gms | German Medical Science

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 (https://www.wvi.org/). Lack of proper hygiene can lead to serious reproductive complications and infections of the urinary tract. Women and girls with adequate knowledge in MHM are more confident when it comes to sustaining themselves. They are also less likely to drop out of school.

Gambia is a small country with the population of about 1.8 million people, 52.4% of which are women and girls. In our country topics surrounding sexual and reproductive health which includes menstrual hygiene is considered as a taboo. Menstruation in most societies is a sign of fertility and readiness for marriage in some. Menstruation is a natural process that we as women go through but its presence is relative compared to the life changing experience the individual encounters. It is the start of a journey to womanhood – the time at which your hormones communicate with you directly. Therefore, menstruation is a personal and private journey but not a secret.

Most of us learnt menstrual hygiene management from our teachers, friends, YouTube, etc. Our parents were too shy and uncomfortable to discuss these issues with us. And we were also too shy to ask. The obstacles surrounding menstrual hygiene management are not only due to lack of awareness but it also extends to poverty, lack of access to hygiene products, culture, etc. We have school going girls who skip school when they are on their periods due to lack of finances to purchase sanitary pads. According to a survey conducted by the Ministry of Basic and Secondary education; 10 to 20% of girls skip school due to menstrual related issues.

Methodology: A mixed methods study was conducted in the rural Kiang West district of The Gambia. Twenty focus group discussions and thirteen in-depth interviews were conducted among mothers, adolescents, and teachers to explore their views on menstruation, cultural beliefs, sources, and level of knowledge on menstruation and MHM practices. In addition, a survey was done among 331 school girls to assess their knowledge, practices and attitudes of menstruation and its management. Inductive content analysis was used to analyze the qualitative data, and descriptive analysis and chi-squared tests were used to analyze quantitative data.

Conclusion: Taboos, secrecy, and embarrassment associated with discussing menstruation hinder adolescents from seeking advice from parents and teachers on appropriate MHM practices. Strategies to encourage positive social norms towards menstruation would help to promote more open discussions about it at the family, community, and national level, which will support improvements in MHM in this and similar communities in low- and middle-income settings.