Factors associated with knowledge, attitudes, and hygiene practices during menstruation among adolescent girls in Uttar Pradesh
Alka Malhotra | Srinivas Goli | Sue Coates | Mario Mosquera-Vasquez
This paper investigates the factors associated with knowledge, attitudes, autonomy, and constraints in the management of menstruation in three districts of Uttar Pradesh. The paper uses data collected from 1,800 post-menarche adolescent girls under a baseline study commissioned by UNICEF in 2012 for a social and behaviour change project, called ‘Girls Today, Women Tomorrow’, on menstrual management. The findings suggest that about half of the girls did not have information or knowledge about menstruation. Less than one-quarter of them followed correct hygiene practices, with very few using ‘sanitary napkin’ as a menstrual absorbent. It was also found that 31 per cent, 20 per cent, and 24 per cent of girls felt impure, isolated, and irritated respectively during menstruation. Two-thirds of the girls reported constraints in the management of menstruation and nearly one-quarter had low autonomy during menstruation. Multivariate analyses indicated that socioeconomic characteristics, such as place of residence (district), the girl’s and her mother’s education, ethnicity, household occupation, economic status, exposure to mass media, and availability of private space, were significant factors influencing menstrual hygiene and autonomy in the management of menstruation.Adinma, E.D. and Adinma, J.I.B. (2008) ‘Perceptions and practices on menstruation amongst Nigerian secondary school girls’, African Journal of Reproductive Health 12(1): 74–83 <http://dx.doi.org/10.2307/25470636>.
Agarwal, A.K. and Agarwal, A. (2010) ‘A study of dysmenorrheal during menstruation in adolescent girls’, Indian Journal of Community Medicine 35(1): 159–164 <http://dx.doi.org/10.4103/0970-0218.62586>.
Ahmed, R. and Yesmin, K. (2008) ‘Menstrual hygiene: breaking the silence’, in J. Wicken, J. Verhage, C. Sijbesma, C. Da Silva, and P. Ryan (eds), Beyond Construction Use By All, pp. 283–7, Delft: IRC International Water and Sanitation Centre and London: WaterAid.
Anson, O. (1999) ‘Exploring the bio-psycho-social approach to premenstrual experiences’, Social Science and Medicine 49: 67–80.
Bharadwaj, S. and Patkar, A. (2004) Menstrual Hygiene and Management in Developing Countries: Taking Stock, Mumbai: Junction Social, Social Development Consultants.
Bramwell, R.S, Biswas, E.L. and Anderson, C. (2002) ‘Using the menstrual attitude questionnaire with a British and an Indian sample’, Journal of Reproductive and Infant Psychology 20: 159–70 <http://dx.doi.org/10.1080/0264683021000006741>.
Das, P., Baker, K.K., Dutta, A., Swain, T., Sahoo, S., Das, B.S., Panda, B., Nayak, A., Bara, M., Bilung, B., Mishra, P.R., Panigrahi, P., Cairncross, S. and Torondel, B. (2015) ‘Menstrual hygiene practices, WASH access and the risk of urogenital infection in women from Odisha, India’, PLoS ONE 10(6): e0130777 <http://dx.doi.org/10.1371/journal.pone.0130777>.
Dasgupta, A. and Sarkar, M. (2008) ‘Menstrual hygiene: how hygienic is the adolescent girl?’ Indian Journal of Community Medicine 33(2): 77–80 <http://dx.doi.org/10.4103/0970-0218.40872>.
Dhingra, R., Kumar, A. and Kour, M. (2009) ‘Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls’, Ethno Medicine 3(1): 43–8.
Drakshayani, D.K. and Venkata, R.P. (1994) ‘A study on menstrual hygiene among rural adolescent girls’, Indian Journal of Medical Sciences 48(6): 139–43.
Fernandes, M. (2010) ‘Freedom of mobility: experiences from villages in the states of Madhya Pradesh and Chhattisgarh, India’, presented at South Asia Hygiene Practitioners’ Workshop, Dhaka, Bangladesh, February.
Freeman, E.W. (2002) ‘Treatment of depression associated with the menstrual cycle: premenstrual dysphoriya, postpartum depression and the permenopause’, Dialogues in Clinical Neuroscience 4(2): 177–91.
Ghattargi, C.H. and Deo, D.S. (2005) ‘Perceptions and practices regarding menstruation: a comparative study in urban and rural adolescent girls’, Indian Journal of Community Medicine 30(1): 10–4.
Government of India (2003) Towards Total Sanitation and Hygiene: A Challenge for India, New Delhi: Ministry of Rural Development.
Government of India (2007) Rural Drinking Water and Sanitation in the Eleventh Plan Period: Excerpts, Planning Commission, Eleventh Five Year Plan, 2007–2012, 54th NDC Meeting.
Gupta, J. and Gupta, H. (2001) ‘Adolescents and menstruation’, Journal of Family Welfare 47(1): 1–13.
Jones, L.L., Griffiths, P.L., Norris, S.A., Pettifor, J.M. and Cameron, N. (2009) ‘Age at menarche and the evidence for a positive secular trend in urban South Africa’, American Journal of Human Biology 21: 130–2 <http://dx.doi.org/10.1002/ajhb.20836>.
Katiyar, K., Chopra, H., Garg, S.K., Bajpai, S.K., Bano, T., Jain, S. and Kumar A. (2013) ‘KAP Study of menstrual problems in adolescent females in am urban area of Meerut’, Indian Journal of Community Health 25(3): 217–20.
Kaundal, M. and Thakur, B. (2014) ‘A dialogue on menstrual taboo’, Indian Journal of Community Health 26(2): 192–4.
Lal, S., Nawaz, J. and Raza, S. (2007) ‘Screened sanitation units: the Pakistan earthquake’, Waterlines 25(3): 28–9 <http://dx.doi.org/10.1080/13552071003600067>.
Liu, Y., Gold, E.B., Lesley, B.L. and Johnson, W.O. (2004) ‘Factors affecting menstrual cycle characteristics’, American Journal of Epidemiology 160: 131–40 <http://dx.doi.org/10.1093/aje/kwh188>.
Marván, M.L, Espinosa-Hernandez, G. and Vacio, A. (2002). ‘Premenarcheal Mexican girls expectations concerning premenstrual changes and menstrual attitudes,’ Journal of Psychosomatic Obstetrics and Gynaecology 23: 89–96 <http://dx.doi.org/10.3109/01674820209042790>.
Marván, M.L., Iniestra, S.C. and Gonzalez, R. (2005) ‘Beliefs about and attitudes toward menstruation among young and middle-aged Mexicans’, Sex Roles 53(3/4): 273–9 <http://dx.doi.org/10.1007/s11199-005-5685-3>.
Narayan, K.A., Srinivasa, D.K. Pelto, P.J. and Veeramal, S. (2001) ‘Puberty rituals, reproductive knowledge and health of adolescent schoolgirls in South Asia’, Asia Pacific Population Journal 16(2): 225–38.
Paria, B., Bhattacharyya, A. and Das, S. (2014) ‘A comparative study on menstrual hygiene among urban and rural adolescent girls of West Bengal’, Journal of Family Medicine and Primary Care 3(4): 413–7 <http://dx.doi.org/10.4103/2249-4863.148131>.
Shah, P.S., Nair, R., Shah, P.P., Modi, D.K., Desai, S.A. and Desai, L. (2013) ‘Improving quality of life with new menstrual hygiene practices among adolescent tribal girls in rural Gujarat, India’, Reproductive Health Matters 21(41): 205–13 <http://dx.doi.org/10.1016/S0968-8080(13)41691-9>.
Sharma, M. and Gupta, S. (2003) ‘Menstrual pattern and abnormalities in the high school girls of Dhahran: a cross sectional study in two boarding schools’, Nepal Medical College Journal 5(1): 34–6.
Singh, A.J. (2006) ‘Place of menstruation in the reproductive lives of women of rural North India’, Indian Journal of Community Medicine 31(1): 10–4.
Stephens, W.N. (1961) ‘A cross-cultural study of menstrual taboos’, Genetic Psychology Monograph 64: 385–416.
Sudeshna, R. and Aparajita, D. (2012) ‘Determinants of menstrual hygiene among adolescent girls: a multivariate analysis’, National Journal of Community Medicine 5(2): 294–301.
Thakre, S.B., Thakre, S.S., Reddy, M., Rathi, N., Pathak, K. and Ughade, S. (2011) ‘Menstrual hygiene: knowledge and practice among adolescent school girls of Saoner, Nagpur District’, Journal of Clinical and Diagnostic Research 5(5): 1027–33.
UNICEF (2008) Sharing Simple Facts: Useful Information about Menstrual Health and Hygiene, New Delhi, India: Child’s Environment Section, UNICEF.
UNICEF (2012) Girls Today, Women Tomorrow: Research Highlights on Knowledge, Practice, Attitude and Norms on Menstrual Hygiene, India: UNICEF.
Adinma, E.D. and Adinma, J.I.B. (2008) ‘Perceptions and practices on menstruation amongst Nigerian secondary school girls’, African Journal of Reproductive Health 12(1): 74–83 <http://dx.doi.org/10.2307/25470636>.
Agarwal, A.K. and Agarwal, A. (2010) ‘A study of dysmenorrheal during menstruation in adolescent girls’, Indian Journal of Community Medicine 35(1): 159–164 <http://dx.doi.org/10.4103/0970-0218.62586>.
Ahmed, R. and Yesmin, K. (2008) ‘Menstrual hygiene: breaking the silence’, in J. Wicken, J. Verhage, C. Sijbesma, C. Da Silva, and P. Ryan (eds), Beyond Construction Use By All, pp. 283–7, Delft: IRC International Water and Sanitation Centre and London: WaterAid.
Anson, O. (1999) ‘Exploring the bio-psycho-social approach to premenstrual experiences’, Social Science and Medicine 49: 67–80.
Bharadwaj, S. and Patkar, A. (2004) Menstrual Hygiene and Management in Developing Countries: Taking Stock, Mumbai: Junction Social, Social Development Consultants.
Bramwell, R.S, Biswas, E.L. and Anderson, C. (2002) ‘Using the menstrual attitude questionnaire with a British and an Indian sample’, Journal of Reproductive and Infant Psychology 20: 159–70 <http://dx.doi.org/10.1080/0264683021000006741>.
Das, P., Baker, K.K., Dutta, A., Swain, T., Sahoo, S., Das, B.S., Panda, B., Nayak, A., Bara, M., Bilung, B., Mishra, P.R., Panigrahi, P., Cairncross, S. and Torondel, B. (2015) ‘Menstrual hygiene practices, WASH access and the risk of urogenital infection in women from Odisha, India’, PLoS ONE 10(6): e0130777 <http://dx.doi.org/10.1371/journal.pone.0130777>.
Dasgupta, A. and Sarkar, M. (2008) ‘Menstrual hygiene: how hygienic is the adolescent girl?’ Indian Journal of Community Medicine 33(2): 77–80 <http://dx.doi.org/10.4103/0970-0218.40872>.
Dhingra, R., Kumar, A. and Kour, M. (2009) ‘Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls’, Ethno Medicine 3(1): 43–8.
Drakshayani, D.K. and Venkata, R.P. (1994) ‘A study on menstrual hygiene among rural adolescent girls’, Indian Journal of Medical Sciences 48(6): 139–43.
Fernandes, M. (2010) ‘Freedom of mobility: experiences from villages in the states of Madhya Pradesh and Chhattisgarh, India’, presented at South Asia Hygiene Practitioners’ Workshop, Dhaka, Bangladesh, February.
Freeman, E.W. (2002) ‘Treatment of depression associated with the menstrual cycle: premenstrual dysphoriya, postpartum depression and the permenopause’, Dialogues in Clinical Neuroscience 4(2): 177–91.
Ghattargi, C.H. and Deo, D.S. (2005) ‘Perceptions and practices regarding menstruation: a comparative study in urban and rural adolescent girls’, Indian Journal of Community Medicine 30(1): 10–4.
Government of India (2003) Towards Total Sanitation and Hygiene: A Challenge for India, New Delhi: Ministry of Rural Development.
Government of India (2007) Rural Drinking Water and Sanitation in the Eleventh Plan Period: Excerpts, Planning Commission, Eleventh Five Year Plan, 2007–2012, 54th NDC Meeting.
Gupta, J. and Gupta, H. (2001) ‘Adolescents and menstruation’, Journal of Family Welfare 47(1): 1–13.
Jones, L.L., Griffiths, P.L., Norris, S.A., Pettifor, J.M. and Cameron, N. (2009) ‘Age at menarche and the evidence for a positive secular trend in urban South Africa’, American Journal of Human Biology 21: 130–2 <http://dx.doi.org/10.1002/ajhb.20836>.
Katiyar, K., Chopra, H., Garg, S.K., Bajpai, S.K., Bano, T., Jain, S. and Kumar A. (2013) ‘KAP Study of menstrual problems in adolescent females in am urban area of Meerut’, Indian Journal of Community Health 25(3): 217–20.
Kaundal, M. and Thakur, B. (2014) ‘A dialogue on menstrual taboo’, Indian Journal of Community Health 26(2): 192–4.
Lal, S., Nawaz, J. and Raza, S. (2007) ‘Screened sanitation units: the Pakistan earthquake’, Waterlines 25(3): 28–9 <http://dx.doi.org/10.1080/13552071003600067>.
Liu, Y., Gold, E.B., Lesley, B.L. and Johnson, W.O. (2004) ‘Factors affecting menstrual cycle characteristics’, American Journal of Epidemiology 160: 131–40 <http://dx.doi.org/10.1093/aje/kwh188>.
Marván, M.L, Espinosa-Hernandez, G. and Vacio, A. (2002). ‘Premenarcheal Mexican girls expectations concerning premenstrual changes and menstrual attitudes,’ Journal of Psychosomatic Obstetrics and Gynaecology 23: 89–96 <http://dx.doi.org/10.3109/01674820209042790>.
Marván, M.L., Iniestra, S.C. and Gonzalez, R. (2005) ‘Beliefs about and attitudes toward menstruation among young and middle-aged Mexicans’, Sex Roles 53(3/4): 273–9 <http://dx.doi.org/10.1007/s11199-005-5685-3>.
Narayan, K.A., Srinivasa, D.K. Pelto, P.J. and Veeramal, S. (2001) ‘Puberty rituals, reproductive knowledge and health of adolescent schoolgirls in South Asia’, Asia Pacific Population Journal 16(2): 225–38.
Paria, B., Bhattacharyya, A. and Das, S. (2014) ‘A comparative study on menstrual hygiene among urban and rural adolescent girls of West Bengal’, Journal of Family Medicine and Primary Care 3(4): 413–7 <http://dx.doi.org/10.4103/2249-4863.148131>.
Shah, P.S., Nair, R., Shah, P.P., Modi, D.K., Desai, S.A. and Desai, L. (2013) ‘Improving quality of life with new menstrual hygiene practices among adolescent tribal girls in rural Gujarat, India’, Reproductive Health Matters 21(41): 205–13 <http://dx.doi.org/10.1016/S0968-8080(13)41691-9>.
Sharma, M. and Gupta, S. (2003) ‘Menstrual pattern and abnormalities in the high school girls of Dhahran: a cross sectional study in two boarding schools’, Nepal Medical College Journal 5(1): 34–6.
Singh, A.J. (2006) ‘Place of menstruation in the reproductive lives of women of rural North India’, Indian Journal of Community Medicine 31(1): 10–4.
Stephens, W.N. (1961) ‘A cross-cultural study of menstrual taboos’, Genetic Psychology Monograph 64: 385–416.
Sudeshna, R. and Aparajita, D. (2012) ‘Determinants of menstrual hygiene among adolescent girls: a multivariate analysis’, National Journal of Community Medicine 5(2): 294–301.
Thakre, S.B., Thakre, S.S., Reddy, M., Rathi, N., Pathak, K. and Ughade, S. (2011) ‘Menstrual hygiene: knowledge and practice among adolescent school girls of Saoner, Nagpur District’, Journal of Clinical and Diagnostic Research 5(5): 1027–33.
UNICEF (2008) Sharing Simple Facts: Useful Information about Menstrual Health and Hygiene, New Delhi, India: Child’s Environment Section, UNICEF.
UNICEF (2012) Girls Today, Women Tomorrow: Research Highlights on Knowledge, Practice, Attitude and Norms on Menstrual Hygiene, India: UNICEF.
Adinma, E.D. and Adinma, J.I.B. (2008) ‘Perceptions and practices on menstruation amongst Nigerian secondary school girls’, African Journal of Reproductive Health 12(1): 74–83 <http://dx.doi.org/10.2307/25470636>.
Agarwal, A.K. and Agarwal, A. (2010) ‘A study of dysmenorrheal during menstruation in adolescent girls’, Indian Journal of Community Medicine 35(1): 159–164 <http://dx.doi.org/10.4103/0970-0218.62586>.
Ahmed, R. and Yesmin, K. (2008) ‘Menstrual hygiene: breaking the silence’, in J. Wicken, J. Verhage, C. Sijbesma, C. Da Silva, and P. Ryan (eds), Beyond Construction Use By All, pp. 283–7, Delft: IRC International Water and Sanitation Centre and London: WaterAid.
Anson, O. (1999) ‘Exploring the bio-psycho-social approach to premenstrual experiences’, Social Science and Medicine 49: 67–80.
Bharadwaj, S. and Patkar, A. (2004) Menstrual Hygiene and Management in Developing Countries: Taking Stock, Mumbai: Junction Social, Social Development Consultants.
Bramwell, R.S, Biswas, E.L. and Anderson, C. (2002) ‘Using the menstrual attitude questionnaire with a British and an Indian sample’, Journal of Reproductive and Infant Psychology 20: 159–70 <http://dx.doi.org/10.1080/0264683021000006741>.
Das, P., Baker, K.K., Dutta, A., Swain, T., Sahoo, S., Das, B.S., Panda, B., Nayak, A., Bara, M., Bilung, B., Mishra, P.R., Panigrahi, P., Cairncross, S. and Torondel, B. (2015) ‘Menstrual hygiene practices, WASH access and the risk of urogenital infection in women from Odisha, India’, PLoS ONE 10(6): e0130777 <http://dx.doi.org/10.1371/journal.pone.0130777>.
Dasgupta, A. and Sarkar, M. (2008) ‘Menstrual hygiene: how hygienic is the adolescent girl?’ Indian Journal of Community Medicine 33(2): 77–80 <http://dx.doi.org/10.4103/0970-0218.40872>.
Dhingra, R., Kumar, A. and Kour, M. (2009) ‘Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls’, Ethno Medicine 3(1): 43–8.
Drakshayani, D.K. and Venkata, R.P. (1994) ‘A study on menstrual hygiene among rural adolescent girls’, Indian Journal of Medical Sciences 48(6): 139–43.
Fernandes, M. (2010) ‘Freedom of mobility: experiences from villages in the states of Madhya Pradesh and Chhattisgarh, India’, presented at South Asia Hygiene Practitioners’ Workshop, Dhaka, Bangladesh, February.
Freeman, E.W. (2002) ‘Treatment of depression associated with the menstrual cycle: premenstrual dysphoriya, postpartum depression and the permenopause’, Dialogues in Clinical Neuroscience 4(2): 177–91.
Ghattargi, C.H. and Deo, D.S. (2005) ‘Perceptions and practices regarding menstruation: a comparative study in urban and rural adolescent girls’, Indian Journal of Community Medicine 30(1): 10–4.
Government of India (2003) Towards Total Sanitation and Hygiene: A Challenge for India, New Delhi: Ministry of Rural Development.
Government of India (2007) Rural Drinking Water and Sanitation in the Eleventh Plan Period: Excerpts, Planning Commission, Eleventh Five Year Plan, 2007–2012, 54th NDC Meeting.
Gupta, J. and Gupta, H. (2001) ‘Adolescents and menstruation’, Journal of Family Welfare 47(1): 1–13.
Jones, L.L., Griffiths, P.L., Norris, S.A., Pettifor, J.M. and Cameron, N. (2009) ‘Age at menarche and the evidence for a positive secular trend in urban South Africa’, American Journal of Human Biology 21: 130–2 <http://dx.doi.org/10.1002/ajhb.20836>.
Katiyar, K., Chopra, H., Garg, S.K., Bajpai, S.K., Bano, T., Jain, S. and Kumar A. (2013) ‘KAP Study of menstrual problems in adolescent females in am urban area of Meerut’, Indian Journal of Community Health 25(3): 217–20.
Kaundal, M. and Thakur, B. (2014) ‘A dialogue on menstrual taboo’, Indian Journal of Community Health 26(2): 192–4.
Lal, S., Nawaz, J. and Raza, S. (2007) ‘Screened sanitation units: the Pakistan earthquake’, Waterlines 25(3): 28–9 <http://dx.doi.org/10.1080/13552071003600067>.
Liu, Y., Gold, E.B., Lesley, B.L. and Johnson, W.O. (2004) ‘Factors affecting menstrual cycle characteristics’, American Journal of Epidemiology 160: 131–40 <http://dx.doi.org/10.1093/aje/kwh188>.
Marván, M.L, Espinosa-Hernandez, G. and Vacio, A. (2002). ‘Premenarcheal Mexican girls expectations concerning premenstrual changes and menstrual attitudes,’ Journal of Psychosomatic Obstetrics and Gynaecology 23: 89–96 <http://dx.doi.org/10.3109/01674820209042790>.
Marván, M.L., Iniestra, S.C. and Gonzalez, R. (2005) ‘Beliefs about and attitudes toward menstruation among young and middle-aged Mexicans’, Sex Roles 53(3/4): 273–9 <http://dx.doi.org/10.1007/s11199-005-5685-3>.
Narayan, K.A., Srinivasa, D.K. Pelto, P.J. and Veeramal, S. (2001) ‘Puberty rituals, reproductive knowledge and health of adolescent schoolgirls in South Asia’, Asia Pacific Population Journal 16(2): 225–38.
Paria, B., Bhattacharyya, A. and Das, S. (2014) ‘A comparative study on menstrual hygiene among urban and rural adolescent girls of West Bengal’, Journal of Family Medicine and Primary Care 3(4): 413–7 <http://dx.doi.org/10.4103/2249-4863.148131>.
Shah, P.S., Nair, R., Shah, P.P., Modi, D.K., Desai, S.A. and Desai, L. (2013) ‘Improving quality of life with new menstrual hygiene practices among adolescent tribal girls in rural Gujarat, India’, Reproductive Health Matters 21(41): 205–13 <http://dx.doi.org/10.1016/S0968-8080(13)41691-9>.
Sharma, M. and Gupta, S. (2003) ‘Menstrual pattern and abnormalities in the high school girls of Dhahran: a cross sectional study in two boarding schools’, Nepal Medical College Journal 5(1): 34–6.
Singh, A.J. (2006) ‘Place of menstruation in the reproductive lives of women of rural North India’, Indian Journal of Community Medicine 31(1): 10–4.
Stephens, W.N. (1961) ‘A cross-cultural study of menstrual taboos’, Genetic Psychology Monograph 64: 385–416.
Sudeshna, R. and Aparajita, D. (2012) ‘Determinants of menstrual hygiene among adolescent girls: a multivariate analysis’, National Journal of Community Medicine 5(2): 294–301.
Thakre, S.B., Thakre, S.S., Reddy, M., Rathi, N., Pathak, K. and Ughade, S. (2011) ‘Menstrual hygiene: knowledge and practice among adolescent school girls of Saoner, Nagpur District’, Journal of Clinical and Diagnostic Research 5(5): 1027–33.
UNICEF (2008) Sharing Simple Facts: Useful Information about Menstrual Health and Hygiene, New Delhi, India: Child’s Environment Section, UNICEF.
UNICEF (2012) Girls Today, Women Tomorrow: Research Highlights on Knowledge, Practice, Attitude and Norms on Menstrual Hygiene, India: UNICEF.
Adinma, E.D. and Adinma, J.I.B. (2008) ‘Perceptions and practices on menstruation amongst Nigerian secondary school girls’, African Journal of Reproductive Health 12(1): 74–83 <http://dx.doi.org/10.2307/25470636>.
Agarwal, A.K. and Agarwal, A. (2010) ‘A study of dysmenorrheal during menstruation in adolescent girls’, Indian Journal of Community Medicine 35(1): 159–164 <http://dx.doi.org/10.4103/0970-0218.62586>.
Ahmed, R. and Yesmin, K. (2008) ‘Menstrual hygiene: breaking the silence’, in J. Wicken, J. Verhage, C. Sijbesma, C. Da Silva, and P. Ryan (eds), Beyond Construction Use By All, pp. 283–7, Delft: IRC International Water and Sanitation Centre and London: WaterAid.
Anson, O. (1999) ‘Exploring the bio-psycho-social approach to premenstrual experiences’, Social Science and Medicine 49: 67–80.
Bharadwaj, S. and Patkar, A. (2004) Menstrual Hygiene and Management in Developing Countries: Taking Stock, Mumbai: Junction Social, Social Development Consultants.
Bramwell, R.S, Biswas, E.L. and Anderson, C. (2002) ‘Using the menstrual attitude questionnaire with a British and an Indian sample’, Journal of Reproductive and Infant Psychology 20: 159–70 <http://dx.doi.org/10.1080/0264683021000006741>.
Das, P., Baker, K.K., Dutta, A., Swain, T., Sahoo, S., Das, B.S., Panda, B., Nayak, A., Bara, M., Bilung, B., Mishra, P.R., Panigrahi, P., Cairncross, S. and Torondel, B. (2015) ‘Menstrual hygiene practices, WASH access and the risk of urogenital infection in women from Odisha, India’, PLoS ONE 10(6): e0130777 <http://dx.doi.org/10.1371/journal.pone.0130777>.
Dasgupta, A. and Sarkar, M. (2008) ‘Menstrual hygiene: how hygienic is the adolescent girl?’ Indian Journal of Community Medicine 33(2): 77–80 <http://dx.doi.org/10.4103/0970-0218.40872>.
Dhingra, R., Kumar, A. and Kour, M. (2009) ‘Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls’, Ethno Medicine 3(1): 43–8.
Drakshayani, D.K. and Venkata, R.P. (1994) ‘A study on menstrual hygiene among rural adolescent girls’, Indian Journal of Medical Sciences 48(6): 139–43.
Fernandes, M. (2010) ‘Freedom of mobility: experiences from villages in the states of Madhya Pradesh and Chhattisgarh, India’, presented at South Asia Hygiene Practitioners’ Workshop, Dhaka, Bangladesh, February.
Freeman, E.W. (2002) ‘Treatment of depression associated with the menstrual cycle: premenstrual dysphoriya, postpartum depression and the permenopause’, Dialogues in Clinical Neuroscience 4(2): 177–91.
Ghattargi, C.H. and Deo, D.S. (2005) ‘Perceptions and practices regarding menstruation: a comparative study in urban and rural adolescent girls’, Indian Journal of Community Medicine 30(1): 10–4.
Government of India (2003) Towards Total Sanitation and Hygiene: A Challenge for India, New Delhi: Ministry of Rural Development.
Government of India (2007) Rural Drinking Water and Sanitation in the Eleventh Plan Period: Excerpts, Planning Commission, Eleventh Five Year Plan, 2007–2012, 54th NDC Meeting.
Gupta, J. and Gupta, H. (2001) ‘Adolescents and menstruation’, Journal of Family Welfare 47(1): 1–13.
Jones, L.L., Griffiths, P.L., Norris, S.A., Pettifor, J.M. and Cameron, N. (2009) ‘Age at menarche and the evidence for a positive secular trend in urban South Africa’, American Journal of Human Biology 21: 130–2 <http://dx.doi.org/10.1002/ajhb.20836>.
Katiyar, K., Chopra, H., Garg, S.K., Bajpai, S.K., Bano, T., Jain, S. and Kumar A. (2013) ‘KAP Study of menstrual problems in adolescent females in am urban area of Meerut’, Indian Journal of Community Health 25(3): 217–20.
Kaundal, M. and Thakur, B. (2014) ‘A dialogue on menstrual taboo’, Indian Journal of Community Health 26(2): 192–4.
Lal, S., Nawaz, J. and Raza, S. (2007) ‘Screened sanitation units: the Pakistan earthquake’, Waterlines 25(3): 28–9 <http://dx.doi.org/10.1080/13552071003600067>.
Liu, Y., Gold, E.B., Lesley, B.L. and Johnson, W.O. (2004) ‘Factors affecting menstrual cycle characteristics’, American Journal of Epidemiology 160: 131–40 <http://dx.doi.org/10.1093/aje/kwh188>.
Marván, M.L, Espinosa-Hernandez, G. and Vacio, A. (2002). ‘Premenarcheal Mexican girls expectations concerning premenstrual changes and menstrual attitudes,’ Journal of Psychosomatic Obstetrics and Gynaecology 23: 89–96 <http://dx.doi.org/10.3109/01674820209042790>.
Marván, M.L., Iniestra, S.C. and Gonzalez, R. (2005) ‘Beliefs about and attitudes toward menstruation among young and middle-aged Mexicans’, Sex Roles 53(3/4): 273–9 <http://dx.doi.org/10.1007/s11199-005-5685-3>.
Narayan, K.A., Srinivasa, D.K. Pelto, P.J. and Veeramal, S. (2001) ‘Puberty rituals, reproductive knowledge and health of adolescent schoolgirls in South Asia’, Asia Pacific Population Journal 16(2): 225–38.
Paria, B., Bhattacharyya, A. and Das, S. (2014) ‘A comparative study on menstrual hygiene among urban and rural adolescent girls of West Bengal’, Journal of Family Medicine and Primary Care 3(4): 413–7 <http://dx.doi.org/10.4103/2249-4863.148131>.
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