Lost in transition: menstrual experiences of intellectually disabled school-going adolescents in Delhi, India
Issues around reproductive health of intellectually disabled adolescents have received limited attention in India. This study aimed to bring to light these issues to inform policy and practice surrounding reproductive health among intellectually disabled adolescents. The objectives of this study were to understand the problems encountered by intellectually disabled adolescents and their primary caretakers during management of the adolescent’s menstrual cycle, and to explore the strategies adopted to overcome them. Using qualitative methodology, in-depth interviews were carried out with 23 primary caretakers (all mothers) of adolescent girls in the age group of 11–19 years with IQ of 20–50 were interviewed using in-depth interviews. The mothers of adolescents were selected using purposive sampling and grounded theory methodology was followed for data analysis. The adolescents faced a whole range of issues; from not being able to change sanitary napkins due to physical constraints, to not being able to communicate their physical discomforts, such as stomach cramps, to their caretakers. Their caretakers adopted various strategies such as changing the sanitary napkins for the adolescent themselves, trying to train the adolescent to maintain hygiene, or in some cases even surgical removal of the adolescent’s uterus for the cessation of menstruation. Overall, the adolescents did not play a very significant role in the management of their own menstruation, which might prevent them from achieving reproductive health to the best of their potential.
Menstrual hygiene management and reproductive tract infections: a comparison between rural and urban India
The objective of the research was to compare factors associated with menstrual hygiene management (MHM) between urban and rural ever-married women in India, and its effect on reproductive tract infections (RTIs). A cross-sectional study was performed analysing data from the Indian District Level Household and Facility Survey 2007–08 (DLHS-3). The respondents were ever-married women between 15 and 49 years of age (N = 577,768). A quarter of women from urban areas use improved methods compared with only 4.3 per cent in rural areas. Cloth had the highest prevalence of usage in both areas. Socio-demographic factors associated with the usage of improved methods were almost the same between localities. Women using improved methods were less likely to suffer from RTIs across localities, except for urinary tract infections (UTIs) in rural areas; UTIs (adjusted odds ratio (AOR) = 0.95 – 1.03 in rural areas and AOR = 0.80 – 0.88 in urban areas). Findings reiterate the complexity of MHM and the need for immediate attention from the government and other agencies to ensure that girls and women have hygienic practices during their menstrual periods which will help prevent RTIs related to poor MHM.
How socio-demographic and mass media factors affect sanitary item usage among women in rural and urban India
Our study’s objective is to examine the various socio-demographic and mass media factors of sanitary item usage among rural and urban women in India. We have used data from the Indian version of the Demographic and Health Survey, conducted in 2015–16 for this study, with a sample of 247,833 women in the age group of 15 to 24 years. Binary logistics regression was performed separately for urban and rural women to understand the various determinants of sanitary item usage. We found that three-quarters of women in urban areas use sanitary items compared to half of the women in rural areas. Indian women in rural areas appear to be at a considerable disadvantage compared to their urban counterparts with regard to sanitary item usage. Factors determining sanitary item usage did not vary between urban and rural areas. However, education, wealth, mass media, and toilet facility were the major factors in understanding the improvement in sanitary item usage in urban and rural areas. At the policy level, there is need to focus on (a) disseminating knowledge about menstrual hygiene management (MHM) practices and provisioning of sanitary items; and (b) providing exposure to traditional media channels to potentially reduce the social stigma associated with these issues and bring critical conversations to the forefront, especially among the socio-economically disadvantaged groups.