative as well as quantitative method.

The study followed mixed method research design and for collecting data by following
qualitative approach, FGD (Focus Group Discussion) was conducted and Face to Face
Interview was conducted for collecting data from the field while it was quantitative
approach as well as Sample Survey was selected. Social survey (Sample survey) had been
applied for the purpose of data collection from the respondents. The study was
conducted in Two High School (Abdul Hakim Smriti Model High School and Taragonj
Pilot Girls High School) located in the Nalitabari upazila of Sherpur district.

A total of 90 respondents were selected from total 632 population by following the
simple random sampling technique. Two Focus Group Discussions (FGDs) had been
conducted in two schools from the study area for the collection of qualitative data.
Statistical Package for Social Sciences (SPSS) IBM 22 was used for analyzing the
quantitative data of the research as well as, qualitative data are interpreted in descriptive
manner. From the analysis of the data it was found that the respondents belongs to the
age group of 14-16 years old. 30% respondents were 14 years old, 40% were 15 years
old and 30% were 16 years old. From the observation of the study it was seen that
81.3% respondents live in the nuclear family. On the other hand, 13.8% respondents of
the study belongs to joint family as well as only 5.0% respondents are included in
extended family. According to the table no 3.11 supply water was the main sources of
water in most of the respondent’s area and it was around 73.8%. On the other hand,
around 26.3% respondents’ of the study main water sources was Tube-well. It was also
found from the result that 66.3% respondent’s washroom status was good. It is noticed
that most of the respondents had no knowledge about the physical changes of
adolescence period and the rate of the respondents were 61.3%. 31.3% respondents
knew moderately about the physical changes as well as 7.5% respondents had
knowledge about the changes of adolescence period. From the result it was found that
10% respondents got knowledge adolescence period from social media, 6.3%
respondents got from family members, 7.5% respondents learned from friends, 3.8% got
from posters, 1.3% respondent got from school teacher, 6.3% got from television as well
as 3.8% got knowledge about the adolescence period from text book.

It is seen observed that 22.5% respondents didn’t face any type of problems in their
adolescence period and 77.5% respondents faced various types of physical or mental
problems in the adolescence period. Among them 43.8% respondents didn’t receive any
treatment and 18.8% respondents have received treatment at the time of their sickness.
According to the table no 3.20 it was found that, 86.3% respondents received
knowledge about menstruation after starting their first menstruation and 13.8%
respondents of the study received knowledge about menstruation before starting their
first menstruation.

It is observed from the study that 20% respondents got their first period at the age of
12, 41.3% respondents had received their first menstruation at the age of 13 and 38.8%
respondents of the study got their first period at the age of 14. Among the respondents
86.3% said that menstruation is painful, but 13.8% respondents of the study said that
menstruation is not painful to them at all. For the mitigation of menstrual pain 7.5%
respondents of the study used heating pads, 2.5% respondents of the study took herbal
medicine, 5.0% respondents of the study used hot water bottle, 15.0% respondents of
the study took medicine and 3.8% respondents took warm shower. It is found that
70.0% respondents had no knowledge about menstrual hygiene management, 7.5%
respondents had knowledge about menstrual hygiene management and 22.5%
respondents were known moderately about menstrual hygiene management. For the
management of menstrual blood 62.5% respondents of the study used sanitary pads at
the time of menstruation, 15.0% respondents used clothes and pads at the same time,
17.5% respondents used only cloths and only 5.0% respondents of the study used
tissues and pads together for the management of menstrual blood at the time of
menstruation. 6.3% respondents of the study said that they used hot water for cleaning
vagina at the time of menstruation for menstrual hygiene management. It is found that
for the management of menstrual hygiene 6.3% respondents used hot water with soap
at the same time, 81.3% respondents used normal water to clean vagina as well as 6.3%
respondents of the study used soap with normal water for cleaning vagina at the time of
menstruation.

According to the data presented in the table no 3.32, the rate of presentation of the
respondents at the time of menstruation was 76.3% and the rate of absenteeism was
23.8%. It was found that 93.8% respondents of the study didn’t get proper lesson from
school about menstrual hygiene management and 6.3% respondents of the study said
that they had received proper lesson from school about MHM. 77.5% respondents of
the study didn’t know about the effect of using unhygienic menstrual materials and
22.5% respondents had knowledge about the effect of using unhygienic menstrual
materials. From the table no 3.38 it was found that most of the respondents said that
period is a taboo in the society and it was 91.3% and only 8.8% respondents of the
study thought that menstruation is not a taboo at all. 92.5% respondents said that they
did not follow any strict guidelines at the time of menstruation but 7.5% said that they
had to follow some strict guidelines at the time of menstruation.

From the qualitative findings it is found that, to the discussants menstruation was a
pathological and painful process and they felt scared, discomfort at the time of their first
menstruation. They were unknown totally about the menstruation before starting their
first menses and did not get much knowledge about the menstrual hygiene
management from school. For the management of menstrual hygiene they tried to use
sanitary pads as well as clean clothes at the time of menstruation and used soap with
hot as well as normal water for cleaning private part.

At the school time they felt hesitate to changing menstrual products because of unclean
washroom status. The respondents had shared that to them menstruation is a very
secret issue and they didn’t share the issue with any male members of their family or
outside of the family as well as felt hesitate and shy to share. They didn’t follow strict
guidelines at the time of menstruation but they thought that it seems a taboo. CHAPTER
ONE 1. BACKGROUND OF THE STUDY 1.1 INTRODUCTION Menstruation is a normal
physiological process and a very natural changes of a female’s body.

It is defined as the “periodic discharge of blood from the uterus occurring more or less
at regular monthly intervals throughout the active reproductive life of a female.” It is
also called menses or a period of monthly flow. For every adolescent girls menstruation
is a very natural and beneficial monthly occurrence of body. For reproduction of human
being period or menstruation is one of the key determinants. The age of occurring
menstruation various factors are responsible, such as-physical activity, geographical
region, race, ethnicity, etc.

Most of the female child start their menstruation at the first time at the age of 12, but
menstruation can start as early as 8 (Starting your periods – NHS). Adolescence is the
most crucial stage in the life of every girl and women. The word “adolescent” is derived
from the Latin word “adolescere”, which means to grow into maturity. The United
Nations define adolescents as individuals being 10-19 years old. Adolescents are a large
and growing segment of the world’s population. They constitute a vulnerable group not
only in terms of their social status, but also in relation to their health.

More than half of the world’s population is below the age of 25 and one in every two
young people in the world is adolescent (African Journal of Reproductive Health Sept.
2013). In Bangladesh, there are 29.9 million adolescents aged 10-19 years and among
them there are 14.4 million girls and 15.1 million boys, together representing nearly
one-fifth of the country’s total population of 144 million (Bangladesh-ASRH-Report,
January-2017). Every adolescent girls have to undergo in this natural process of
menstruation. Though it is a natural phenomenon, most of the adolescent girls in our
country have no proper knowledge about it as well as they have some wrong attitude
regarding menstruation.

But management and practices of menstrual hygiene during menstruation are of

considerable importance especially for adolescent or young girls. The knowledge about
menstruation and proper practices on menstrual hygiene management among
adolescent girls is very limited. In the rural areas, only 10% girl use improved menstrual
products at the time of menstruation, while others use old cloths, rags, cotton or tissue.

In the urban areas, 21% girls and women use improved products during menstruation
and rest of the women use old cloths without proper washing them in a hygienic
manner (Mandal et al. 2010). For menstrual hygiene 5 things are important to keep in
mind. They are- changing of sanitary napkin every 4-6 hours, washing thyself properly,
don't using of soaps or vagina hygiene products, discarding of the sanitary napkin or
products properly, sticking to one method of sanitation (5 things to keep in mind for
your menstrual hygiene - Lifestyle News).

Menstrual hygiene management is a problem for adolescent girls in developing

countries like Bangladesh, particularly when they are attending in school and they do
not get adequate time and opportunity to clean and change timely at school. But good
hygiene practices, such as the use of clean sanitary pads and adequate washing of the
genital areas are highly essential during the period of menstruation. Many studies have
shown poor menstrual hygiene management during adolescence period. Improper use
of menstrual hygiene materials may involve the various types of diseases and
gynecological problems. Menstruation is a very secret topic in the background of our
country.

Adolescent girls mostly get information about the process and management of
menstruation from their mothers and other few female members of the family. 64% girls
are not introduced about the menstruation before menarche (Tasnim, et al. 2017). Most
of the parents feel hesitation to share this topic with their female children. On the other
hand, most of the schools do not provide proper lesson about the cycle of menstruation
as well as about the management and practices of menstrual hygiene. At school,
menstrual hygiene management is constrained by poor accessibility of water and
sanitation, lacking of privacy as well as limited education about menstrual hygiene.

For the adolescent girls menstruation or period creates various types of challenges, such
as- physical challenges, sociocultural challenges, economical challenges etc. These
challenges are harmful for the adolescent girls and for the effect of such challenges
hampers the ability of the girls to attend the school properly as well as participating in
classroom for learning (MU Alam, et al. 2017). Management of menstrual hygiene is very
much needed for the girls who are undergoing menstruation. Period or menstruation is
a physiological phenomenon for adolescent girls and pre-menopausal women which
occurred naturally.

Menstrual Hygiene Management (MHM) is defined as ‘Women and adolescent girls

using a clean menstrual management material to absorb or collect blood that can be
changed in privacy as often as necessary for the duration of the menstruation period,
using soap and water for washing the body as required, and having access to facilities to
dispose of used menstrual management materials (SS Budhathoki, et all. 2018).’ For the
management of menstrual hygiene as well as it is very necessary of using cleaned
menstrual products for every adolescent girls. But in our country maximum people think
menstruation as a taboo and shameful matter.

Stigma and taboo associated with menstruation is still a challenge in Bangladesh

(BREAKING THE TABOO: MENSTRUATION IN BANGLADESH). For those reason, most of
the adolescent girls in our society have no proper knowledge about menstruation and
proper menstrual hygiene management. So it is necessary to know about the actual
condition of adolescent girls in our society regarding menstrual hygiene management.
1.2 LITERATURE REVIEW Adhikari, P., Kadel, B., Dhungel, S. I., Mandal, A.

(2007), conducted a study on “Knowledge and practice regarding menstrual hygiene in

rural adolescent girls of Nepal” for the evaluation of different aspects of menstrual
hygiene. One hundred and fifty adolescent girls participated in the study and found that
their menstrual hygiene were not maintained properly. Only 6.0% girls had a knowledge
that menstruation is a physiologic process as well as only 36.7% adolescent girls
thought that menstruation is caused by hormones. It was found that at the time of
menstruation 94% girls used sanitary pads but only 11.3% girls disposed it properly. The
total knowledge and practice regarding menstrual hygiene were 40.6% and 12.9%
respectively (P Adhikari et al. Kathmandu Univ Med J (KUMJ) Jul-Sep 2007). Omari, O. A.,
Abdel Razeq, N. M., & Fooladi, M. M.,

(2016), conducted a study on “Experience of Menarche among the Jordanian

Adolescents Girls: An Interpretive Phenomenological Analysis”. It was found that from
the interpretive phenomenological analysis of experience of menarche among Jordanian
adolescent girls, menstruation is a forbidden topic as well as it was considered a social
taboo. The information and support from the family and school were limited for the
girls. For that reason they felt hesitation as well as alone (O. Al Omari et al. / J Pediatr
Adolesc Gynecol 29 (2016) 246-251). Bosch A. M., Baqui A. H., van Ginneken J.K.,

(2008), conducted a study on “Perceptions of adolescents and their mothers on

reproductive and sexual development in Matlab, Bangladesh.” In this study, survey
method was applied for the data collection from the mothers through in-depth
interviews. It was found that the adolescent girls were not adequately informed about
the menarche and 64% girls reached menarche in fear (AM Bosch, I Hutter, JK van
Ginneken- International journal of …, 2008 - europepmc.org). Chothe, V., Khubchandani,
J., Seabert, D., Asalkar, M., Rakshe, S., Firke, A., Midha I., & Simmons, R.

(2014), conducted a case study in India about the students’ perceptions and doubts
about menstruation named “Students’ perceptions and doubts about menstruation in
developing countries: a case study from India” and 381 girls participated in this study. It
was found that, students had substantial doubts about menstruation as well as
menstrual practice related societal myths and taboos were influenced them (V Chothe, J
Khubchandani, D Seabert… - Health promotion …, 2014 – journals.sagepub.com).
Dasgupta, A. & Sarkar, M. (2008), conducted a descriptive cross sectional study on
menstrual hygiene among 160 adolescent girls of a secondary school named “Menstrual
Hygiene: how hygienic is the adolescent girl?”. It was found that 108 (67.5%) girls were
aware about menstruation prior to attainment of menarche, among 160 respondents.
Regarding menstruation mother was the first informant. Among the respondents,
86.25% girls believed that menstruation is a physiological process. Though 48.75% girls
knew the use of sanitary pads but only 11.25% girls used sanitary pads at the time of
menstruation (Indian journal of community medicine: official publication of Indian
Association of Preventive & Social Medicine 33 (2), 77, 2008). Jogdand, K.

& Yerpude, P. (2011), conducted a community based cross sectional study named “A
community based study on menstrual hygiene among adolescent girls” to know about
the menstrual hygiene practices among adolescent girls of Andra-Pradesh in India. 360
adolescent girls were selected randomly for this purpose. It was found that prior to the
attainment of menarche 36.19% girls were aware about menstruation. Regarding
menstruation mother was the first source of information provider. During menstruation,
34.63% girls used old clothes and 78.99% were restricted from joining religious
functions (K Jogdand, P Yerpude- Indian Journal of Maternal and Child Health, 2011-
ircwash.org). Rani, A., Kumar, V., Karya, U., Chand, D.,
& Singh, H. (2016), conducted a survey to access the menstrual problems of school
going unmarried adolescent girls and to investigate their treatment seeking behavior
named “A Study to Know the Attitude, Knowledge and Practices about Menstrual
Hygiene in School going Girls”. 655 girls were selected for the study and it was found in
the study that the overall prevalence of menstrual problem was 64.6%.

The treatment seeking behavior of the girls was very disappointing and about only 25%
girls approached for the treatment who had menstrual (https://www.researchgate.net ›
publication › 301663218_...). Marvan, M. L., & Alcala-Herrera, V. (2014), conducted a
cross-sectional survey to investigate the age of menstruation as well as reactions and
attitudes towards menstruation among adolescent girls of Mexico named “Age at
menarche, reactions to menarche and attitudes towards menstruation among Mexican
adolescent girls”. The respondents of that study were the Mexican post-menarcheal
adolescents aging from 11 to 16 years old.

It was found that the early maturers were unknown about the management of period at
the time of their first menstruation as well as they thought that it’s a secret issue. They
felt scared, worried and sad whereas the late maturers had positive attitude towards
menstruation (ML Marvan, V Alcala-Herrera- Journal of pediatric and adolescent..., 2014-
Elsevier). Thakre, S. B., Thakre, S. S., Reddy, M., Rathi, N., Pathak, K., & Ughade, S. (2011),
conducted a community based cross sectional study on 387 school going girls to assess
the knowledge and practices of menstrual hygiene in Nagpur District, India. It was found
from the study that before menarche only 36.95% of the girls were aware of
menstruation and 49.35% girls used sanitary pads.

Restrictions was found among the three fourth of the girls and there was a significant
differe nces among the rural and urban girls about menstrual hygiene (SB Thakre, SS
Thakre, M Reddy, N Rathi…- J Clin Diagn…, 2011-researchgate.net). Thakur, H., Aronsson,
A., Bansode, S., Lundbora, C. S., & Dalvie, S. (2014), had conducted a study “Knowledge,
practices, and restrictions related to menstruation among young women from low
socioeconomic community in Mumbai, India” to assess knowledge, practices and
restrictions among young women related to menstruation and its hygiene. Mixed
method approach such as qualitative as well as quantitative methods were used for the
purpose of collecting data from 192 respondents.

It was found that before menarche 30-40% girls didn’t receive any information
regarding menstruation as well as there were certain unhygienic practices about
menstrual hygiene and there were many unnecessary restrictions also (Thakur H,
Aronsson A, Bansode S, Stalsby Lundborg C, Dalvie S and Faxelid E (2014) ...). Van Eijk, A.
M., Sivakami, M., Thakkar, M. B., Bauman, A., Laserson, K, F., Coates, S., &
Phillips-Howard, P. A., (2016), conducted a meta-analysis and followed systematic review
named “Menstrual hygiene management among adolescent girls in India” to assess the
status of menstrual hygiene management among adolescent girls in India.

It was found that using commercial pad was common among girls of urban than rural
and there were inappropriate disposal as well as many restrictions among the
menstruating girls (AM Van Eijk, M Sivakami, MB Thakkar, A Bauman…-BMJ open, 2016-
bmjopen.bmj.com). Alam, M. U., Luby, S. P., Halder, A, K., Islam, K., Opel, A., Shoab, A. K.,
Ghosh, P. K., Rahman, M., Mahon, T., & Unicomb, L. (2017), conducted a cross-sectional
survey in Bangladesh among adolescent school girls named “Menstrual hygiene
management among Bangladeshi adolescent schoolgirls and risk factors affecting
school absence: results from a cross-sectional survey” to know about the menstrual
hygiene management and the risk factors which affects school absence. 2332 adolescent
school girls age from 11 to 17 years were interviewed for the study.

It was found from the study that 41% girls missed school because of menstruation and
the girls who felt uncomfortable at school at the time of menstruation, 99% vs 32%;
ADP=58%; CL 54 to 63(MU Alam, SP Luby, AK Halder, K Islam, A Opel… - BMJ open,
2017 - bmjopen.bmj.com). Mondal, B. K., Ali, M. K., Dewan, T., & Tasnim, T. (2017),
conducted a study “Practices and effects of menstrual hygiene management in rural
Bangladesh” to explore the existing practices on menstrual hygiene management and its
effects of the girls as well as women in rural Bangladesh.

It was a mixed method research which followed both qualitative and quantitative
research methods. It was found that only 10% school girls used improved products
while 90% girls used old unhygienic cloths for the management of menstruation and
90% girls disposed menstrual products un-hygienically at the time of menstruation (BK
Mondal, MK Ali, T Dewan… - …, sanitation and hygiene …, 2017 -
pdfs.semanticscholar.org). Maknun, S. S., Nahar, N., & Kabir, H.

(2017), conducted a study “Women Health and Menstrual Hygiene Management in

Natural Disasters: A Study in Islampur Upazila of Jamalpur District” to examine health as
well as menstrual hygiene management of disaster affected women at Jamalpur District
of Bangladesh. It was a primary field based investigation and found that during disaster
because of unhygienic sanitation and unclean water they were affected many
gynecological problems. It also found that 21% respondents experienced urinary tract
infections and 24% respondents faced rashes on sensitive private parts of their bodies
as well as menstrual hygiene management was very difficult for them (SS Maknun, N
Nahar, H Kabir - Journal of the Asiatic Society of …, 2017 - banglajol.info). Hennegan, J.,
& Solto, L. (2020), conducted a cross sectional survey “Confidence to management of
menstruation at home as well as at school in rural Bangladesh.”

There were 1359 school girls participated in the study and it was found that 57% girls
were very confident to manage their menstrual bleeding at home but only 7% in their
school. At home the using of sanitary pads at the time of menstruation built up the
confidence of the girls while other menstrual hygiene practices were unrelated (J
Hennegan, L Sol - Culture, health & sexuality, 2020 - Taylor & Francis). Torondel, B.,
Sinha, S., Mohanty, J. R., Swain, T., Sahoo, P., Panda, B., Nayak, A., Bara, M., Bilung, B.,
Cumming, O., Panigrahi, P., & Das, P.

(2018), conducted a cross sectional study in India named “Association between

unhygienic menstrual management practices and prevalence of lower reproductive tract
infections: a hospital-b ased cross-sectional study in Odisha, India” to know the
association between unhygienic menstrual management practices and prevalence of
lower reproductive tract infections. 558 non-pregnant women of reproductive age
participated as respondents in the study. It was found that 62.4% women were
diagnosed with at least one of the infections (BV, Candida and TV infection) and 41%
women were affected by BV infection, 34% were affected by Candida infection and 5.6%
were affected by TV infection (B Torondel, S Sinha, JR Mohanty, T Swain… - BMC
infectious …, 2018 – Springe). Khan, Z., Ahmad, S., Singh, J. V., & Dwivedi, A. D.,

(2019), conducted a descriptive cross-sectional study among adolescent school girls of a

rural area in India to assess the menstrual hygiene management practices and
socio-cultural restriction associated with it. There were total 640 adolescent school girls
aging from 10 to 19 years old participated in the study. It was found that at the time of
menstruation 60.5% girls were using sanitary pads and their menstrual hygiene
management practices were unsatisfactory high as well as 82.8% girls faced religious
restriction (https://www.scirp.org › ojog_2020022416154213). Asha, A. C., Karim, N. B.,
Bakhtiar, M.,

& Rahaman, K. S., (2019), conducted a cross-sectional study “Adolescent athlete’s

knowledge, attitude and practices about menstrual hygiene management (MHM) in
BKSP, Bangladesh” to assess the level of knowledge, attitude as well as practices about
menstrual hygiene management among adolescent trainee athletes of BKSP in
Bangladesh. Data was collected from the 143 female athletes and it was found that
39.9% respondents were scared at the time of their first period. 56.6% respondents had
poor knowledge and 68.5% had poor practices regarding menstrual hygiene but 67.1%
respondents had the good level of attitude about menstruation (AC Asha, NB Karim, M
Bakhtiar… - Asian Journal of Medical …, 2019 - banglajol.info). Acharya, A. S., Tiwari, N.,
Rasania, S. K.,
Khandekar, J., & Bachani, D. (2019), conducted a community-based descriptive
cross-sectional research from an urban resettlement colony of East Delhi, India for the
assessment of menstrual hygiene among adolescent girls named “Assessment of
menstrual hygiene among adolescent girls of East Delhi: A community-based
cross-sectional research from an urban resettlement colony”. 105 respondents
participated in the study and found that only 35.2% girls were knowledgeable about
menstruation before their experience about it. Only 56.2% girls had awareness about
menstruation as it’s a normal physiological process. During menstruation, only 31.4%
respondents were using sanitary pads, 59.25% had good practices and about 12.4% had
positive attitude towards menstrual hygiene (AS Acharya, N Tiwari, SK Rasania, J
Khandekar… - Indian Journal of …, 2019 - ijcfm.org). Seydou F et al.

2020), conducted a study about menstrual hygiene management in school setting for
girls ageing from16 to 18 years old in two secondary schools in Bamako named
“Menstrual Hygiene Management in School Setting in Two Secondary Schools in the
Bamako District, Case of the School “La Chaine Grise” and the School Cheick Modibo
Diarra”. It was a transversal and qualitative research and it was found that 50% girls of
the study had poor knowledge about menstruation, 10% were missing school at least
one day a month, 90% were using hygienic cotton for the management of menstrual
blood and 99% of girls said that there was poor state of health infrastructures and which
was one of the causes of genital infections (F Seydou, B Amadou, S Abdoulaye, T
Alassane… - … Journal of Obstetrics and …, 2020 - scirp.org). Sharma, S., Mehra, D.,

Brusselaers, N., & Mehra, S. (2020), conducted a systematic review regarding the existing
evidence on menstrual hygiene preparedness among schools in India named “Menstrual
Hygiene Preparedness among Schools in India: A Systematic Review and Meta-Analysis
of System-and Policy-Level Actions”. It was found that meta-analysis was used for the
estimation of the pooled prevalence of menstrual hygiene practices in schools and
before menarche less than half of the girls had awareness regarding menstruation.

For the girls teachers were the source of information provider regarding menstruation
and around half of the schools had separate toilets for the girls (S Sharma, D Mehra, N
Brusselaers… - International journal of …, 2020 - mdpi.com). Michael, J., Iqbal, Q., Haider,
S., Khalid, A., Haque, N., Ishaq, R., Saleem, F., Hassali, M. A., & Bashaar, M. (2020),
conducted a questionnaire-based cross-sectional survey to assess knowledge and
practices of adolescent females visiting a public healthcare institute of Quetta, Pakistan
regarding menstruation and menstruation hygiene named “Knowledge and practice of
adolescent females about menstruation and menstruation hygiene visiting a public
healthcare institute of Quetta, Pakistan”. 923 female adolescents participated in the
study and their mean age was 15 years old. It was found that 77.7% respondents never
got any lesson regarding menstruation in their schools, 44% had knowledge as it’s a
physiological phenomenon, 60.2% had known that vagina is the source of bleeding.

About 40% respondents were missing their school during menstruation, 90% were using
absorbent materials, 68.7% were using sanitary napkins, 58.2% were not taking baths
and 80.5% were cleaning their genitalia with only water at the time of menstruation. (J
Michael, Q Iqbal, S Haider… - … women's …, 2020 - bmcwomenshealth.biomedcentral ...).
Kokiwar, P. R., & Nikitha, P. (2020), conducted a community-based interventional study
among 260 adolescent girls to know the efficacy of focused group discussion on
knowledge and practices related to menstruation among adolescent girls of rural areas
named “Efficacy of Focused Group Discussion on Knowledge and Practices Related to
Menstruation among Adolescent Girls of Rural Areas of Rhtc of a Medical College: An
Interventional Study”.

It was found that the 260 respondents were randomly allocated to two groups of 130
each and it was observed that during menstruation 51.3% girls used only water to wash
the cloth which was used to manage menstrual blood, only 4.3% girls sun-dried the
cloths and 51.3% girls were burning their final disposal (PR Kokiwar, P Nikitha - …:
official publication of Indian Association of …, 2020 - ncbi.nlm.nih.gov). Afiaz, A. &
Biswas, RK. (2021), conducted a nationwide cross-sectional survey named “Awareness on
menstrual hygiene management in Bangladesh and the possibilities of media
interventions”.

It was found from the study that stratified cluster sampling approach applied with a
study sample of 54 242 women and the age group was between 15 and 49 years old.
Only 24.3% women used modern absorbents for menstrual hygiene management and
most of the women used unhygienic traditional practices. Spatial distribution showed
that the use of modern absorbent of MHM was limited to the major cities. It was known
from the study that the women who were used to mobile phones as well as had
accessibility of media, used modern absorbents of menstrual hygiene management and
the rate of that were nearly 43% and 47%.

Modern absorbents of menstrual hygiene management were also used by educated

women living in urban solvent households with educated house heads (A Afiaz, RK
Biswas - BMJ open, 2021 - bmjopen.bmj.com). 1.3 RESEARCH GAPS There may not have
such type of research on Menstrual Hygiene Management among Adolescent Girls in
Sherpur District of Bangladesh. Maximum number of the research on ‘Menstruation
Hygiene Management among Adolescent Girls’ reveals the statistical data. There are a
very few numbers of mixed method research founded on Menstruation Hygiene
Management among Adolescent Girls in Bangladesh.

Almost all of the research on Menstruation Hygiene Management among Adolescent

Girls are based on analytical or historical research. The number of descriptive or
exploratory researches on Menstrual Hygiene Management among Adolescent Girls are
existing at a very low rate. The adolescent girls of Nalitabari Upazila were not previously
taken into consideration as the respondents of such type of research. Only the
questionnaire technique was founded as the most used data collection technique and
question paper as the tool.

1.4 RATIONALE OF THE STUDY The menstrual period is a physiological process that
occurs throughout the reproductive years of every girl and woman in life. This period is
marked with onset of menarche. The process of menstruation is associated with various
mental as well as physical morbidities like premenstrual syndrome. Menstruation and its
management are still bounded by socio cultural restriction and taboos in our country
resulting in adolescent girls remain ignore of scientific facts and hygienic management
during menstruation.

But unfortunately most of the adolescent girls do not maintain proper hygiene during
menstruation because of ignorance. Menstrual hygiene management is a very important
issue for adolescent girls in our country like other countries of the world. Lack of
education and communication regarding reproductive system further adds to the
problem. Several studies have shown that the knowledge regarding menstrual cycle is
not sufficient. Insufficient management of menstrual hygiene may result in symptoms
involving genitourinary tracts. There are a very few research has been conducted on
menstruation hygiene management among adolescent school girls in Bangladesh.

It was observed both casually as well through regular reports and reviews that ‘WASH’
facilities in schools has been neglected. In our country over 40% girls do not attend
school at the time of menstruation for an average of three days in a month which
instigate bad school performance. The facilities in schools for menstruating girls is very
rare and too much limited. Only 3% school girls have a trash can inside their school
toilet. 53% girls do not have access to toilet with adequate privacy at school and 30%
girls face the same problem at their home (MLGRDC, 2014).

Most of the adolescent school girls in our country both rural and urban areas do not
have proper knowledge as well as many of them holds a very wrong idea and
misconception about the management of menstrual hygiene. It is very necessary to
know about the actual state of management of menstrual hygiene among adolescent
girls in Bangladesh. In order to know the actual condition of the adolescent girls, I have
purposively selected two high school from the study area and have gathered data from
those adolescent girls of that schools who read in class nine and ten.

Gathering information regarding the management of menstrual hygiene among

adolescent girls is will be helpful for the adolescent girls as well as their families to be
conscious about it. Finding of the study will be also helpful for both government and
community development organization as well as NGO’s to undertake appropriate and
need based interventions for improving the situation of adolescent girls in their school
as well as in society. 1.5

STUDY QUESTIONS What do the adolescent girls know about menstruation? What type
of practices they followed during menstruation for menstrual hygiene? What are the
management process of menstrual hygiene among the adolescent girls? What type of
prejudice and misconception does belong to adolescent girls in Bangladesh? 1.6 STUDY
OBJECTIVES General Objective To study about the menstrual hygiene management
among adolescent girls at the period of menstruation. Specific Objectives To know
about the misconceptions and attitude about menstruation and its management among
adolescent girls in Bangladesh. To realize the knowledge regarding menstruation among
adolescent girls in Bangladesh.

To know about the practices of menstrual hygiene during menstruation. 1.7

OPERATIONAL DEFINITION OF THE CONCEPTS Menstruation Menstruation, also known
as a period or monthly, is the regular discharge of blood and mucosal tissue from the
inner lining of the uterus through the vagina. In this research, menstruation is mainly
defined as the process of monthly bleeding of a girl (respondent) in the adolescence
period.

Hygiene Hygiene is the practice of keeping oneself and one’s surroundings clean,
especially in order to prevent illness or the spread of diseases. In this study, hygiene is
defined as practicing cleanliness (of the respondents) at the time of menstruation.
Menstrual Hygiene Menstrual hygiene is defined as women and adolescent girls using a
clean menstrual management material to absorb or collect blood that can be changed
in privacy as often as necessary for the duration of the menstruation period. In this
research, menstrual hygiene is mainly defined as the kinds of clean material used by the
adolescent girls (respondents) during the menstruation period for the absorbing of
blood.

Management Management is a process of dealing with or controlling things or people.

In this study, management means controlling of menstrual hygiene at the time of
menstruation by the adolescent girls (respondents). Adolescent Girls Adolescence is a
transitional stage or period between childhood and adulthood. A female child get her
first menstruation at the age of 8 to 15 years old and the average age of getting first
menstruation of an adolescent girl is 12. In this research, adolescent girls are the
students goes to high school for their 9th -10th class (age range 13-15) education in the
selected area is counted as respondent among the population.

Sherpur District Sherpur is one of the famous district in Bangladesh. It is a part of

Mymensingh Division. The total area of Sherpur District is 1359.87 square kilometer
which is located in between 24°18' and 25°18' north latitudes and in between 89°53' and
90°91' east longitudes. It is bounded by Mymensingh district on the east, Jamalpur
district on the west, Meghalaya state of India on the north, Mymensingh and Jamalpur
districts on the south (http://en.banglapedia.org). CHAPTER TWO 2.

METHODOLOGY OF THE STUDY In simplest term, research methodology means the way
of achieving the research objectives. To be more precise, it mainly focuses on the
methods of data collection with the justification of unique method. 2.1 NATURE OF THE
STUDY The study had been comprised of both the qualitative as well as quantitative
method. These two methods had been applied jointly for data collection from primary
and secondary sources. 2.2 REDEARCH DESIGN The study followed mixed method
research design. Social survey (Sample survey) had been applied for the purpose of data
collection from the respondents.

Following qualitative approach, the researcher coherently conducted FGD (Focus Group
Discussion) and Face-to-face Interview for collecting data from the field while for the
quantitative approach, Sample survey was selected. Descriptive as well as exploratory
statistical way had been used for the analysis of data. 2.3 VARIABLES OF STUDY Both
dependent and independent variables had been followed to conduct the research. 2.4
AREA OF THE STUDY The research had been conducted on the adolescent girls who are
living at the Nalitabari Upazila in Sherpur District.

It is bounded by Meghalaya state of India on the north, Sherpur Sadar and Nakla
upazilas on the south, Haluaghat upazila on the east, Jhenaigati upazila on the west. The
total population of Nalitabari is 252935 (male 128963 and female 123972). Nalitabari
has an average literacy rate of 19.5% and the national average of 32.4% literate. Two
High School (Abdul Hakim Smriti Model High School and Taragonj Pilot Girls High
School) located in the Nalitabari upazila had been purposively (purposive sampling
technique) selected under consideration for collecting necessary information related to
this research. 2.5 SOURCES OF DATA All of the data had been collected mainly from the
primary sources. Face to face interviews and focus group discussions had been used for
collecting primary information from the respondents.
Some information had been collected from the published articles and journals for the
interpretation of primary data. 2.6 POPULATION OF THE STUDY The population of the
research was all the adolescent girls who read in class nine and ten in the selected two
high school from the area of the study. The total population in the area of the study was
632. 2.7 SAMPLE SIZE AND SAMPLING TECHNIQUE This research was explored by
applying simple random sampling technique.

Each individual has chosen randomly and entirely by chance, such that each individual
had the same probability of being chosen at any stage during the sampling process. To
discuss with the thesis supervisor, eighty respondents (12.65%) was selected from the
total 632 population. Lottery method of simple random sampling was used to select the
respondents for taking face-to-face interview. Each respondent selected for data
collection had been considered as a sample unit. 2.8 SAMPLE SIZE SELECTION PROCESS
The total population in the area of the study was 632. Among them 80 units were picked
up. Population, N = 632 Pre-determined sample, s = 80 Number of Groups = ?? ?? =
632 80 = 7.9

~ 8 This 80 units were picked up for making a simple randomized sample from the total
population by using lottery method following statistical frequency table. No _Class
_Frequency _Number of Girls _School _ _1 _001-079 _10 _30 _Abdul Hakim Smriti Model
High School (219) _ _2 _080-158 _10 _ _ _ _3 _159-237 _10 _ _ _ _4 _238-316 _10 _50
_Taragonj Pilot Girls High School (413) _ _5 _317-395 _10 _ _ _ _6 _396-474 _10 _ _ _ _7
_475-553 _10 _ _ _ _8 _554-632 _10 _ _ _ _ _Total = 80 _ _ _ Sample percentile = ?? ??
×100= 80 632 ×100=12.65% So, the sample size is 80 (12.65%).

A sample was selected using lottery method from the numbers between 1 to interval
number and then the next samples were selected following the interval, thus a total of
80 adolescent girls had been selected as research respondents for taking face to face
interview from the study area. 2.9 TECHNIQUE TO DRAW FDGS RESPONDENTS Two
Focus Group Discussions (FGDs) had been conducted in two schools from the study
area. There were total 16 respondents for two focus group discussions (8 respondents
for 1 FGD) had been selected using purposive sampling technique with the informed
consent of the each respondent.

FGDs were conducted with the respondents with whom face to face interviews were not
conducted. 2.10 DATA COLLECTION TECHNIQUE Interviewing technique had been
applied in this research as a technique of data collection for conducting sample survey.
Because, it may be defined as a systematic conversation between an investigator and an
informant, initiated or obtaining information relevant to a specific study. As well as, as a
technique of data collection focus group discussions had also been applied in this
research. 2.11 SELECTION AND DEVELOPMENT OF TOOLS OF DATA COLLECTION For
conducting a sample survey an interview schedule had been made as a tools of data
collection for conducting face-to-face interview.

Both open ended and close ended questions (semi-structured) had been included in the
interview schedule. As well as a questionnaire paper with some focus group questions
had been prepared for conducting FGDs 2.12 PRE-TESTING OF DATA COLLECTION
TOOLS For pre-testing the data collection tools, interview schedule had been used and
had collected data from 15 respondents of class nine and ten. Some necessary questions
had been included in the interview schedule after reviewing the collected information.
As well as a focus group discussion had been conducted with 8 participants of a group
for the pre-testing of focus group questions. 2.13 DATA COLLECTION, CODING, EDITING
AND TABULATION The researcher had collected primary data from the area of the
study. Data Coding, Editing and Tabulation had been completed after data collection.

The coded and tabulated information from the data processing had been analyzed
according to the objectives of this research. Some information had been cut down which
were not relevant with the research design. 2.14 DATA ANALYSIS Mainly data are
analyzed in two stages. Quantitative data are presented in tables as well as figures.
Statistical Package for Social Sciences (SPSS) IBM 22 was used for analyzing the
quantitative data of the research. As well as, qualitative data are interpreted in
descriptive manner. 2.15 ETHICAL CONSIDERATION Informed consent is the major
ethical issue in conducting research.

It means that a person knowingly, voluntarily and intelligently and in a clear and
manifest way, gives his consent. Data had been collected by gaining informed consent
from the participants of the study. Confidentiality is other important concentration of all
of the ethical consideration as research report has to be submitted in the Department of
Social work, Shahjalal University of Science and Technology and data collected from the
participants had been kept confidential. Assurance had been given to the respondents
that the collected information will not be published publicly and this will be used in
academic purpose.

The interview had been conducted at suitable time and locations that was convenient to
the participants. Participants were in making their decision. Identities of participants had
been protected and participants had been always treated with respect. It was ensured
that no physical or psychological harm will come to anyone who participates in the
study. Any kinds of pressure or threatened gift or persuasive work had not been given
for concluding the study. The researcher had maintained a professional relationship with
the clients of the study and it assured that any kind of problems of the participants will
not be created.

During the research, all types of deception had been avoided and also avoided to
provide any type of false information while collecting data from the respondents. 2.16
REPORT WRITING AND SUBMISSION A Draft report has been prepared based on
proposed data in accordance with the guidance of my respected supervisor. The report
is not larger or smaller but it is reasonable in size. The language of the report is English.
Then report has been submitted to the Department of Social Work, Shahjalal University
of Science and Technology, Sylhet for the evaluation as it is a Lab Course of Masters
Level. CHAPTER THREE 3. MAJOR FINDINGS OF THE STUDY 3.1

ANALYSIS OF QUANTITATIVE DATA GENERAL DEMOGRAPHIC INFORMATION Figure

3.1. Information Related to Age of the Respondents There are more than 32 million
adolescents in Bangladesh (https://www.unicef.org). According to WHO, the age group
of adolescents are 10 years to 19 years old. In Bangladesh, there are about one- in-ten
citizens are adolescents and the age group of the adolescents are between 10-19 years
old (https://www.thedailystar.net). / Figure 3.1. demonstrates the age of the
respondents. From the figure it is clearly seen that, the age of the respondents are
mainly divided into three groups. According to the figure, the age group of the
respondents are 14 years, 15 years and 16 years.

From the above figure, it is estimated that most of the respondents are 15 years old and
it covers 40% of the respondents. It is also seen in the figure that 30% respondents are
14 years old as well as 30% respondents are 16 years old. This data clearly claims that
the respondents of the study belongs to the adolescence period or age group. Table No
3.1. Information about Parents Educational Qualification According to UNESCO, the
adult literacy rate of Bangladesh is 73.91%.While the male literacy rate is 76.67% as well
as female literacy rate is 71.18% (https://countryeconomy.com).

_Father’s Educational Qualification _Mother’s Educational Qualification _ _Level of

Education _Frequency _Percent _Frequency _Percent _ _ _Graduate _22 _27.5 _2 _2.5 _ _
_HSC _7 _8.8 _4 _5.0 _ _ _Illiterate _11 _13.8 _17 _21.3 _ _ _Post Graduate _5 _6.3 _1 _1.3 _
_ _SSC _15 _18.8 _17 _21.3 _ _ _Up to Five _5 _6.3 _15 _18.8 _ _ _Up to Ten _15 _18.8 _24
_30.0 _ _ _Total _80 _100.0 _80 _100.0 _ _ The above table represents the information
about the educational qualification of the parents’ of the respondents of the study. The
above table indicates that 13.8% fathers of the respondents are illiterate. 6.3% fathers
are in the group of up to class five as well as 18.8% are in the group of under 10. 18.8%
fathers have completed SSC and 8.8% have completed HSC. 27.5% fathers have
completed graduation as well as only 6.3% have completed post-graduation.
On the other hand, most of the mothers of the respondents are in the group of up to
class 10. Around 21.3% mothers are illiterate, 18.8% are in the group of up to five. 21.3%
mothers are SSC passed as well as 5.0% are HSC passed. Only 2.5% mothers have
completed their graduation and only 1.3% have completed post-graduation. Table No
3.2. Information about Father’s Profession Refined activity rate of labor force
participation rate of the country shows that 57.1 % of economically active population is
participating in labor force. Among male it is 81.7 percent and among female 32.9
percent (https://www.grin.com). Profession _Frequency _Percentage (%) _ _ _Agronomy
_16 _20.0 _ _ _Business _38 _47.5

_ _ _Employed _14 _17.5 _ _ _Laborer _7 _8.8 _ _ _Others _5 _6.3 _ _ _Total _80 _100.0 _ _
The table indicates the profession of the fathers’ of the respondents of the study.
According to the above table, it is seen that most of the father’s profession is business
to maintain their livelihood and it’s around 47.5%. On the other hand, 20.0% are
associated with agronomy as the sources of income of the family, 17.5% respondents’
fathers are related with various types of government as well as non-government job.
8.8% are laborer who are involved in various types of labor to earn money for the family.
6.3% fathers of the respondents are involved in different sectors of occupations in order
to secure the livelihood of the members of the family. Table No 3.3.

Information about Mother’s Profession According to the International Labour

Organization's (ILO) flagship report titled “World Employment and Social Outlook:
Trends 2018,” female employment in Bangladesh has seen a 35% increase, reaching 18.1
million from 2008 to 2017, while male employment has seen an 11% increase, reaching
45.7 million (Women in workforce: Employment without empowerment). Profession
_Frequency _Percentage (%) _ _ _Employed _9 _11.3 _ _ _Housewife _70 _87.5 _ _ _Laborer
_1 _1.3 _ _ _Total _80 _100.0 _ _ The provided information of the table indicates the
profession or occupation of the mothers of the respondents of the study.

From the above table it is seen that most of the mothers are not involved in any type of
profession or occupation. They play the role of housekeeping in the family and it is
87.5%. The table also demonstrates that 11.3% women are involved in various types of
government or non-government jobs those are one of the income sources for the
women. From the table it is also seen that only 1.3% mother of the respondent is
involved with labor to earn money for the livelihood of the family. Table 3.4. Information
about Monthly Income of Family Wages in Bangladesh is expected to reach 15100.00
BDT/Month by the end of 2020, according to Trading Economics global macro models
and analysts expectations. In the long-term, the Bangladesh average monthly income is
projected to trend around 15100.00 BDT/Month in 2021, according to our econometric
models (Bangladesh Average Monthly Income | 2020-2021 Forecast). Monthly Income
_Frequency _Percentage (%) _ _ _10000-15000 _14 _17.5 _ _ _15000-20000 _6 _7.5 _ _
_20000-25000 _7 _8.8

_ _ _25000-30000 _14 _17.5 _ _ _30000-35000 _3 _3.8 _ _ _35000-40000 _3 _3.8 _ _

_40000-45000 _6 _7.5 _ _ _45000-50000 _2 _2.5 _ _ _5000-10000 _25 _31.3 _ _ _Total _80
_100.0 _ _
Monthly income source of a family is one of the important point to run a family.
According to the table it is found that, around 31.3% of the families of the respondents
of the study earn 5000-10000 Tk. monthly. Around 17.5% families of the respondents
monthly income is 10000-15000 Tk. On the other hand, 7.5% families of the respondents
earn 15000-20000 Tk. monthly. The monthly income of 8.8% families of the respondents
is 20000-25000 Tk. 17.5% families of the respondents earn 25000-30000 Tk. in one
month. The monthly family income of 3.8% respondents of the study is 30000-35000 Tk.,
and 3.8% earns 35000-40000 Tk. 7.5% families of the respondents earn 40000-45000 Tk.

monthly as well as only 2.5% of the families earns 45000-50000 Tk. monthly. Table No
3.5. Information about Religious Status The major religion in Bangladesh is Islam
(90.4%), but a significant percentage of the population adheres to Hinduism (8.5%) as
per the 2011 census ; other religious groups include Buddhists 0.6%, (mostly Theravada),
Christians (0.3%, mostly Roman Catholics), and Animists (0.2%) (Freedom of religion in
Bangladesh – Wikipedia). Religion _Frequency _Percentage (%) _ _ _Christian _1 _1.3 _ _
_Hindu _5 _6.3 _ _ _Muslim _74 _92.5 _ _ _Total _80 _100.0 _ _ The above data of the table
reveals the information about religious status of the respondents of the study.

The above table shows that, most of the respondents of the study were Muslim and it is
around 92.5%. On the other hand, around 6.3% of the study were Hindu. The
percentage of Christian respondent was too less and it was only 1.3%. INFORMATION
ABOUT HOUSEHOLD Table No 3.6. Information about Types of the Family In Bangladesh
two types of families are generally noticed and these are nuclear families and extended
families. Nuclear families are small families consisting of father, mother and their
children. But extended families mean large families where father, mother, children,
grandfather, grandmother, uncles, aunts, cousins etc.

live together (Family Patterns in Bangladesh | studyaid365). Types of Family _Frequency _

Percentage (%) _ _ _Extended _4 _5.0 _ _ _Joint _11 _13.8 _ _ _Nuclear _65 _81.3 _ _ _Total
_80 _100.0 _ _ From the table it seen that the information about the types of the family
of the respondents of the study. From the above table, it is shown that most of the
families of the respondents are nuclear family and it is around 81.3%. On the other
hand, around 13.8% respondents of the study are included in joint family as well as only
5.0% respondents are live in extended family. Table No 3.7.

Information about Number of the Family Members Nationally, the average household
size is 4.5 people per household. It is calculated by dividing the household population
by total households (Bangladesh Average Household Size – Overview). No. of Family
Members _Frequency _Percentage (%) _ _ _3.0 _1 _1.3 _ _ _4.0 _30 _37.5 _ _ _5.0 _26 _32.5
_ _ _6.0 _8 _10.0 _ _ _7.0 _5 _6.3 _ _ _8.0 _4 _5.0 _ _ _9.0 _2 _2.5 _ _ _10.0 _1 _1.3 _ _ _11.0 _1
_1.3 _ _ _12.0 _2 _2.5 _ _ _Total _80 _100.0 _ _ The data of the table reveals the
information about the number of the family members of the respondents of the study.
According to the table, there are a major part of the family members are 4 and it is
around 37.5%. 1.3% respondent’s family members are 3. On the other hand, 32.5%
respondents of the study have 5 family members and 10.0% respondents’ family
members are 6. It is also seen that 6.3% have 7 members in their family and 5.0%
respondents have 8 members. 2.5% respondents of the study shared that they have 9
members in their family. Only 1.3% respondent has 10 family members as well as 1.3%
respondent has 11 members in the family. The number of family members of the 2.5%
respondents of the study are 12.

Table No 3.8. Information about the Number of Siblings Siblings, it’s an important part
of every family. The following table demonstrates the information about the number of
siblings in their family. No. of Siblings _Frequency _Percentage (%) _ _ _1.0 _8 _10.0 _ _
_2.0 _41 _51.2 _ _ _3.0 _27 _33.8 _ _ _4.0 _4 _5.0 _ _ _Total _80 _100.0 _ _ From the above
table it is seen that the most of the respondents have only two siblings and it is around
51.2%. On the other hand, 10.1% respondents have 1 siblings and 33.8% respondents of
the study have 3 siblings. 5.0% respondents of the study have 4 siblings in their family.
Table No 3.9.

Information about the Relationship Status It is very much necessary to build up a good
relationship with the members of a family mainly in the adolescence period. So that an
adolescent child can share everything with the family members. Relationship _Frequency
_Percentage (%) _ _ _Good _24 _30.0 _ _ _Average _47 _58.8 _ _ _Bad _4 _5.0 _ _ _Excellent
_5 _6.3 _ _ _Total _80 _100.0 _ _ Table 3.9 shows the information about the relationship
status of the respondents with their family members. Most of the respondents have said
that they have average relationship with their family members and it is 58.8%. 30.0%
respondents have good relationship with their family members. On the other hand, 5.0%
respondents have bad relationship with the members of the family and 6.3%
respondents have said that they have excellent relationship with their family members.
Table No 3.10.

Information about the Decision Making Process of the Family Decision making is a term
used to describe the process by which families make choices, determine judgements
and come to conclusions that guide behaviors (https://family.jrank.org). Decision Maker
_Frequency _Percentage (%) _ _ _Father _27 _33.8 _ _ _Grand parents _3 _3.8 _ _ _Mutual
agreement _50 _62.5 _ _ _Total _80 _100.0 _ _ It is found from the table that the
information about the decision making process of the family of the respondents of the
study.

Most of the respondents have said that the decision making process of their family is
mutual agreement and it is around 62.5%. On the other hand, 33.8% families of the
respondents of the study’s decision makers are father as well as only 3.8% families of
the respondents decision makers are their grand-parents. Table No 3.11. Information
about the Sources of Water Improved water facilities is very important for everyone.
There are various sources of water in Bangladesh. The main sources of water are surface
water, ground water and rainwater (Water Supply Situation Analysis). Water Sources
_Frequency _Percentage (%) _ _ _Supply water _59 _73.8 _ _ _Tube-well _21 _26.3 _ _
_Total _80 _100.0

_ _ The above table presents the information about the water sources of the
respondents of the study. There are mainly two sources of water from where the
respondents collect water. Supply water is the main sources of water in most of the
respondent’s area and it is around 73.8%. On the other hand, around 26.3%
respondents’ of the study main water sources is Tube-well. Table No 3.12. Information
about the Status of Washroom For living a dignified as well as healthy life decent
washroom and good hygiene are vital. 85.6 million people in Bangladesh one in two do
not have a decent toilet for their own (Bangladesh- Facts and Statistics).

Washroom Status _Frequency _Percentage (%) _ _ _Bad _4 _5.0 _ _ _Good _53 _66.3 _ _
_Average _17 _21.3 _ _ _Very bad _1 _1.3 _ _ _Very good _5 _6.3 _ _ _Total _80 _100.0 _ _
From the above table it is found that the information about the status of washroom of
the respondents of the study. From the above table, it is shown that 66.3% respondent’s
washroom status is good. On the other hand, 5.0% respondents shared that the
washroom status of their house is bad. 21.3% respondents said that the washroom
status of their home is average and only 1.3% said that the status of washroom is very
bad. According to 6.3% respondents of the study, the status of washroom of their house
is very good. INFORMATION ABOUT ADOLESCENCE PERIOD Table No 3.13.

Information about Knowledge of Changes in Adolescence Period In the development a

human being adolescence is one of the most rapid phases. During the adolescence
period, many biological as well as mental changes can take place of a human body and
in his characteristics. Some of the most obvious physical changes are increases in height,
acquisition of muscle mass, the distribution of body fat and the development of
secondary sexual characteristics (a period needing special attention -
adolescence-physical ...).

So it is very necessary for every adolescents to know about the physical changes in the
adolescence period. Knowledge _Frequency _Percentage (%) _ _ _Don't know _49 _61.3 _
_ _Know _6 _7.5 _ _ _Moderately know _25 _31.3 _ _ _Total _80 _100.0 _ _ The above table
represents the information about the knowledge of physical changes in the adolescence
period of the respondents of the study. From the table it is know that most of the
respondents has no knowledge about the physical changes of adolescence period and
the rate of the respondents are 61.3%. 31.3% respondents know moderately about the
physical changes as well as 7.5% respondents have knowledge about the changes of
adolescence period. Table No 3.14.

Information about the Medium of Getting Knowledge about Adolescence Period The
five leading characteristics of adolescence are biological growth and development, an
undefined status, increased decision making, increased pressures, and the search for self
(The Adolescent in Society - Central Lyon CSD). There are various sources or medium of
getting knowledge about adolescence period. Such as- Family Members, Text Book,
School Teacher, Friends, Television, News Paper, Radio, Online or Internet, Relatives,
Posters etc. Medium _Frequency _Percentage (%) _ _N/A _ _49 _61.3 _ _ _Family members
_5 _6.3 _ _ _Friends _6 _7.5

_ _ _Social Media _8 _10.0 _ _ _Posters _3 _3.8 _ _ _School teacher _1 _1.3 _ _ _Television

_5 _6.3 _ _ _Text books _3 _3.8 _ _ _Total _80 _100.0 _ _ The above table demonstrate the
information about the medium or sources of getting knowledge about adolescence
period of the respondents of the study. From the table it is seen that a big number of
the respondents didn’t get any information about the sources of adolescence period
and the type of physical changes in this period and it is 61.3%.

It is seen from the table that 10% respondents got knowledge about the changes of
adolescence period from social media. Similarly, 6.3% respondents got knowledge about
the various types of changes of adolescence period from the family members. 7.5%
respondents learned about the changes of adolescence period from their friends, 3.8%
got from posters, only 1.3% respondent got knowledge from school teacher, 6.3% got
from television as well as 3.8% got knowledge about the adolescence period from text
book. Table No 3.15. Information about Facing Problems in the Adolescence Period
Adolescence is a time for growth spurts and puberty changes.

An adolescent may grow several inches in several months followed by a period of very
slow growth, then have another growth spurt. Changes with puberty (sexual maturation)
may happen gradually or several signs may become visible at the same time (The
Growing Child: Adolescent 13 to 18 Years | Johns Hopkins ...). In the adolescence period
of a human being various types of physical as well as mental or behavioral changes can
occur. Types of answer _Frequency _Percentage (%) _ _ _No _18 _22.5 _ _ _Yes _62 _77.5 _
_ _Total _80 _100.0 _ _ Table no 3.15 shows the information about the facing problems in
the adolescence period of the respondents of the study. From the above table, it is seen
that 22.5% respondents didn’t face any type of problems in their adolescence period. On
the other hand, 77.5% respondents faced various types of physical or mental problems
in the adolescence period. Table No 3.16. Information about Types of Faced Physical
Problems During adolescence period various types of physical problem can occurred.

Such as- Adolescent health problems and injuries, Acne, Asthma, Diabetes, Menstrual
disorders, High blood pressure, Oral health, Orthodontics and braces, Wisdom teeth
extraction, Periodontal disease, Scoliosis, Mouth guards, Heat-related illnesses (heat
cramps, heat exhaustion, heat stroke) etc. (Adolescent health problems and injuries |
Children's Wisconsin) Types of Physical Problem _Frequency _Percentage (%) _ _N/A _
_30 _37.5 _ _ _Acne _30 _37.5 _ _ _Gastrointestinal problem _7 _8.8 _ _ _Headache _7 _8.8
_ _ _Injuries _5 _6.3 _ _ _Oral health problem _1 _1.3 _ _ _Total _80 _100.0 _ _ The above
data on the table demonstrates the information about the types of physical problems
faced by the respondents of the study.

From the data it is seen that 37.5% respondents of the study said that they didn’t face
any type of physical problems in their adolescence period. The data on the table also
show that, most of the respondents have faced a common problem in the adolescence
period and it is acne. It is seen that 37.5% respondents have faced acne problem. 8.8%
said that they have faced gastrointestinal problem as well as 8.8% respondents shared
that they were suffering from headache problem. From the table it is also seen that 6.3%
respondents have faced injuries and only 1.3% have faced oral health problem.

Table No 3.17. Information about Receiving Treatment In the adolescence period facing
of any physical or mental problem is very common. But proper treatment can be helpful
to mitigate the problems most. Half of all mental health disorders in adulthood start by
age 14, but some stages which can be helpful to minimize the physical and
psychological consequences. Such as- antiretroviral treatment, adherence to treatment,
retention in care and viral suppression (Adolescent and young adult health). Types of
Answer _Frequency _Percentage (%) _ _N/A _ _30 _37.5 _ _ _No _35 _43.8 _ _ _Yes _15
_18.8 _ _ _Total _80 _100.0

_ _ From the table it is estimated that, 37.5% respondents didn’t face any type of
physical problem, that’s why they didn’t take any type of treatment also. The above
table shows that, 43.8% respondents didn’t receive any treatment when they have
affected various types of physical problems. On the other hand, 18.8% respondents have
received treatment at the time of their sickness. Table No 3.18. Information about Types
of Faced Mental Problems The most common mental illnesses in adolescence periods
are anxiety, mood, attention, and behavior disorders.

Suicide is the second leading cause of death in young people aged 15–24 years (Mental
Health Disorders in Adolescents | ACOG). Types of Mental Problem _Frequency
_Percentage (%) _ _N/A _ _58 _72.5 _ _ _Attention Deficit Hyperactivity _1 _1.3 _ _
_Anxiety _4 _5.0 _ _ _Depression _1 _1.3 _ _ _Frustration _1 _1.3 _ _ _Loneliness _1 _1.3 _ _
_Shyness _14 _17.5 _ _ _Total _80 _100.0 _ _ The table shows the information of
respondents that who have faced various types of mental problem in their adolescence
period. From the above table it is seen that, some respondents have affected some
common mental problems.

Most of the respondents have shared that, shyness was common mental problem to
them and the rate of this problem is 17.5%. It is also seen from the table that, 1.3%
respondent have faced Attention Deficit Hyperactivity. On the other hand, 5.0%
respondents have shared that they were facing Anxiety problem. Only 1.3% respondent
has shared that she was depressed, 1.3% respondent was frustrated as well as 1.3%
respondent felt loneliness in the adolescence period. Table No 3.19. Information about
Rate of Sharing about the Problems with Family Members Family is the single most
important influence in a child's life. From their first moments of life, children depend on
parents and family to protect them and provide for their needs.

They are a child's first teachers and act as role models in how to act and how to
experience the world around them (Why is family support important? | Smart Beginnings
MHC). In the adolescence period, a child can faces various types of physical or mental
problems. It can be very helpful to share those problems with the members of the
family. Types of Answer _Frequency _Percentage (%) _ _N/A _ _30 _37.5 _ _ _No _30 _37.5
_ _ _Yes _20 _25.0 _ _ _Total _80 _100.0 _ _ From the table it is known the information
about rate of sharing about the problems with family members of the respondents of
the study. The above table indicates that, 37.5% respondents didn’t share about their
mental or physical sickness with their family members and 25.0% have shared about
their problems of adolescence period with the members of the family. KNOWLEDGE
ABOUT MENSTRUATION Table No 3.20.

The Time of Receiving Knowledge about Menstruation Menstruation, or period, is

normal vaginal bleeding that occurs as part of a woman's monthly cycle. Every month, a
female body prepares for pregnancy (Menstruation | Period | MedlinePlus). It is very
necessary to have knowledge about the menstruation for every adolescent girls.
Knowledge _Frequency _Percentage (%) _ _ _Know after menarche _69 _86.3 _ _ _Know
before menarche _11 _13.8 _ _ _Total _80 _100.0 _ _
The table presents the information about the time of receiving knowledge about
menstruation of the respondents of the study.

Though it is helpful to know about the menstruation in the early stage of adolescence of
a female child but from the above table it is seen that, 86.3% respondents received
knowledge about menstruation after starting their first menstruation. On the other
hand, only13.8% respondents of the study received knowledge about menstruation
before starting their first menstruation. Figure 3.2. Information about Occurring of First
Menstruation For most girls, their first menstrual period, or menarche begins about 2
years after she first starts to get breasts. For most girls this is around age 12.

But it can be as early as age 8 or as late as 15 (When Will I Get My Period? (for Kids) -
Nemours KidsHealth). / Information presented in the above figure shows the age limit of
the respondents about occurring their first menstruation. The age limit of the
respondents of the study was 14-16 years old and the age limit of starting their first
menstruation was 12-14 years old. The data of the figure shows that, 20% respondents
of the study received their first period at the age of 12. On the other hand, 41.3%
respondents have shared that they have received their first menstruation at the age of
13. And rest of the respondents (38.8%) said that the first menstruation of them
occurred at the age of 14. Table No 3.21.

Information about Sharing Persons When Received First Period In the early stages of
adolescence maximum adolescents has no knowledge about the physical changes. So
maximum adolescent girls have no knowledge about the menstruation. To know about
the physical changes properly and to know the management process of the changes, it
is very necessary to share with any comfortable person. Sharing Person _Frequency
_Percentage (%) _ _ _Father _1 _1.3 _ _ _Friends _4 _5.0 _ _ _Grand mother _5 _6.3 _ _
_Mother _64 _80.0 _ _ _Other relative _1 _1.3 _ _ _Sister _5 _6.3 _ _ _Total _80 _100.0 _ _
The above table shows the information about sharing persons when the respondents of
the study received first menstruation.

From the above table, it is seen that most of the respondents shared about their first
period with their mother and it is 80.0%. Only 1.3% respondent of the study shared with
father. On the other hand, 5.0% respondents of the study shared with friends about their
first menstruation, 6.3% respondents shared with grand-mother as well as 6.3%
respondents of the study shared with sister. Only 1.3% respondent shared information
about their first period with other relatives. Table No 3.22.

Information about Types of Products used at the Time of Menstruation There are various
types of period products which can be used at the time of menstruation for the
management of menstrual blood. Such as- Pads, Reusable pads, Tampons, Menstrual
cups, Period underwear etc (Period products - Family Planning). Types of Products
_Frequency _Percentage (%) _ _ _Clothes and pads _12 _15.0 _ _ _Cloths _14 _17.5 _ _
_Sanitary pads _50 _62.5 _ _ _Tissues and pads _4 _5.0 _ _ _Total _80 _100.0 _ _ Data
presented in the above table show the information about the types of products used at
the time of menstruation for the management of menstrual blood of the respondents of
the study.

The data of the table indicates that 62.5% respondents of the study use sanitary pads at
the time of menstruation for the management of menstrual blood. On the other hand,
15.0% respondents of the study use clothes and pads at the same time. 17.5%
respondents use only cloths at the time of menstruation as well as only 5.0%
respondents of the study use tissues and pads together for the management of
menstrual blood at the time of menstruation. Table No 3.23. Information about Period is
Painful or Not Period pain is common and a normal part of menstrual cycle. Most
women get it at some point in their lives. It's usually felt as painful muscle cramps in the
tummy, which can spread to the back and thighs.

The pain sometimes comes in intense spasms, while at other times it may be dull but
more constant (Period pain – NHS). Types of Answer _Frequency _Percentage (%) _ _
_Yes _69 _86.3 _ _ _No _11 _13.8 _ _ _Total _80 _100.0 _ _ The above table shows the
information about period is painful or not painful to the respondents of the study.
According to the data of the table it is seen that 86.3% respondents of the study shared
that to them menstruation is painful. On the other hand, 13.8% respondents of the study
said that period is not painful to them at all. Table No 3.24. Information about Using
Products for the Management of Menstrual Pain To relieve pain applying heat to
abdomen and lower back may be helpful.

A 2012 study focused on 147 women 18 to 30 years old who had regular menstrual
cycles found that a heat patch at 104°F (40°C) was as effective as ibuprofen. If hot water
bottle or heating pad is not available, taking warm bath or using of hot towel may
reduce the menstrual pain at the time of menstruation. (Menstrual Cramp Home
Remedies for Natural Relief – Healthline). Types of Products _Frequency _Percentage (%)
_ _N/A _ _53 _66.3 _ _ _Heating pads _6 _7.5 _ _ _Herbal medicine _2 _2.5 _ _ _Hot water
bottle _4 _5.0 _ _ _Medicine _12 _15.0 _ _ _Warm shower _3 _3.8 _ _ _Total _80 _100.0
_ _ The table presents the information about the using products of the respondents of
the study for the management of menstrual pain at the time of menstruation. From the
above table it is seen that 7.5% respondents of the study use heating pads at the time of
menstruation to minimize the pain of menstruation. On the other hand, only 2.5%
respondents of the study take herbal medicine to mitigate menstrual pain. For the
management of menstrual pain 5.0% respondents of the study use hot water bottle as
well as 15.0% respondents of the study take medicine. Only 3.8% study respondents
take warm shower for the management or mitigation of menstrual pain at the time of
menstruation.

INFORMATION ABOUT MENSTRUAL HYGIENE Table No 3.25. Knowledge about

Menstrual Hygiene At the time of menstruation menstrual hygiene is a hygienic practice
which can prevent women from the infection in reproductive and urinary tract.
Hygiene-related practices of women during menstruation are of considerable
importance, as it may increase vulnerability to Reproductive Tract Infections (RTI's)
(Importance of Maintaining Menstrual Hygiene | Blog). Knowledge _Frequency
_Percentage (%) _ _ _Don't know _56 _70.0 _ _ _Know _6 _7.5 _ _ _Know moderately _18
_22.5 _ _ _Total _80 _100.0 _ _ The above table reveals the knowledge of the respondents
of the study about menstrual hygiene. 70.0% respondents shared that they have no
knowledge about menstrual hygiene. On the other hand, 7.5% respondents of the study
shared that they have knowledge about menstrual hygiene and 22.5% respondents were
known moderately about menstrual hygiene.

Table No 3.26. Thinking about Menstrual Hygiene Menstrual Hygiene is vital to the
empowerment and well-being of women and girls worldwide. It is about more than just
access to sanitary pads and appropriate toilets – though those are important. It is also
about ensuring women and girls live in an environment that values and supports their
ability to manage their menstruation with dignity (Menstrual Hygiene | Clean Water |
World Vision International). Thinking _Frequency _Percentage (%) _ _ _Necessary _56
_70.0 _ _ _Neutral _8 _10.0 _ _ _Very necessary _16 _20.0 _ _ _Total _80 _100.0 _ _ The data
of the table demonstrates the information about the thinking of the respondents about
menstrual hygiene.

In the study 70.0% respondents shared that to know about menstrual hygiene is
necessary. On the other hand, 10.0% respondents had no opinion regarding it and
20.0% respondents of the study said that to know about menstrual hygiene is very
necessary. INFORMATION ABOUT MENSTRUAL HYGIENE MANAGEMENT Table No 3.27.
Information about Menstrual Hygiene Management Menstrual hygiene management
(MHM) or menstrual health and hygiene (MHH) refers to access to menstrual hygiene
products to absorb or collect the flow of blood during menstruation, privacy to change
the materials, and access to facilities to dispose of used menstrual management
materials (Menstrual hygiene management – Wikipedia). It is very necessary for every
adolescent girls to know about menstrual hygiene management properly.

Knowledge _Frequency _Percentage (%) _ _ _Don't know _56 _70.0 _ _ _Know _6 _7.5 _ _
_Know moderately _18 _22.5 _ _ _Total _80 _100.0 _ _ The above table indicates the
knowledge of the respondents of the study about menstrual hygiene management.
70.0% respondents shared that they have no knowledge about menstrual hygiene. On
the other hand, 7.5% respondents of the study shared that they have knowledge about
menstrual hygiene management and 22.5% respondents were known moderately about
menstrual hygiene. Table No 3.28. The Medium of Learning about Menstrual Hygiene
Management To know about the menstrual hygiene management is very important for
every girls in their adolescence period. They can get information from various sources.

Medium _Frequency _Percentage (%) _ _N/A _ _56 _70.0 _ _ _Friend _3 _3.75 _ _ _Mother
_7 _8.75 _ _ _Posters _1 _1.3 _ _ _Sister _2 _2.5 _ _ _Social media _6 _7.5 _ _ _Television _1
_1.3 _ _ _Text book _4 _5.0 _ _ _Total _80 _100.0 _ _ _ _ The above table indicates the
medium of learning about menstrual hygiene management of the respondents of the
study. It is seen that, 3.75% respondents of the study have learnt about menstrual
hygiene management from their friends. On the other hand, 8.75% respondents got
knowledge about MHM from their mother. 1.3% respondents learnt from posters about
MHM. 2.5% respondents of the study learnt about menstrual hygiene management from
their sister. 7.5% respondents got knowledge about MHM from social media, 1.3%
respondent learnt about MHM from television and other 5.0% respondents of the study
learnt about menstrual hygiene management from text book. Table No 3.29.

Thinking about Menstrual Hygiene Management Hygiene-related practices of women

during menstruation are of considerable importance, as it may increase vulnerability to
Reproductive Tract Infections (RTI's). Poor menstrual hygiene is one of the major
reasons for the high prevalence of RTIs in the country and contributes significantly to
female morbidity (Importance of Maintaining Menstrual Hygiene | Blog). To know about
the menstrual hygiene management is very necessary for every adolescent girls.
Thinking _Frequency _Percentage (%) _ _ _Necessary _56 _70.0 _ _ _Neutral _8 _10.0 _ _
_Very necessary _16 _20.0 _ _ _Total _80 _100.0

_ _ The data of the table shows the information about the thinking of the respondents
about menstrual hygiene management. In the study 70.0% respondents shared that to
know about menstrual hygiene management is necessary. On the other hand, 10.0%
respondents had no opinion regarding it and 20.0% respondents of the study said that
to know about menstrual hygiene management is very necessary. Table No 3.30.
Information about Types of Products Using for Menstrual Blood Management There are
various types of period products which can be used at the time of menstruation for the
management of menstrual blood.

Such as- Pads, Reusable pads, Tampons, Menstrual cups, Period underwear etc (Period
products - Family Planning). Types of Products _Frequency _Percentage (%) _ _ _Clothes
and Pads _12 _15.0 _ _ _Cloths _14 _17.5 _ _ _Sanitary pads _50 _62.5 _ _ _Tissues and
pads _4 _5.0 _ _ _Total _80 _100.0 _ _ Data presented in the above table show the
information about the types of products used at the time of menstruation for the
management of menstrual blood of the respondents of the study. The data of the table
indicates that 62.5% respondents of the study use sanitary pads at the time of
menstruation for the management of menstrual blood. On the other hand, 15.0%
respondents of the study use clothes and pads at the same time. 17.5% respondents use
only cloths at the time of menstruation as well as only 5.0% respondents of the study
use tissues and pads together for the management of menstrual blood at the time of
menstruation. Table No 3.31.

Using Products for Cleaning Vagina for the Management of Menstrual Hygiene To clean
the vulva, people can wash the external area with warm water. If they wish to, they can
use a mild, unscented soap (https://www.medicalnewstoday). At the time of
menstruation it is very necessary to clean the vagina to maintain menstrual hygiene.
Types of Products _Frequency _Percentage (%) _ _ _Hot water _5 _6.3 _ _ _Hot water and
soap _5 _6.3 _ _ _Normal water _65 _81.3 _ _ _Soap _5 _6.3 _ _ _Total _80 _100.0 _ _ The
above study shows the information about the using products for cleaning vagina for the
management of menstrual hygiene. From the above table it is seen that, 6.3%
respondents of the study said that they use hot water for cleaning vagina at the time of
menstruation for menstrual hygiene management. On the other hand, 6.3% respondents
said that at the time of menstruation they use hot water with soap at the same time.
81.3% respondents of the study use normal water to clean vagina at the time of
menstruation and only 6.3% respondents of the study use soap with normal water for
cleaning vagina at the time of menstruation for the management of menstrual hygiene.
Table No 3.32.

Information about Rate of Presence in School At the time of menstruation school

absenteeism is very common among adolescent girls in our country. For example it is
seen from a cross-sectional study which was conducted from April to November 2019
based on a sample of 442 school-going adolescent girls (aged 10–19 years) from
randomly selected nine Girls’ Schools in the Dhaka division, Bangladesh. It was seen
from the study that the prevalence of school absenteeism was (35.1%) among
school-going adolescent girls in Bangladesh (Menstrual hygiene practices and school
absenteeism among adolescent girls in Bangladesh: A cross-sectional study).

Rate of Presence _Frequency _Percentage (%) _ _ _Absent _19 _23.8 _ _ _Present _61 _76.3
_ _ _Total _80 _100.0 _ _ The above data of the table shows the information about rate of
presence in school of the respondents of the study. From the above table it is seen that
76.3% respondents of the study go to school at the time of menstruation. On the other
hand, 23.8% respondents of the study said that they don’t go to school at the time of
period. Table No 3.33. Information about the Status of Washroom in School In
December 2020, the Bangladesh National Hygiene Survey 2018 full report was launched.

The report highlighted the knowledge and practice of hand washing, accessibility of
improved toilet facilities and hygiene services in public places. From the report it is seen
that 39% boys and girls have access to improved, unlocked, accessible toilets that have
soap and water available. But sanitary pad disposal bins were available in 22% schools
having separate improved toilets for menstrual management purposes (National
Hygiene Survey 2018 | WaterAid Bangladesh). Status _Frequency _Percentage (%) _ _
_Bad _50 _62.5

_ _ _Very Good _2 _2.5 _ _ _Good _11 _13.8 _ _ _Average _12 _15.0 _ _ _Very bad _5 _6.3 _
_ _Total _80 _100.0 _ _ The table demonstrate the information about the status of
washroom in the schools of the respondents of the study. The data of the table show
that, 62.5% respondents of the study said that the washroom status of their school is
bad. On the other hand, around 13.8% respondents said that the washroom status of
the school is good. 15.0% respondents shared that the washroom status of the school is
average. 6.3% respondents of the study said that the status of their washroom is very
bad. Only 2.5% respondents of the study shared that the status of the washroom of the
school is very good.

Table No 3.34. Information about Getting Proper Lesson about MHM from School For
every adolescent girls it is very necessary to know about the menstrual hygiene
management. School can be play a great role to provide proper lesson about menstrual
hygiene management to the adolescent girl students. Types of Answer _Frequency
_Percentage (%) _ _ _No _75 _93.8 _ _ _Yes _5 _6.3 _ _ _Total _80 _100.0 _ _ The above
table of the study show the information about getting proper lesson about MHM from
school. It is seen that, around 93.8% respondents of the study didn’t get proper lesson
from school about menstrual hygiene management.

On the other hand, 6.3% respondents of the study said that they have received proper
lesson from school about MHM. Table No 3.35. Knowledge about the Effect of Using
Unhygienic Menstrual Materials Unhygienic practices during menstruation including use
of unhygienic material for the absorption of blood can be very harmful. It can be causes
various types of diseases also. Such as- abnormal uterine bleeding, excessive or
prolonged menstrual bleeding, amenorrhea, the absence of menstrual bleeding,
Oligomenorrhea, light or infrequent menstruation, fibroids, noncancerous uterine
tumors, premenstrual syndrome (PMS), Premenstrual dysphonic disorder (PMDD) etc
(Menstrual Disorders - Baylor College of Medicine) Knowledge _Frequency _Percentage
(%) _ _ _Don't know _62 _77.5 _ _ _Know _18 _22.5 _ _ _Total _80 _100.0

_ _ The data of the table reveals the knowledge about the effect of using unhygienic
menstrual materials of the respondents of the study. It is seen that, 77.5% respondents
of the study don’t know about the effect of using unhygienic menstrual materials. On
the other hand, 22.5% respondents said that they have knowledge about the effect of
using unhygienic menstrual materials. Table No 3.36. Knowledge about Types of
Diseases and Gynecological Problem At the time of menstruation, using of unhygienic
menstrual products as well as unhygienic menstrual practices can causes various types
of diseases and gynecological problems.

General gynecological issues are- Ovarian cysts, Pelvic pain, Endometriosis, Uterine
fibroids, Polycystic ovarian syndrome (PCOS), Acne and abnormal female hair
distribution, Genital tract infections, Vulva and vagina skin disorders (Common
Gynaecological Conditions, Gynaecologists Brisbane). Knowledge _Frequency
_Percentage (%) _ _ _Don't know _62 _77.5 _ _ _Know _18 _22.5 _ _ _Total _80 _100.0 _ _
The data of the above table shows the knowledge of the respondents of the study about
the types of diseases and gynecological problems. 77.5% respondents of the study
shared that they don’t know about the types of diseases and gynecological problems for
using of unhygienic menstrual products as well as unhygienic menstrual practices. On
the other hand, 22.5% respondents of the study said that they have knowledge about
some types of diseases and gynecological problems. Table No 3.37.

Information about the Medium of Receiving Knowledge about Diseases and

Gynecological Problems To know properly about menstrual related diseases and
gynecological problems due to unhygienic menstrual practices, it’s very necessary for
every adolescent girls. Types of Medium _Frequency _Percentage (%) _ _N/A _ _62 _77.5
_ _ _Parents _4 _5.0 _ _ _School _2 _2.5 _ _ _Siblings _2 _2.5 _ _ _Social media _5 _6.3 _ _
_Television _3 _3.8 _ _ _Text book _2 _2.5 _ _ _Total _80 _100.0 _ _ It is seen from the table
that, most of the respondents of the study didn’t know about the types of diseases and
gynecological problems for using of unhygienic menstrual products as well as
unhygienic menstrual practices. 5.0% respondents have received knowledge about
diseases and gynecological problems due to unhygienic menstrual materials from their
parents. 2.5% respondents of the study have received knowledge from school. On the
other hand, only 2.5% respondents of the study have received knowledge from siblings
and 6.3% respondents have received from social media. It is also known that, 3.8%
respondents of the study got knowledge about menstrual related diseases and
gynecological problems from television as well as only 2.5% respondents got knowledge
about diseases and gynecological problems related to unhygienic materials from
face-book.

KNOWLEDGE ABOUT ATTITUDES AND MISCONCEPTIONS REGARDING MENSTRUATION

AND ITS MANAGEMENT Table No 3.38. Information about Period is or isn’t a Taboo A
menstrual taboo is any social taboo concerned with menstruation. In some societies it
involves menstruation being perceived as unclean or embarrassing, inhibiting even the
mention of menstruation whether in public (in the media and advertising) or in private
(among friends, in the household, or with men) (Culture and menstruation – Wikipedia).
Types of Answer _Frequency _Percentage (%) _ _ _No _7 _8.8 _ _ _Yes _73 _91.3 _ _ _Total
_80 _100.0

_ _ The above table demonstrates the information about period or menstruation is a

taboo or not in the society of the respondents of the study. From the table it is shown
that most of the respondents said that period is a taboo in the society and it is around
91.3%. On the other hand only 8.8% respondents of the study think that period or
menstruation is not a taboo at all. Table No 3.39. Information about Following of Strict
Guidelines during Menstruation Strict guidelines or social stigma around menstruation
that is often experienced by many adolescent girls in our society. Types of Answer
_Frequency _Percentage (%) _ _ _No _74 _92.5

_ _ _Yes _6 _7.5 _ _ _Total _80 _100.0 _ _ The above table demonstrates the information
about following of strict guidelines during menstruation. According to the table, most of
the respondent 92.5% said that they do not follow any strict guidelines at the time of
menstruation. But 7.5% said that they have to follow some strict guidelines at the time
of menstruation. Table No 3.40. Information about Feelings while Talking with Another
about Menstruation Menstruation is the regular discharge of blood and mucosal tissue
from the inner lining of the uterus through the vagina (Menstruation – Wikipedia).

In our society, most of the adolescent girls feel very hesitate as well as shy to discuss the
topic about menstruation with other persons. Types of Feelings _Frequency _Percentage
(%) _ _ _Hesitate _64 _80.0 _ _ _Neural _2 _2.5 _ _ _Normal _4 _5.0 _ _ _Very hesitate _9
_11.3 _ _ _Very normal _1 _1.3 _ _ _Total _80 _100.0 _ _ The following data of the table
shows the information about feelings of the respondents of the study while talking with
another about menstruation. From the table it can be said that most of the respondents
feel hesitation at the time of talking with other persons about menstruation and it is
80.0%. Around 5.0% respondents think that it’s normal. On the other hand, 2.5%
respondents feel neutral while talking with other people about menstruation. 1.3%
respondents think it’s very normal and 11.3% feel very hesitation to talk with other
persons about menstruation as well as menstrual issues. 3.2

ANALYSIS OF QUALITATIVE DATA FOCUS GROUP DISCUSSIONS (FGDS) Objectives of

the FGD To assess general notion about menstruation among adolescent girls. To study
about the management of menstrual hygiene among adolescent girls at the time of
menstruation. To know about the practices of menstrual hygiene during menstruation.
To identify the challenges at the time of menstruation. FGD-1 Methodology Study
Period The first focus group discussion of the study was conducted on 2nd October,
2019. Study Area In Abdul Hakim Smriti Model High School, the FGD was conducted.
Study Population The discussants of the focus group discussion were 8 adolescent girls
of class 9 of Abdul Hakim Smriti Model High School.

Purposive or convenience sampling method was used for selecting participants for focus
group. They were selected with their informed consent. The FGD was conducted at the
selected place according to the pre-determined time. Key Findings of the FGD The
respondents were very responsive in the focus group discussion. According to the
respondents, “menstruation is a painful process. The management of menstruation is a
troublesome matter.” The respondents didn’t have any idea about the menstruation
before starting their first period. Two of them had just heard the word ‘Menstruation’
from their friends.

The respondents had get first information about menstruation and its management
from the female members such as- mother, grand-mother, sister or friends and they feel
comfortable to share their personal matter only the female members not the male
members. One of the respondent (Lima, age-14) has shared that, “Menstruation is a very
shameful process. Whenever I have received my first menstruation I didn’t have any idea
what to do. I asked my mother and at the time of my period I always share about it with
my mother or sister. But I never share about the issue with my father. I feel hesitate and
shy to share about menstruation or other personal matter with my father.”

They don’t know much about the menstrual hygiene. Mainly they use sanitary pads,
cloths and tissues to manage their menstrual blood. Some of the respondents change
their menstrual materials only one time in a day and some other changes two or three
times in a day. The respondents had shared with me that they have no separate
washroom. For that reason they can’t change their menstrual materials in the school.
One of the respondent (Sadia, age-15) has told me that, “Our school is a combined
school. But in the school there are not any separate washroom for the girls.
The status of our common washroom is very dirty. The basin of our washroom is useless.
We can’t wash our hands or face in the washroom. At the time of period I feel very
hesitate to change my menstrual products at the washroom because of the dirty staus
of washroom.” Most of the respondents had no idea about the effect of using
unhygienic menstrual materials. Only one respondent (Shila, age-15) had shared with
me that, “I don’t know much about the effects of using unhygienic menstrual materials
at the time of menstruation. But I know that unhygienic menstrual materials can be
harmful.

If I use dirty cloth to manage my menstrual blood I will be affected by cancer. That’s why
I don’t use dirty menstrual products at the time of menstruation. I try to use pads always
to manage my menstrual blood.” The respondents uses different types of methods to
reduce their menstrual pain. One of the respondent (Sumaiya, age-14) has told me that,
“Menstruation is a very painful process to me. Sometimes I feel acute pain at the time of
menstruation and mainly the first two days of menstruation is very painful to me. When I
feel acute pain, I eat Napa-extra to reduce my pain.”

Another respondent (Takia, age-15) had shared with me that, “At the time of
menstruation I feel very pain in my abdomen. That time it’s very painful to me to normal
walk also. I use hot water to remove my menstrual pain.” Most of the respondent had
shared that they usually go to private hospital, pharmacy or community clinic for their
health care or treatment. The respondents shared that they have no strict guidelines at
the time of menstruation. One respondent (Proma Das, age-15) has shared with me that,
“Menstruation is a normal process to me. Sometimes I feel pain at the time of
menstruation. But at the time of menstruation I do not follow any strict guidelines.

But I can’t participate in our Puja at the time of menstruation.” Result of the FGD
Knowledge about Menstruation The discussants said that menstruation is a pathological
as well as a painful process. The discussants had described about their first menses as
scary, discomforting or emotionally disturbing. Majority of the respondents had known
about the menstruation after receiving their first period. They had received their first
period when they were class 6-7. Most of the respondents had shared about her first
period with their mother or sister. Abdominal pains and anorexia are the major
symptoms experienced during menstruation among the respondents.

Mainly they uses sanitary pads and cloths for the management of their period. Some of
the respondents do not attend at the school during their menstruation. One of the
discussants said that, “To me menstruation is very hurting. At the time of period I feel
very pain in my abdomen as well as in my waist and back. I can’t go to the school totally
because of the acute pain of period.” Information about Menstrual Hygiene
Management Most of the respondents don’t know much about menstrual hygiene and
its management. For the management of menstrual hygiene they uses sanitary pads and
cloths.

But they do not use soap or anything to clean their genitalia during the time of
menstruation. In the school they have no any facilities to change their menstrual
products in the washroom. One of the respondent had shared that, “there is no separate
washroom for the girls in our school. Besides our washroom is very dirty and unclean. I
feel hesitate to change my pads in the washroom.” From the school they didn’t get
proper lesson about the adolescence period and its management. Most of the
respondents I had talked don’t know more about the effect of using unhygienic
menstrual materials.

Mainly the respondents go to access health care in the pharmacy and private hospital or
community clinic. Knowledge about Menstrual Hygiene Practices The discussants had no
much knowledge about the importance of menstrual hygiene practices. For practicing
menstrual hygiene most of them uses sanitary pads. They have shared that if they don’t
practice menstrual hygiene at the time of menstruation, they will suffer from cancer.
Knowledge about the Challenges of Menstruation Most of the discussants said that they
don’t have strict guidelines at the time of period. But they have different types of beliefs
regarding menstruation.

One respondent had shared that’ “At the time of menstruation I feel dizziness as well as
headache. I also feel retch. But I do not follow any guidelines taking my food. But I try to
avoid to take fish in my food menu and I don’t eat fish at the time of menstruation.”
Another respondent had shared that, “At the time of menstruation I feel pain in my
abdomen as well as in my body parts. I don’t eat ice-cream and don’t take cold drinks at
the time of my period. If I take any cold food items I feel more pain in my abdomen.”
Mainly they have no any serious misconception regarding menstruation.

But one respondent have shared that, “Period is a very painful process to me. I feel very
pain in my belly, abdomen, thighs, legs. I eat Mimosa flower for the reduction of my
menstrual pain.” FGD-2 Methodology Study Period The second focus group discussion
of the study was conducted on 5th October, 2019. Study Area The focus group
discussion of the study was conducted in Taragonj Pilot Girls High School. Study
Population By using purposive sampling method 8 adolescent girls of class 10 of
Taragonj Pilot Girls High School was selected and the discussants of the focus group
were participated in the discussion by their informed consent.
The FGD was conducted in the school campus at 11 am-12 am. Key Findings of the FGD
The majority of the respondents had heard about the menstruation from their mother,
sister or friends. But most of them did not know about the physical changes in this
period. When they were undergoing various physical changes and menstruation those
changes were totally unknown to them, they were very afraid as well as anxious. One of
the respondent has shared about her experience that she was very afraid when she has
received her first period. “When I was in class 6 I have received my first menstruation.
But I have totally no idea about this.

I was afraid and was crying over night. I thought that I am suffering from blood cancer.”
(Riya, class-10, age- 16, school-Taragonj Pilot Girls High School). Another respondent
(Mina, class-10, age-15, school- Taragonj Pilot Girls High School) has shared that-
“When I have received my first period I was in class 7. My mother is a working women.
She was not at home in that time. I have no idea about the management of
menstruation. I was afraid and felt ashamed to share my problem with my father.” The
discussants had shared that menstrual hygiene management is important but they
didn’t know much about it.

They had also shared that they feel shy as well as hesitation to share about menstrual
related concept with the male person but feel quite normal to share with the female
persons. They use sanitary pads as well as cloths at the time of menstruation. The
discussants had shared that in the school the washroom is very dirty. That’s why they
didn’t change their menstrual materials while attending in school. They didn’t have
much knowledge about the STD, but one of the discussants had shared that unhygienic
as well as dirty menstrual materials is harmful for health. Mainly they have received
health treatment from nearly private hospital and pharmacy.

They didn’t faced problem at the time of getting medical treatment. One of the
discussants had shared that she feel shy at the time of buying menstrual materials from
pharmacy. The discussants had shared that they avoid cold drinks or taking any cold
food items at time of menstruation. One of the discussants had shared that she don’t
eat cucumber at the time of menarche. To the discussants, though menstruation is a
painful process but, they didn’t face any major problems to manage it. But two of the
respondent had shared that they feel discomfort to go outside at the time of
menstruation.

Result of the FGD Knowledge about Menstruation To the discussants menstruation was
totally a new term. They had totally no idea about the menstrual changes. After
receiving their first menstruation they had learnt about the management process from
the female members only. Most of the discussants were so much afraid as well as
anxious about their physical changes. One of the discussants even thought that she was
undergoing blood cancer. Mainly they feel ashamed to share about menstruation with
the male members of their family.

Information about Menstrual Hygiene Management The discussants had shared that to
know about menstrual hygiene is very important. For the management of menstrual
blood as well as hygiene sanitary pads and cloths are the hygienic products to them.
The discussants had shared that, the washroom status of their school is not so good,
that’s why they can’t use it. They don’t change their menstrual products at the school
time. For receiving treatment they mainly goes to nearly private clinic and pharmacy. For
the managemt of menstrual pain two of the respondent take painkiller named Algin and
Dysmel as well as one of them uses hot water pad. Most of the discussants don’t attend
in school at the time of menstruation.

Knowledge about Menstrual Hygiene Practices To the discussants practicing menstrual

hygiene is important. They had shared that, they uses clean cloths as well as sanitary
pads for practicing menstrual hygiene. One of the discussants had shared that she uses
hot water with soap to clean her private part at the time of menstruation. They had
shared that without maintaining menstrual hygiene they will be affected by diseases. But
they had not knowledge about STD. Knowledge about the Challenges of Menstruation
Buying menstrual products from the pharmacy or shop is very shameful matter to the
respondents. That’s why they didn’t buy the products by themselves. Their mother or
sister mainly buy the products for them.

The respondents had shared that they usually don’t take cold food items at the period
them. One of them avoid cucumber at the menstrual time. Going outside at the
menstrual time is disturbing as well as painful to the most of the respondents. Analysis
of Qualitative Data Collected Through Focus Group Discussions (FGDs) There were
conducted two focus group discussions in the selected two schools. The first FGDs was
conducted in Abdul Hakim Smriti Model High School and the discussants of the focus
group discussion were 8 adolescent girls of class 9.

For the selection of participants purposive or convenience sampling method was used
for selecting participants for focus group with the informed consent of the participants.
The second FGDs was conducted in Taragonj Pilot Girls High School. By using purposive
sampling method 8 adolescent girls of class 10 of that school was selected with their
informed consent. A Focus Group Questionnaire was used to conduct the study. Various
issues related to menstruation and its management were included in the questionnaire.

Such as- general notion about menstruation, experience about the first menstruation,
knowledge about menstrual hygiene and its management, management of menstrual
bleeding, effects of using unhygienic menstrual materials, major problems or challenges
at the time of menstruation etc. General notion about the topic In the focus group
discussion, the discussants were asked about the general notion of ‘Menstrual Hygiene
Management among Adolescent Girls in Bangladesh.’ Each of the participants of two
FGDs shared about their notion from their own point of view. All the participants were
different from their family background, economic status, environmental status etc.

After hearing the topic most of discussants were very excited because to them it’s a very
important issue. But they have shared that they don’t have much knowledge about the
issue. They had shared that they think knowing about the menstrual hygiene
management is very necessary. Knowledge about adolescence period and menstruation
The discussants had shared that they have heard the word ‘adolescence period’ from the
school. They said that in this stage some physical changes occur in the human body, but
they had no clear idea about all the physical changes. To the discussants menstruation is
a pathological and painful process.

They felt scared, discomfort at the time of their first menstruation. Some of the
discussants had shared that before starting their first menstruation, the term was totally
unfamiliar to them. Maximum respondents had shared that they heard about the
menstruation after receiving their first menses. A respondent’s statement should be
cited here about the thinking of first menstruation. “I have received my first
menstruation when I was a student of class six. At midnight I waked up from sleep. I felt
so stomach-ache and it was very painful. After sometimes I felt wet in my pant and
checked.

When I have checked, I was very afraid because it was blood. I have totally no idea
about the reason of bleeding. I thought that I’m undergoing blood cancer. I was very
shocked and whole night I was crying” (Translated from one respondent of class ten of
Taragonj Pilot Girls High School). Receiving of information about menstruation at the
first time Most of the discussants had shared that they were unknown totally about the
menstruation before starting their first menses. For that reason they had totally no
curiosity about the topic.

From 16 respondents, two of them had heard about menstruation, one of them from
television and other from newspaper. After receiving first menstruation most of the
respondents had shared about it with the female members of the family. Such
as-mother, sister or grandmother. The female members of the family told the
discussants about the management of menstrual blood at the time of menstruation.
Thinking about menstrual hygiene management Menstrual hygiene management is very
important issue and it is very necessary to know about the management of menstrual
hygiene properly.

The discussants had shared that they had no idea about menstruation before starting
their first menarche. When they had received their menstruation first they have received
knowledge about the management of menstrual blood as well as menstrual hygiene
management mainly from the female members of the family. But they did not get much
knowledge about the management of menstrual hygiene from the teachers of their
school.

The discussants had shared that for the management of menstrual hygiene they try to
use sanitary pads as well as clean clothes at the time of menstruation. Some of the
respondents had shared that for cleansing their private part at the menstruating time
they uses soap with hot as well as normal water. Comfortable person to share about
menstrual issue The respondents had shared that to them menstruation is a very secret
issue. Some of them defined is as a taboo.

They shared that they don’t shared the issue any male members of their family or
outside of the family. Whenever it necessary they have only share about menstruation,
its management or any gynecological problems only with the female persons. Such as,
mother, sister or female friends. Changes of menstrual materials At the time of
menstruation changing the menstrual products properly is very important. For the
management of menstrual blood the discussants mainly uses sanitary pads, clothes as
well as tissues. The discussants had shared that they changes their menstrual blood
absorbants one or two or three times a day when they stay at home.

But when they stay at school it is very problem for them for changing the products.
Most of the discussants had shared that the washroom status of their school is very
unclean. They feel very hesitate to use the washrooms. At the time of menstruation, it
feels troublesome to use the washrooms for changes menstrual products. And for the
reason in maximum time they do not changes the products timely. Effects of using
unhygienic menstrual materials Using of unhygienic menstrual products are very
harmful at the time of menstruation. It can causes various gynecological problems.

The discussants had shared they don’t had much knowledge about the effects of using
unhygienic menstrual products. Some of the respondents had shared that usage of
unclean as well as unhygienic menstrual products for management of menstrual blood
at the time of menstruation can causes cancer. But they had not knowledge about the
other gynecological problems and STDs also. Periodical strict guidelines Most of the
discussants had shared that they don’t have strict guidelines at the time of period.
But they follows some guidelines at the time of menstruation. They don’t follows
religious rituals at the menstruating time. Some of the discussants had shared that they
avoid cold food items such as cold drinks or ice-creams at the period of menstruation.
Some respondents also avoid fish or cucumber at that time. Some of the discussants
had shared that for the management of menstrual pain they take napa-extra, align,
dysmel etc medicine. Community conceptions or challenges about menstruation In the
community of the respondents has no strict conception regarding menstruation. But it
seems a taboo.

The discussants had shared that they don’t discuss about menstruation in open places
any time. They feel hesitate as well as shy to talk about menstrual issues with any male
members. Mainly they have no any serious misconception regarding menstruation. But
one respondent had shared that sometimes she eats Mimosa flower for the reduction of
menstrual pain. The discussants had shared that they feel shy at the time of buying
menstrual products from the pharmacy or shop is very shameful matter to the
respondents. For that reason their mother or sister buys the products for them from
pharmacy, shop or parlor. CHAPTER FOUR 4. PROBLEMS AND LIMITATIONS OF THE
STUDY There had been arisen some limitations of the study.

Those were__- Problems and Limitations of the Methodology As a new researcher and
lacking of work experience, it was quite difficult to work with the adolescent girls about
menstrual hygiene as well as collecting information from them. As there were used a
mixed approach of both qualitative and quantitative research design, the regular
structure of the study was short and the approaches were not too elaborated. As, there
were used simple random sampling technique and because of time, budget and the
researcher personal limit the sample size was short than its population size, it didn’t
reveal the states of all the adolescent girls in Sherpur District.

In this research, as a new and not a professional researcher, there was not used good
photo camera and data record tools. Problems and Limitations about Selection of
Respondents As a Muslim and developing country, most of the adolescent girls do not
usually disclose their personal matters to others and for that reason some of them were
a little bit shy before taking the interview. In this study, the limitation was arisen during
selection of respondents and find the respondents who want to participate in the
process of interview and focus group discussions.

Problems and Limitations about Data Collection The respondents might be given some
false information. The session of data collection might not be adjusted with the
environment of the interview session. Time limitation for data collection was another
problem in the study. Problems and Limitations about Data Analysis Data analysis is not
an easy task for a new researcher. There were arisen some limitations regarding the
coding, decoding, tabulating, analyzing and interpreting the collected data by using
SPSS software. The quantitative data were analyzed in percentage only.

Other statistical techniques such as- mean, median, standard deviation, correlation etc
were not used to analyze the quantitative data of the study. On the other hand,
qualitative data were interpreted in descriptive manner only. CHAPTER FIVE 5.
RECOMMENDATION AND CONCLUSION 5.1. RECOMMENDATION Providing basic
health education Most of the adolescent girls had no knowledge about the basic health
care. It is very much necessary to educate the adolescent girls how to maintain a healthy
life style from the family as well as from the school. Providing knowledge about
menstruation Menstruation is a very normal process.

But most of the girls had no idea about the menstrual process before starting their
menarche. For that reason some of them were very scared at the first time. So it is very
important to provide menstrual education so that girls feel very normal at their first
time. Improving washroom status Most of the girls said that the washroom status of
their school was not so good. For that reason they feel discomfort to change their
menstrual products at the time of menstruation in their washroom. It is so much
necessary to improvement the status of washroom in every girls’ schools of Bangladesh.

Providing education about menstrual hygiene management It is much needed to

provide education about management of menstrual hygiene to the adolescent girls
from school as well as from the family. It is necessary to aware the girls about the using
of hygienic menstrual materials. Arranging hygienic menstrual product corner It will be
helpful for the girls if every school arranges a corner for the girls so that they can find
hygienic menstrual materials at the time of menstruation at a minimum cost.

Awareness about unhygienic menstrual management It is very necessary to provide

awareness to the adolescent girls about the negative side of hygienic menstrual
management as well as about the STD. Eradication of superstitions It is needed to try to
eradicate the superstitions related to menstruation and its management from the
society. Arranging Seminar Health education related seminar can be arranged in every
school monthly or weekly so that girls can find health related guidelines easily.

Arranging free doctor check up Monthly free doctor check-up can be arranged in every
school so that girls can find suitable guideline as well as treatment. Role of GO and
NGOs Various GO as well as NGOs can be helpful in arranging effective programs for
the adolescent girls about puberty, menstruation, menstrual hygiene management etc.
5.2. CONCLUSION Menstruation is a very natural process in the life of every women
which starts from the adolescence period. In the adolescence period various physical,
mental or emotional changes can occur and it increases a sign of maturity among the
girls.

Menstruation is one of the compulsory process for every healthy female adolescent in
the adolescence period. But it is a matter of sorrow that in Bangladesh, most of the
adolescent girls do not have proper idea about menstruation and management of
menstrual hygiene in a proper way. Rather, many of them have lots of misconception
and wrong beliefs which are responsible for the improper menstrual hygiene
management. Most of the adolescent girls do not use hygienic products for the
management of menstrual blood.

In the school they do not have enough facilities for changing their menstrual products.
Even they do not receive proper education about menstrual hygiene management from
school as well as from the family. Most of the girls think that menstruation is a top
secret and shameful topic. That’s why they fell shy and hesitation to talk with other
persons about menstruation and its hygienic management. To maximum respondents
it’s a taboo. To know about the menstrual hygiene management in the adolescence
period is must for the every adolescent girl. At first, it is needed to provide knowledge
to the adolescent girls that period is a very natural process and it’s totally not a
shameful topic.

Family and school can be the valuable learning source for the girls to know about
properly about puberty, menstruation, menstrual hygiene as well as its management
process. Various Government and Non-Government Organizations can be helpful by
arranging health related program or seminar for the adolescents. The girls should be
very careful in the adolescence period as well as they have to be interested to know
about menstrual hygiene management in a proper way. CHAPTER SIX 6.

APPENDIX Interview Schedule Department of Social Work Shahjalal University of Science

and Technology, Sylhet Title of Thesis: Menstrual Hygiene Management among
Adolescent Girls in Bangladesh: A Case of Sherpur District (Data of this interview will be
used only for academic purposes. Privacy will be maintained always.) 1. General
Demographic Information 1.1. What is your age? 1.2. What is your parent’s educational
qualification? Father (Level of Education) a. Illiterate b. Up to Five c. Up to Eight d. SSC e.
HSC f. Graduate g. Post Graduate h. Others Mother (Level of Education) a. Illiterate b. Up
to Five c. Up to Eight d. SSC e. HSC f. Graduate g. Post Graduate h. Others 1.3. What is
your parent’s employment status? Father a.
Employed b. Business c. Agronomy d. Laborer e. Unemployed f. Others Mother a.
Employed b. Business c. Housewife d. Laborer e. Unemployed f. Others 1.4. Monthly
income (Approximate) of family? a. 1000-5000 b. 5000-10000 c. 10000-15000 d.
15000-20000 e. 20000-25000 f. 25000-30000 g. 30000-35000 h. 35000-40000 i.
40000-45000 j. 45000-50000 k. Above 1.5. What is your religion? a. Muslim b. Hindu c.
Christian d. Buddies e. Tribal f. Others 2. Information about Household 2.1. What is the
type of your family? a. Nuclear b. Joint c. Extended d. Single-parent e. Others 2.2. What
is the number of your family members? 2.3. How many siblings do you have? 2.4. Please
tell me about the relationship status with your family members.

a. Good b. Bad c. Average d. Excellent 2.5. Who is the decision maker of your family? a.
Mutual agreement b. Father c. Mother d. Brother e. Sister f. By yourself g. Grand-parents
h. Others 2.6. What is the sources of water of your area? a. Tube well b. Pond c. River d.
Supply water e. Others 2.7. What is the status of washroom of your family? a. Very good
b. Good c. Average d. Bad e. Very Bad 3. Information about Adolescence Period 3.1. Do
you know about the various changes of adolescence period? a. Know b. Moderately
Know c. Don’t know 3.2. What is the medium of getting knowledge about the changes
of adolescence period? a. Family Members b. Text Book c. School Teacher d. Friends e.
Television f. News Paper g. Radio h. Online or Internet i.

Relatives j. Posters k. Others 3.3. Did you have faced any type of physical problem
(sickness) in the adolescence period? Answer: a. Yes b. No 3.4. If the answer is ‘Yes’ what
type of physical problem you have faced? a. Acne b. Asthma c. Diabetes d. High Blood
Pressure e. Infectious Disease f. Injuries g. Headaches h. Gastrointestinal Problems i.
Obesity j. Oral Health Problem k. Menstrual Disorders l. Others 3.5. Did you have receive
medical treatment to solve your physical problem? Answer: a. Yes b. No 3.6. Did you
have faced any type of mental problem (sickness) in your adolescence period? Answer:
a. Yes b. No 3.7. If the answer is ‘Yes’ what type of mental problem you have faced? a.
Mood Disorder b. Frustration c. Shyness d. Loneliness e.

Anxiety f. Depression g. Attention Deficit-hyperactivity h. Thought Disorder i.

Psychological Disorder j. Others 3.8. Did you have share about your problems with your
family members? Answer: a. Yes b. No 4. Knowledge about Menstruation 4.1. When did
you have received (occurred) your first period? 4.2. What was the age of yourself, when
you have received your first menstruation? 4.3. Who is the sharing person when you
have received your first period? 4.4. What type of products you have used at the time of
menstruation? 4.5. What do you think about period, is it painful or not? 4.6. What type
of products you have used for the management of menstrual pain? 5. Information about
Menstrual Hygiene 5.1.
Do you know about menstrual hygiene? a. Know b. Moderately Know c. Don’t know 5.2.
What do you think about menstrual hygiene? 6. Information about Menstrual Hygiene
Management 6.1. Do you know about menstrual hygiene management? a. Know b.
Know moderately c. Don’t know 6.2. What are the medium of learning about MHM? 6.3.
What do you think about Menstrual Hygiene Management? a. Very Necessary b.
Necessary c. Neutral or No Opinion d. Unnecessary e. Very Unnecessary 6.4. What type
of products/materials/absorbents do you use during menstruation for MHM? a. Sanitary
pads b. Menstrual Cups c. Cotton d. Cloths (Rags) or Old Cloths e. Tissue f. Clothes and
pad g. Others 6.5.

What type of products you have used for cleaning Vagina for MHM? 6.6. Do you go to
school at the time of menstruation? 6.7. What is the status of washroom of your school?
a. Very Good b. Good c. Medium or Moderate d. Bad e. Very Bad 6.8. Did you get
received proper lesson about MHM from your school? Answer a. Yes b. No 6.9. Do you
know about the effect of using unhygienic menstrual materials? 6.10. Are you informed
about the types of diseases and gynecological problems due to using unhygienic
menstrual products? Answer a. Yes b. No 6.11. If your answer is ‘Yes’ from where you
have known about that? a. Parents b. Siblings c. Grand Parents d.

Text Book e. School f. Social Media g. Television h. Radio i. Campaign or Seminar j.

Poster k. Others 7. Knowledge about Attitudes and Misconceptions regarding
Menstruation and its Management 7.1. What do you think- ‘Is period a taboo’? 7.2. Have
you ever been given strict guidelines for eating, sleeping, walking and living life in a
certain way during your period? 7.3. What do you feel while talking about menstruation
with another? 7.4. Please share your feelings, notions, conceptions (misconceptions and
myths) and beliefs about menstruation and its hygiene management. Thank you very
much for your patience in proving information.

Would it be alright to call you again if I have any more questions? Thanks again.
Signature: Date: Focus Group Questionnaire Menstrual Hygiene Management among
Adolescent Girls in Bangladesh: A Case of Sherpur District (Collected data will be used
only for academic purposes and all kinds of confidentiality will be preserved) Topics to
be discussed Today’s topic is ‘Menstrual Hygiene Management among Adolescent Girls
in Bangladesh.’

What are your general feelings about it? What do you know about adolescence period
and menstruation? Where did you get first information about menstruation? What do
you think about menstrual hygiene and its management? Who do you feel most
comfortable to talk with about your menstruation and its management? What do you
use to manage your monthly period? Where do you change your materials and how
often do you change your materials? How do you maintain management of menstrual
hygiene when you are attending in school? Do you know about the effect of using
unhygienic menstrual materials and types of diseases and gynecological problems due
to using unhygienic menstrual products? Where do you usually go to access health care
and did you ever have faced any problem or discrimination in term of getting medicare
facilities? What do you know about the beliefs and conceptions about menstruation and
its management in your community and do they have any effect on you? Have you ever
been given any restriction or strict guidelines (can do/ can’t do) during your period?
What are the major problems or challenges you feel in managing your menstruation? Is
there anything else you would like to share about menstrual hygiene management or
your experiences? Do you have any questions or inquiry?

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