Menstrual knowledge and perceptions of schoolgirls in Bangladesh: do socio-economic factors really matter?

• Date: 07 October 2021
• Pages: 277-294
• DOI: https://doi.org/10.1108/IJHRH-07-2021-0145
• Published date: 07 October 2021
• Subject Matter: Health & social care,Vulnerable groups,Inequalities & diverse/minority groups,Sociology,Race & ethnic studies,Minorities,Multiculturalism,Racial identity,Work,economy & organizations
• Author: Gulsan Ara Parvin,Nina Takashino,Md. Shahidul Islam,Md. Habibur Rahman,Md. Anwarul Abedin,Mrittika Basu

Menstrual knowledge and perceptions

of schoolgirls in Bangladesh: do

socio-economic factors really matter?

Gulsan Ara Parvin, Nina Takashino, Md. Shahidul Islam, Md. Habibur Rahman,

Md. Anwarul Abedin and Mrittika Basu

Abstract

Purpose –This study aims to explore whethersocio-economic factors determine the level of menstrual

knowledge and perceptions of schoolgirls in Bangladesh. The aim of this study is to understand how

knowledge and perceptionsvary with variations in the different socio-economic factorsin a schoolgirl’s

life such as place of residence, religion, age, grade, parents’ education, parents’ occupation, family

income andeven family size.

Design/methodology/approach –Data were collectedfrom four schools (two in urban areasand two in

rural areas). A totalof 450 schoolgirls from grades V–X were interviewed to examinehow knowledge and

perceptionsvaried with different socio-economic aspects.Multiple logistic regression modelswere used

to measure the associations between various socio-economic variables and perceptions of and

knowledgeabout menstruation.

Findings –Respondents from urban areas were 4.75 times more likely and those 14–16 years old were two

times more likely to report higher levels of knowledge about menstruation compared to their counterparts.

Based on the father’s occupation, respondents whose father was engaged in a professional occupation

were 1.983 times more likely to have a higher level of knowledge on menstruation compared to those whose

fathers were in an unskilled profession. Similarly, the odds of positive perceptions on menstruation were

1.456 and 1.987 times higher, respectively, among respondents living in urban areas and those 14–16 years

old, compared to their counterparts.

Originality/value –This study provides evidence that different socio-economic and even demographic

factors are important in the development of menstrual knowledge and perceptions. Policy formulation and

development actions related to adolescent girls’ physical and reproductive health development need to

consider these factors in Bangladesh and in other developing countries, where poor knowledge and

perception related to menstruation are hindering girls’ mental and physical development. This is expected

that better knowledge and perception willfacilitate girls’ right to have better health and social lives.

Keywords Social care, Human rights, Gender, Health care, Bangladesh,

Menstrual knowledge and perception, Urban and rural, Schoolgirls, Adolescent

Paper type Research paper

Introduction

Menstruation is one of the healthiest symptoms of adolescence. Nevertheless, in

developing countries, menstruation is always associated with girls’ inadequate knowledge

and perceptions (Sharma et al., 2008). One prior study reveals that 64% of girls in

Bangladesh reported that they did not know about menstruation before reaching menarche

(Alam et al.,2017). It is claimed that, due to the lack of adequate information, most

adolescent girls (10–19years old) enter puberty (maturity) without being prepared

(Dasgupta and Sarkar, 2008). It is also reported that young adolescent girls in low- and

middle-income countries are under-prepared for puberty and menstruation (Coast et al., 2019).

(Informationabout the

authorscan be found at the

end of this article.)

Received 15 July 2021

Revised 30 August 2021

Accepted 3 September 2021

This research was funded by

the Japan Society for the

Promotion of Science (JSPS)

through its Grants-in-Aid for

Scientific Research, KAKENHI

Grant Number 21H03727). We

highly appreciate the kind

cooperation of schoolgirls and

their teachers from the

Government Coronation Girls’

School, Sultana Hamidali Girls’

School, Shahos Nowakathi

Government High School and

Ulamoikhali Government

School of Khulna District. We

also thank survey assistants

Farhana Islam, Jesmine Khan

and Tamim Shamshi Mim for

their sincere efforts in

conducting this survey.

DOI 10.1108/IJHRH-07-2021-0145VOL. 16 NO. 3 2023, pp. 277-294, ©Emerald Publishing Limited, ISSN 2056-4902 jINTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE jPAGE 277

Furthermore, in these countries, the natural process of menstruation is experienced negatively

and presents a barrier to health and gender equality (Sommer et al., 2016). This negative

experience sometimes causes psychological stress among young girls, affecting their

menstrual cycle (Sanders and Bruce, 1999). In one study, Sommer (2010) reports that girls

did not receive adequate guidance prior to their first menstrual period, therefore experiencing

fear, shame and embarrassment managing menstruation, particularly at school. However,

having adequate knowledge and appropriate information regarding menstrual health is an

essential human right (OHCHR, 2014). Attaining this right can lead girls and women to better

health and hygiene practices during menstruation and minimize associated problems

(Shanbhag et al., 2012).

Scholars claim that today, increasing openness is evident toward menstruation. However,

menstruation is perceived differently throughout the world; therefore, differences in attitude

persist between different populations (Thakur et al., 2014). Perceptions and attitudes

related to menstruation vary between countries, cultures, religions and ethnic groups

(Thakur et al.,2014). Furthermore, knowledge, perceptions and associated problems are

not the same between urban and rural girls (Belayneh and Mekuriaw, 2019;Thakre et al.,

2012). Place of residence, cultural factors and the mother’s education level are also

considered to be factors that play a role in menstrual health and hygiene (Thakre et al.,

2012). In another study, Haque et al. (2014) advise that prevailing socio-cultural and

economic factors should be considered when formulating effective strategies to support

schoolgirls in their adoption of healthy menstrual practices. A study conducted among

many adolescent girls in China concludes that the mother’s education level, family monthly

income and family type, as well as the girl’s age and grade significantlyinfluence menstrual

knowledge, attitudes and practice (Borjigen et al., 2019). One recent study conducted in

Ethiopia claims that the menstruation process in developing countries is bounded by social

taboos and supernatural beliefs (Belayneh and Mekuriaw, 2019). Another study claims that

family environment, culture, beliefs, attitudes, religion and girls’ education influence

menstrual practices and knowledge(Thakur et al.,2014).

In developing countries, sometimes menstruation is treated like an unclean or dirty

condition (Dasgupta and Sarkar, 2008), which poses a set of physical, socio-cultural

and economic challenges to adolescent girls. As a developing country, B angladesh is

no exception to this prevailing situation related to girls’ menstruation knowledge,

perception and practices. As in other South Asian countries, the culture of silence is

predominant about menstruation and related issues in Bangladesh and this secrecy

or silence often causes a lack of adequate knowledge and insufficient guidance

during girls’ menstruation (Rajagopal and Mathur, 2017). Regard ing this culture of

silence and stigma, Jyoti Sanghera, chief of Human Rights and Economic and Social

Issues Section, Office of the United Nations High Commissioner for Human Rights

(OHCHR) stated that “stigma around menstruation and menstrual hygiene is a

violation of several human rights, most importantly of the right to human dignity

(OHCHR, 2014).” Therefore, the silence and stigma associated with menstruation

must be needed to be eliminated to enhance adequate and appropriate knowl edge

and perception about menstrual health. Other research related to the management of

menstruation among schoolgirls in rural Bangladesh also advises that the silence

around menstruation in schools should be broken, with it thought that th is may

improve girls’ confidence in their management of menstruation (Hennegan and So l,

2020).

In Bangladesh, numerous studies have been conducted related to menstrual

knowledge, health, hygiene and practices. However, schoolgirls’ menstrual knowledge

and perceptions and how these are associated with socio-cultural and economic

factors have not yet been adequately studied or these aspects have only been sparsely

mentioned. To address this gap, the current study aims to examine the level of

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