Menstrual Hygiene Management Among Vulnerable Rural Adolescent Schoolgirls in South Africa's Rural Learning Ecologies
DOI:
https://doi.org/10.57125/FED.2024.09.25.02Keywords:
menstrual hygiene management (MHM), vulnerable rural adolescent schoolgirls, rural learning ecologies, academic performance, theory of change (ToC), menstrual health cycle (MHC)Abstract
This qualitative research paper examined the menstrual health challenges and hygiene that were faced by vulnerable rural adolescent schoolgirls in South Africa, their negative effects on school attendance, academic performance and wellbeing. Seeing the above challenges as barriers to sustainable development goals (SDG) 4 quality education and SDG 5 gender equality, the study used a critical emancipatory approach alongside the theory of change (ToC) as its framework. The purpose was to give a hearing to the voiceless and lived experiences of this group of people to provided a platform for empowering and transformative actions. The focus group discussions (FGDs) with vulnerable rural adolescent schoolgirls, their parents and teachers and school administrators were held at a designated learning ecology. Open-ended Interviews (OEIs) assisted to collect phenomenological narratives with many ethnographic perspectives. The data was analysed thematically to make major themes inductively reflect their real life conditions. The research findings reflected that the gaps in menstrual information, restricted availability and the use of sanitary products, conformity of cultural norms and inadequate amount of water, sanitation and hygiene facilities (WASH) helped creating considerable barriers for many rural adolescent schoolgirls thereby compelling them to miss school during their menstruation. The study highlighted the importance of comprehensive MHM programmes that envisage availability of materials and amenities, menstruation education and psychological support, as well as stigmatisation measures. To move forward with context relevant and community centred interventions, the study suggested a collaborative, multi-stakeholder approach involving the community. Tackling these converging problems was paramount to the preservation of the menstrual health rights of vulnerable rural schoolgirls, education gender equity as well as the attainment of the SDG 4 and SDG 5 goals by 2030. The practice would comprehend all-encompassing evidence-based policies and curricula, and promotion of life-long learning opportunities for all vulnerable rural adolescent schoolgirl through active learning ecologies.
References
Abayneh, S., Lempp, H. & Kohrt, B. A. (2022). Using participatory action research to pilot a model of service user and caregiver involvement in mental health system strengthening in Ethiopian primary healthcare: A case study. International Journal of Mental Health Systems, 16(1), Article 33. https://doi.org/10.1186/s13033-022-00545-8
Anbesu, E. W., & Asgedom, D. K. (2023). Menstrual hygiene practice and associated factors among adolescent girls in sub-Saharan Africa: A systematic review and meta-analysis. BMC Public Health, 23, 1–14. https://doi.org/10.1186/s12889-022-14942-8
Barbrook-Johnson, P., & Penn, A. S. (2022). Theory of change diagrams: In systems mapping. Cham: Palgrave Macmillan. https://doi.org/10.1007/978-3-031-01919-7_3
Beksinska, M., Milford, C., Devaki, R., Zulu, B., Mona, A., & Cavanagh, T. (2023). Menstrual hygiene management in schools in South Africa: Knowledge, experience and impact on school attendance. Research Square. http://dx.doi.org/10.21203/rs.3.rs-3574433/v1
Beksinska, M., Nkosi, P., Zulu, B., & Smit, J. (2021). Acceptability of the menstrual cup among students in further education institutions in KwaZulu-Natal, South Africa. The European Journal of Contraception & Reproductive Health Care, 26(1), 11–16. https://doi.org/10.1080/13625187.2020.1815005
Boulil, D., & Hanney, R. (2022). Change must come: Mixing methods, evidencing effects, measuring impact. Media Practice and Education, 23(2), 126–137, https://doi.org/10.1080/25741136.2022.2056790
Breuer, E., De Silva, M., & Lund, C. (2018). Theory of change for complex mental health interventions: 10 lessons from the programme for improving mental healthcare. Global Mental Health, 5, Article e24. https://doi.org/10.1017/gmh.2018.13
Burbaugh, B., Seibel, M., & Archibald, T. (2017). Using a participatory approach to investigate a leadership program's theory of change. Journal of Leadership Education, 16(1), 192–204. http://dx.doi.org/10.12806/V16/I1/A3
Chandra-Mouli, V., & Patel, S. V. (2017). Mapping the knowledge and understanding of menarche, menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries. Reproductive Health, 14(1), Article 30. https://doi.org/10.1186/s12978-017-0293-6
Chikulo, B. C. (2015). An exploratory study into menstrual hygiene management amongst rural high school for girls in the North West province, South Africa. African Population Studies, 29(2), 1971–1987. http://dx.doi.org/10.11564/29-2-777
Chowdhury, D., & Chowdhury, I. R. (2023). Knowledge and practices of menstrual hygiene of the adolescent girls of slums in Siliguri City, India: A cross-sectional study. Global Social Welfare, 10(2), 167–79. https://doi.org/10.1007/s40609-023-00281-y
Crankshaw, T. L., Strauss, M., & Gumede, B. (2020). Menstrual health management and schooling experience amongst female learners in Gauteng, South Africa: A mixed method study. Reproductive Health Journal, 17(1), Article 48. https://doi.org/10.1186/s12978-020-0896-1
Department of Women, Republic of South Africa. (2017). Sanitary dignity policy framework. https://static.pmg.org.za/180612Sanitary_Dignity_Policy.pdf
Dogoli, M. A., Nunbogu, A. M., & Elliott, S. J. (2023). Attention to the needs of women and girls in WASH: An analysis of WASH policies in selected sub-Saharan African countries. Global Public Health, 18(1), Article 2256831. https://doi.org/10.1080/17441692.2023.2256831
Fennie, T., Moletsane, M., & Padmanabhanunni, A. (2022). Adolescent girls’ perceptions and cultural beliefs about menstruation and menstrual practices: A scoping review. African Journal of Reproductive Health, 26(2), 88–105. https://doi.org/10.29063/ajrh2022/v26i2.9
Fennie, T., Moletsane, M., & Padmanabhanunni, A. (2023). Teachers’ reflections on menstrual management among urban and rural schoolgirls in South Africa. African Journal of Reproductive Health, 27(2), 34–44. https://doi.org/10.29063/ajrh2023/v27i2.3
Guenther, J., & Falk, I. (2022). “Change” in micro/macro contexts. In R. Baikady, S. Sajid, V. Nadesan, J. Przeperski, M. R. Islam, & J. Gao (Eds.), The Palgrave handbook of global social change (pp.1–18). Cham: Palgrave Macmillan. https://doi.org/10.1007/978-3-030-87624-1_74-1
Hendrickson, C. Y., & Henrysson, M. (2023). Theories of change and results-based management for the sustainable development agenda. In L. Simeone, D. Drabble, N. Morelli, & A. de Götzen (Eds.), Strategic thinking, design and the theory of change (pp. 56–75). Cheltenham, UK: Edward Elgar Publishing. https://doi.org/10.4337/9781803927718.00010
Hennegan, J., Nansubuga, A., Akullo, A., Smith, C., & Schwab, K. J. (2020). The Menstrual Practices Questionnaire (MPQ): Development, elaboration, and implications for future research. Global Health Action, 13(1), Article 1829402. https://doi.org/10.1080/16549716.2020.1829402
Hennegan, J., OlaOlorun, F. M., Oumarou, S., Alzouma, S., Guiella, G., Omoluabi, E., & Schwab, K. J. (2021). School and work absenteeism due to menstruation in three West African countries: Findings from PMA2020 surveys. Sexual and Reproductive Health Matters, 29(1), 409–424. https://doi.org/10.1080/26410397.2021.1915940
Kalpokaite, N., & Radivojevic, I. (2019). Demystifying qualitative data analysis for novice qualitative researchers. The Qualitative Report, 24(13), 44–57. https://doi.org/10.46743/2160-3715/2019.4120
Kansiime, C., Hytti, L., Nalugya, R., Nakuya, K., Namirembe, P., Nakalema, S. … Weiss, H. A. (2020). Menstrual health intervention and school attendance in Uganda (MENISCUS-2): A pilot intervention study. BMJ Open, 10(2), Article e031182. https://doi.org/10.1136/bmjopen-2019-031182
Khamisa, N., Nanji, N., Tshuma, N., & Kagura, J. (2022). The relationship between menstrual hygiene management, practices, and school absenteeism among adolescent girls in Johannesburg, South Africa. South African Journal of Child Health, 16(1), 7–12. http://www.sajch.org.za/index.php/SAJCH/article/view/1659
Krusz, E., Hall, N., Dani J., Barrington, D. J., Creamer, S., Anders, W. … Hennegan, J. (2019). Menstrual health and hygiene among Indigenous Australian girls and women: Barriers and opportunities. BMC Women's Health, 19(146), 2–7. https://doi.org/10.1186/s12905-019-0846-7
Kumar, D., Vaiyam, P., & Thakur, R. S. (2021). Management of menstrual hygiene, practices and perceptions among vulnerable Bharia women in Madhya Pradesh: A pilot survey. Journal of Community Health Management, 8(4), 169–175. https://doi.org/10.18231/j.jchm.2021.038
LaMarre, A., & Chamberlain, K. (2022). Innovating qualitative research methods: Proposals and possibilities. Methods in Psychology, 6, Article 100083. https://doi.org/10.1016/j.metip.2021.100083
Macleod, C. I., Du Toit, R., Paphitis, S., & Kelland, L. (2020). Social and structural barriers related to menstruation across diverse schools in the Eastern Cape. South Africa Journal of Education, 40(3), Article 1663. https://doi.org/10.15700/saje.v40n3a1663
Madziyire, M, G., Magure, T. M., & Madziwa, C. F. (2018). Menstrual cups as a menstrual management method for low socioeconomic status women and girls in Zimbabwe: A pilot study. Women's Reproductive Health, 5(1), 59–65. https://doi.org/10.1080/23293691.2018.1429371
Mahfuz, M. T, Sultana, F., Hunter, E. C., Fahan, F., Akand, F., Khan, S. … Winch, P. (2021). Teachers’ perspective on implementation of menstrual hygiene management and puberty education in a pilot study in Bangladeshi schools, Global Health Action, 14(1), Article 1955492. https://doi.org/10.1080/16549716.2021.1955492
Malik, M., Hashmi, A., Hussain, A., Khan, W., Jahangir, N., Malik, A., & Ansari, N. (2023). Experiences, awareness, perceptions and attitudes of women and girls towards menstrual hygiene management and safe menstrual products in Pakistan. Frontiers in Public Health, 11, Article 1242169. https://doi.org/10.3389/fpubh.2023.1242169
Miiro, G., Rutakumwa, R., Nakiyingi-Miiro, J., Nakuya, K., Musoke, S., Namakula, J. … Weiss, H. A. (2018). Menstrual health and school absenteeism among adolescent girls in Uganda (MENISCUS): A feasibility study. BMC Women's Health, 18, Article 4. https://doi.org/10.1186/s12905-017-0502-z
Mittal, S., Priya, S., & Kumar, R. (2023). Menstrual hygiene practices in Indian tribal females: A systematic review and meta-analysis. Cureus, 15(7), Article e42216. https://doi.org/10.7759/cureus.42216
Nassaji, H. (2020). Good qualitative research. Language Teaching Research, 24(4), 427–431. https://doi.org/10.1177/1362168820941288
Nassozi, P., Muweesi, C., & Sserwadda, L. (2024). Integration of water and sanitation facilities programs for menstruation management: A focus on university planning and budgeting processes at Kyambogo University, Uganda. Sexuality, Gender & Policy, 7(1), 65–84. https://doi.org/10.1002/sgp2.12086
Patel, K., Panda, N., Sahoo, K. C., Saxena, S., Chouhan, N. S., Singh, P. … Panda, B. (2022). A systematic review of menstrual hygiene management (MHM) during humanitarian crises and/or emergencies in low- and middle-income countries. Frontiers in Public Health, 10, Article 1018092. https://doi.org/10.3389/fpubh.2022.1018092
Phillips, J., & Klein, J. D. (2023). Change management: From theory to practice. TechTrends, 67(1), 189–197. https://doi.org/10.1007/s11528-022-00775-0
Pithouse-Morgan, K., & Samaras, A. P. (2024). Rethinking qualitative data analysis in a co-creative experimental approach. In J. DeHart & P. Hash (Eds.), Arts-based research across textual media in education (pp. 12–27). Routledge. https://doi.org/10.4324/9781003294597
Rengarajan, V., & Sivasubramaniyan, K. (2020). Theories of change in the process of rural transformation: A refined way forward. International Journal of Research, 8(7), 279–297. https://doi.org/10.29121/granthaalayah.v8.i7.2020.727
Rossouw, L., & Ross, H. (2021). Understanding period poverty: Socio-economic inequalities in menstrual hygiene management in eight low- and middle-income countries. International Journal of Environmental Research and Public Health, 18(5), Article 2571. https://doi.org/10.3390/ijerph18052571
Scheytt, C., & Pflüger, J. (2024). Conducting qualitative research in organizations ethically: Organizationality as a heuristic to identify ethical challenges. International Journal of Qualitative Methods, 23. https://doi.org/10.1177/16094069241237548
Seneviwickrama, K. L. M. D. (2020). Theory of change: Can its application really make a change?. Journal of the College of Community Physicians of Sri Lanka, 26(4), 234–237. https://doi.org/10.4038/jccpsl.v26i4.8391
Serrat, O. (2017). Theories of change. In Knowledge solutions: Tools, methods, and approaches to drive organizational performance (pp. 237–243). Singapore: Springer. https://doi.org/10.1007/978-981-10-0983-9_24
Siddiqui, N., & Mahomed, A. (2023). Menstrual health in South Africa. Wits Journal of Clinical Medicine, 5(2), 125–128. https://doi.org/10.18772/26180197.2023.v5n2a6
Singh, A., Chakrabarty, M., & Singh, S. (2022). Menstrual hygiene practices among adolescent women in rural India: A cross-sectional study. BMC Public Health, 22, Article 2126. https://doi.org/10.1186/s12889-022-14622-7
Sommer, M., Caruso, B. A., Torondel, B., Warren, E. C., Yamakoshi, B., Haver, J. … Phillips-Howard, P. A. (2021). Menstrual hygiene management in schools: Midway progress update on the “MHM in Ten” 2014–2024 global agenda. Health Research Policy and Systems, 19, Article 1. https://doi.org/10.1186/s12961-020-00669-8
Sommer, M., Figueroa, C., Kwauk, C., Jones, M., & Fyles, N. (2017). Attention to menstrual hygiene management in schools: An analysis of education policy documents in low- and middle-income countries. International Journal of Educational Development, Volume 57, 73–82. https://doi.org/10.1016/j.ijedudev.2017.09.008
Thornton, P., Cramer, L., Kristjanson, P., Schuetz, T., & Szilagyi, L. (2023). Theories of change for transformation. In B. Campbell, P. Thornton, A. M. Loboguerrero, D. Dinesh, & A. Nowak (Eds). Transforming food systems under climate change through innovation (pp. 171–184). Cambridge University Press. https://doi.org/10.1017/9781009227216.015
UNESCO. (2023). Menstrual health and hygiene management: A module for gender empowerment. New Delhi: UNESCO. https://unesdoc.unesco.org/ark:/48223/pf0000385604
Vaughn, L., Burkins, P., & Judd, J. (2020). Exploration and self-control: Differences in regulatory focus and need support. PsyArXiv. https://doi.org/10.31234/osf.io/xamdu
Wilbur, J., Torondel, B., Hameed, S., Mahon, T., & Kuper, H. (2019). Systematic review of menstrual hygiene management requirements, its barriers and strategies for disabled people. PLoS ONE 14(2), Article e0210974. https://doi.org/10.1371/journal. pone.0210974
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