title: Age of menarche and knowledge about menstrual hygiene management among adolescent school girls in Amhara province, Ethiopia: implication to health care workers & school teachers.
abstract: BACKGROUND
  Effective menstrual hygiene has direct and indirect effect on achieving millennium development goals two (universal education), three (gender equality and women empowerment) and, five (improving maternal health). However, in Ethiopiait is an issue which is insufficiently acknowledged in the reproductive health sector. The objective of this study therefore, is to assess the age of menarche and knowledge of adolescents about menstrual hygiene management in Amhara province.
  
  
  METHODS
  School based cross sectional study was conducted from November 2012 to June 2013. Multistage stage sampling technique was used. The school was first clustered in to grades & sections and thenparticipants were selected by lottery method. A pretested &structured questionnaire was used. Data were entered, cleaned and analyzed using SPSS version 16.0. Finally, multivariate analysis was used to assess independent effect of predictors.
  
  
  RESULTS
  In this study, 492 students were included, making a response rate of 100%. Mean age at menarche was 14.1±1.4 years. The main sources of information about menstrual hygiene management were teachers for 212 (43.1%). Four hundred forty six (90.7%) respondents had high level knowledge about menstrual hygiene management. Most of the respondents 457 (92.9%) and 475 (96.5%) had access for water and toilet facility respectively. Place of residence (AOR = 1.8, 95%CI: [1.42-1.52]) and educational status of their mothers' (AOR = 95%CI: [1.15-13.95]) were independent predictors of knowledge about menstrual hygiene management.
  
  
  CONCLUSIONS
  Knowledge of respondents about menstrual hygiene management was very high. School teachers were the primary source of information. Place of residence and their mother's educational status were independent predictors of menstrual hygiene management. Thus, the government of Ethiopia in collaboration with its stalk holders should develop and disseminatereproductive health programmes on menstrual hygiene management targeting both parents and their adolescents. Moreover, parents should be made aware about the need to support their children with appropriate sanitary materials.
authors.affiliation: Department of Midwifery, Arba Minch University, Arba Minch, Ethiopia.
authors.forename: Teklemariam
authors.initials: T
authors.lastname: Gultie
authors.affiliation: Department of Nursing, Arba Minch University, Arba Minch, Ethiopia.
authors.forename: Desta
authors.initials: D
authors.lastname: Hailu
authors.affiliation: Department of Nursing, Arba Minch University, Arba Minch, Ethiopia.
authors.forename: Yinager
authors.initials: Y
authors.lastname: Workineh
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D004522:Educational Status; D005002:Ethiopia; D005178:Faculty; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education; D006801:Humans; D006920:Hygiene / Q000193:education*; D008572:Menarche / Q000502:physiology / Q000523:psychology*; D008598:Menstruation / Q000502:physiology / Q000523:psychology*; D009035:Mothers; D060728:Reproductive Health / Q000193:education*; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires