COMPARITIVE STUDY OF KNOWLEDGE, ATTITUDE, PRACTICES REGARDING MENSTRUAL HEALTH AMONG RURAL AND URBAN POPULATION OF WAYANAD

Menstruation is the word derived from the Latin term ‘menstruus’ meaning monthly. The use of the word period starts in 1822. Different menstrual products are used at that time such as, ancient Egyptians may have used tampons made of softened papyrus, the ancient Greek used bits wood with lint wrapped around them and the romans used pads and tampons made of wools.[3] The menstruation is one of the most important process occurring among the girls during the reproductive age. It is a biological, normal process. The first menstruation (Menarche) occurs between 11 years and 15 years with a mean of 13 years.[3] The age of menarche depends upon various factors like genetic and non genetic factors. The non genetic factors include both prenatal and nutritional factors. Prenatal factors are maternal weight gain during pregnancy , gestational diabetes  etc . Nutritional factors such as high protein intake .[1] Poor menstrual hygiene is an important problem and it causes serious health risks like urinary tract infections . Not washing hands after handling of menstrual products can spread serious infections which cause deadly diseases (e.g.; hepatitis) to the individuals and improper disposal of sanitary napkins used by a infected person causes spreading of infections to the public(HIV, hepatitis) . Nowadays  there are cultural and religious taboos blood, menstruating women and girls.[1] This taboos prevent the girls and women from their needs regarding menstrual hygiene and that inversely affect their mental health. From the history menstruation is considered as the mystery and  some of the taboos are present related menstruation.[24] The taboos such as the restrictions to go to temple ,  do not touch males , do not enter into kitchen and pooja room and sleep separate during menstruation are present in our society. Due to these taboos the menstrual hygiene are not properly managed. In 1993 whisper became the first brand to show a sanitary pad in commercial , first to mention the word “ periods” in advertising The governmental and non-governmental organisations in India are initiated several awareness programmes for providing safe menstrual hygiene.[1] There is a need of comparing knowledge, attitude, practices regarding menstrual health among urban and rural population of Wayanad by using survey method.

OBJECTIVE

• To understand the current level of knowledge among urban and rural population of Wayanad regarding menstruation
• To explore attitude of the urban and rural population of wayanad towards menstruation.
• To explore practices of the urban and rural population wayanad during the time of menstruation

MATERIALS AND METHODS

A research study is conducted in a systematic way with proper design and planning in order to reach to the conclusion. This study is conducted based on a pre-structured questionnaire to assess the knowledge, attitude and practices of the urban and rural population of wayanad. A pre-structured questionnaire was selected and a prospective cross sectional study was carried out. All the female respondents of age >18 years who are willing to answer were included in the study and the female respondents <18>18 years, who are willing to participate in the study. Exclusion criteria- Respondents , who are not willing to participate in the study and male respondents are excluded from study. Study was conducted in urban and rural general population of Wayanad. The study was conducted for a period of  4 months (March- June 2024). Those female respondents of age group 18-35 who are willing to answer were included in the study. All the data were made into a table and the data was analyzed by using software SPSS version 22.2. The frequency, percentage, chi square and P value was calculated .

RESULTS AND DISSCUSSION

Knowledge about menstruation

The mother’s education is divided into 5 group that is; No education, Primary, Secondary, Certificate or diploma and Degree +. Over 171 respondents mother’s  of  rural  population  2(1.2%)  have no education, 34(19.9%) have Primary education , 99(57.9%) have Secondary education and 36(27.1%) have degree education.

Over 171 respondents mother’s of urban population 37(21.6%) have primary education,111(64.9) have Secondary education, 11(6.4%) have certificate or diploma education and 12(7.0%) have degree education. The education is divided into 4 groups that is primary(PP to VI), Secondary(Class VII to class XII), Certificate, diploma and Degree+. Over 171 respondents of  rural population anyone have primary education all person have more than primary education. 6(4.51%) have secondary education, 80(46.38%) have certificate or diploma education and 85(49.11%) have degree+ education. Over 171 respondents of urban population all person have more than primary education. 3(1.5%) person have secondary education, 48(27.5%) have certificate or diploma education and 120(71%) have degree+ education.                                                                  
       
           
       
    

respondents of urban population all of the population have proper knowledge about duration of menstruation of a normal person.

Attitude towards menstruation

Mother, Teacher, Friends, Sister are given as  the  sources their information regarding menstruation . Over 171 respondents of rural population 99(45.1%) tell that mothers, 56(32.8%) teachers, 25(14.7%) friends and 13(7.6%) tell that sisters are the sources of information regarding onset of menstruation. In 171 respondents if urban population said that 72(42.1%) mothers, 78(45.7%) teachers , 9(5.2%) friends and 12(7.0%) sisters are the their sources of information regarding menstruation before onset of menstruation. Teachers and parents are the major source of information regarding menstruation. Over 171 respondents of rural  population 126(73.7%)  have knowledge about menstrual hygiene and 45(26.3%) have no knowledge about menstrual hygiene.  In 171 respondents of urban population 159(93.0%) have knowledge about menstrual hygiene and 12(7%) have no knowledge about menstrual hygiene. Over the 171 respondents of rural population 126(73.7%)  said that they have knowledge about infections due to poor menstrual hygiene , 45(26.3%)  have no knowledge about  infections due to poor menstrual hygiene and 171 respondents of urban population 145(84.8%)  have knowledge about infections and 26(15.2%) have no knowledge about infections due to poor menstrual hygiene.

Women must not enter shrines or temples while having  menstruation?

5 options are  given for this set of questions related to attitude towards menstruation that is strongly agree, agree, don’t know, disagree and strongly disagree. Women must not enter shrines or temples while having menstruation is one of the wrong attitude towards menstruation. Among 171 respondents of  rural population 70(40.9%) strongly agree with this statement , 68(39.8%)  agree with this statement, 3(1.8%) chooses the answer don’t know, 28(16.4%) selected the answer disagree and 1(0.8%)  selected the answer strongly disagree. 171 respondents of urban population 5(2.9%) chooses the answer strongly agree, 96(56.1%) selected the answer agree, 10(5.8%)  don’t know , 27(15.8%)  selected the option disagree  and strongly disagree with this attitude question.

It is important to talk about menstrual period with men?

Over 39(22.8%) strongly agree with this statement , 80(46.85%) agree with this statement, just 2(1.2%) don’t know about the statement, 34(19.9%) disagree and 16(9.9%) strongly disagree with this statement . Among 171 respondents from urban population 102(59.6%) strongly agree, 52(30.4%) agree and 17(9.9%) don’t know about this statement.

Women should not touch holy books during menstruation?

The women with menstruation touching the holy books is consider as dirty thing it is a menstrual myth. Among 171 respondents of rural population 40(23.4%) have attitude of strongly agree, 75(43.9%) have attitude of agree, 8(4.7%) have attitude of don’t know, 28(16.4%) have attitude of disagree and 20(11.7%) have attitude of strongly disagree towards this menstrual myth. Among 171 respondents of  urban  population 59(34.6%) have attitude of strongly agree, 63(36.8%) have attitude of agree, 6(3.5%) have attitude of don’t know, 25(14.6%) have attitude of disagree and 18(10.5%) have attitude of strongly disagree towards this menstrual myth.

Practices during menstruation

Do you take bath during menstruation?   

All respondents of both rural and urban population take bath during menstruation.

Do you clean genital area during menstruation?

All respondents of both rural and urban population clean the genital area. Majority of population choose water and soap for cleaning the genital area

Do you wrap the pad before disposing it?

Wrapping of used pad before disposing is a essential method to avoid pollution. Among the 171 respondents of rural population 83(48.5%) wrap the pads before disposing and among 171 respondents of urban population 59(93.0%) wrap the pads. Majority of people choose papers for wrapping the used pads before The problems like menstrual cramp, mood swings etc leads to missing of college among students. Over respondents of rural population  53(31.0%) respondents missing the college during menstruation and among urban population 69(40.4%) missing college. Majority of population choose the answer menstrual cramps as the reason for missing college. Medication, prayers, Take rest are given as the answer for the question what is the remedies take during menstruation. Over 171 respondents of rural population 3(1.8%) choose the answer medication and 41(24.0%) choose the answer take rest and among the respondents of urban population 10(5.8%) choose the answer medication and 153(89.3%) choose the answer take rest. Majority of the population take rest during the menstruation.

Do you avoid some food during menstruation?

Some of the population avoid some food during menstruation like meat, milk, sweets. Among the 171 respondents of rural population 80(46.8%) and 47(27.5%) of urban population avoid some of the food during menstruation.