title: A cross-sectional study to assess awareness about menstruation in adolescent girls of an urban slum in western Maharashtra.
abstract: BACKGROUND
  Reproductive health of adolescent girls is crucial as it determines the health of future generations. School girls when experiencing menarche find themselves in a setting without water, toilets or a supportive female teacher to explain the changes happening in their body. An important concern for adolescent girls is to have adequate, correct knowledge along with facilities and the cultural environment to manage menstruation hygienically and with dignity. Hence, the present study was done to assess knowledge and practices about menstruation in adolescent school girls of an urban slum.
  
  
  METHODS
  This was a descriptive cross-sectional study conducted among girls of a Government School located in an urban slum of western Maharashtra. A total of 250 girls participated. Data collection was through a pilot-tested questionnaire. The data thus collected were entered into Microsoft Excel and analyzed using the SPSS 20 software. All girls were educated about menstrual hygiene after the study.
  
  
  RESULTS
  The mean age of the students was 14.9±1.75 years. The mean age at menarche was 11.97 (95% CI: 11.94-11.99). It was observed that only half (56.4%) had acquired prior knowledge about attaining menarche. Out of these in a large proportion, the knowledge was imparted to them by their mothers (60.7%), followed by friends (31.8%). There was no significant association between educational status of mother and awareness in respondent about menstruation. Regarding the organ of menstrual blood flow, half (50.7%) knew the correct answer (i.e. uterus); whereas the rest believed that it was stomach/kidney, etc. Most of the school girls (90.5%) used sanitary pads. Almost 90% of the young women faced physical complaints or health problems during menstruation. Most of the participants had some kind of restrictions on them during the menstruation and most of these were religious restrictions (69.7%) followed by physical (41.2%) and social restrictions (22.3%). All of them were unsatisfied with the toilets and hand washing facilities available inside the school premises.
  
  
  CONCLUSIONS
  Correct knowledge in adolescent young girls regarding menstruation is lacking. Lack of awareness is a roadblock in adopting safe and hygienic menstrual practices. It also hinders them from overcoming traditional beliefs, misconceptions and restrictions regarding menstruation. This will empower them as they transition into womanhood.
authors.affiliation: Department of Community Medicine, AFMC,Pune, Phone: +9673382611.
authors.forename: Puja
authors.initials: P
authors.lastname: Dudeja
authors.affiliation: Department of Community Medicine, AFMC,Pune.
authors.forename: Apoorva
authors.initials: A
authors.lastname: Sindhu
authors.affiliation: Department of Community Medicine, AFMC,Pune.
authors.forename: Pooja
authors.initials: P
authors.lastname: Shankar
authors.affiliation: Department of Community Medicine, AFMC,Pune.
authors.forename: Tukaram
authors.initials: T
authors.lastname: Gadekar
keywords: adolescents; awareness; hygiene; menstruation