title: The effect of a school-based educational intervention on menstrual health: an intervention study among adolescent girls in Bangladesh.
abstract: OBJECTIVE
  To assess the impact of a school-based menstrual education programme on: (1) menstrual knowledge, beliefs and practices, (2) menstrual disorders experienced, and (3) restrictions on menstruating adolescents.
  
  
  METHODS
  Intervention study.
  
  
  METHODS
  Araihazar area, Bangladesh.
  
  
  METHODS
  416 adolescent female students aged 11-16 years, in grade 6-8, and living with their parents.
  
  
  METHODS
  A school-based health education study conducted from April 2012 to April 2013.
  
  
  METHODS
  We randomly selected 3 of 26 high schools in the study area. We delivered 6 months of educational intervention by trained (by an obstetrician and gynaecologist) research assistants (RAs) on menstrual hygiene among school girls. RAs read the questionnaire and participants answered. The changes in knowledge, beliefs and practices regarding menstruation, menstrual disorders experienced, and the restrictions and behaviours practiced by menstruating adolescents were compared between the baseline and the follow-up assessments.
  
  
  RESULTS
  After health education, participants reported a significant improvement (p<0.001) in 'high knowledge and beliefs' scores compared to baseline (51% vs 82.4%). Significant improvement was also observed in overall good menstrual practices (28.8% vs 88.9%), including improvements in using sanitary pads (22.4% change after the intervention), frequency of changing pads/cloths per day (68.8%), drying the used absorbent (77.6%), methods of disposing of the used absorbent (25.5%), and cleaning of genitalia (19.2%). During the follow-up, the participants reported significant improvements in the regularity of their menstrual cycle (94.5% vs 99.5%) and fewer complications during menstruation (78.6% vs 59.6%).
  
  
  CONCLUSIONS
  The programme produced significant changes in the knowledge, beliefs and practices of menstrual hygiene, complications from lack of hygiene, and the behaviour and restrictions of the menstruating adolescents. These results demonstrate the feasibility of implementing a health education programme for adolescents on menstrual hygiene in secondary schools serving rural Bangladesh.
authors.affiliation: UChicago Research Bangladesh, Dhaka, Bangladesh United Nations University-International Institute for Global Health (UNU-IIGH), Kuala Lumpur, Malaysia.
authors.forename: Syed Emdadul
authors.initials: SE
authors.lastname: Haque
authors.affiliation: International Health and Medicine, Division of Public Health, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Mosiur
authors.initials: M
authors.lastname: Rahman
authors.affiliation: Honjo International Scholarship Foundation, Tokyo, Japan.
authors.forename: Kawashima
authors.initials: K
authors.lastname: Itsuko
authors.affiliation: Wageningen University, Wageningen, The Netherlands.
authors.forename: Mahmuda
authors.initials: M
authors.lastname: Mutahara
authors.affiliation: Faculty of Policy Studies, Chuo University, Tokyo, Japan.
authors.forename: Kayako
authors.initials: K
authors.lastname: Sakisaka
mesh_terms: D000293:Adolescent; D001459:Bangladesh; D002648:Child; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D006920:Hygiene; D008598:Menstruation / Q000523:psychology*; D012424:Rural Population; D012572:School Health Services; D012574:Schools; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Epidemiology