A Study to Assess the Effectiveness of Planned Teaching Programme on

Knowledge Regarding Menstrual Hygiene Among Adolescent Girls in

Selected Higher secondary schools of kakanpur, GODHRA.
CHAPTER : I
 INTRODUCTION
“Yesterday’s girl is today’s adolescent and tomorrow’s mother”

The human life span can be split into a number of stages: infancy, childhood,
adolescence, young adulthood, adulthood and old age. Sharma1 in his report “Identity of the
adolescent girl” had stated that in the life cycle of a homoserine organism, adolescence is a period
of transition from childhood to adulthood. It is characterized by rapid physical, biological and
hormonal changes resulting in psychosocial, behavioral and sexual maturation. It is often described
as a phase of life that begins in biology and ends in society. It means that physical and biological
changes are universal and take place due to maturation but the psychosocial and behavioral
manifestations are determined by the meaning given to these changes within a cultural system.

The experience of adolescents during ten years would vary considerably according
to the cultural and social values of the network of social identities they grow in. WHO2 has defined
adolescence both in terms of age (between 10 and 19 years) and in terms of a phase of life marked
by special attributes. But different policies and programmes has defined the adolescent age group
differently. For example, in the draft Youth Policy, adolescents have been defined as the age group
between 13-19 years; under the ICDS programme adolescent girls are considered to be between
11-18 years; whereas in the Reproductive and Child Health Programme, adolescents are between
10-19 years of age. Internationally, the age group of 10-19 years is considered to be the age of
adolescence. So, it is evident that in India, age limits of adolescents have been fixed differently
under different programmes keeping in view the objectives of that policy or programme but
keeping in view the characteristics of this age group, it would be most appropriate to consider
adolescents as between 10-19 years of age.

Menstruation is a phenomenon unique to the females occurring during the adolescent

years. It is part of the female reproductive cycle that starts when girls become sexually mature at
the time of puberty. It heralds the onset of physiological maturity in girls and becomes the part of
their lives until menopause. Menstruation is the cyclical shedding of the inner lining of the uterus,
the endometrium, under the control of hormones of the hypothalamopituitary axis. During a
menstrual period, a woman bleeds from her uterus via vagina. The onset of menstruation is one of
the most important physiological changes occurring among girls during the adolescent years.
Though it is a natural and normal physiological process for all healthy girls and women, yet has
been clouded by taboos and socio-cultural restrictions. Menstrual hygiene and management is an
issue that is insufficiently acknowledged and has not received adequate attention in the
reproductive health. While the anatomy of the genital tract and physiology of menstruation are
taught in schools, the practical management of menstruation has often been regarded as
inappropriate for public discussion. Myths, superstitious beliefs, and cultural taboos substitute
appropriate information in the growing child.3

Ten4 had stated in his article on menstrual hygiene that in spite of the fact that great
progress has been made but still in many developing countries including India, up until now, poor
menstrual hygiene has been an insufficiently acknowledged problem. In several areas there are
cultural and religious taboos concerning blood, menstruating females as well as menstrual hygiene.
Although there are differences by country, culture, ethnic group, social class or family, the
oppression of women has its effect on issues concerning reproductive health and other issues
related to the reproductive system and its functions and processes. Most striking is the restricted
control, which many women and girls have over their own mobility and behaviour during
menstruation, including the myths, misconceptions, superstitions and cultural or religious taboos
concerning menstrual blood and menstrual hygiene. It is necessary to maintain healthy traditions,
customs and healthy practices in the community and prevent harmful practices. Organization of
education is essential as an agent of change after adequate training to bring about changes
regarding social customs, traditions and health seeking behavior etc.

Adolescence is considered a critical period in human evolution, although it is often not

recognized as such by health care workers and parents as well as professionals in adult medicine
and pediatric disciplines. The onset of menstruation in adolescence is a phenomenon that signals
reproductive maturity and should not be seen as an abnormal condition or disease.

Menstruation is a phenomenon unique to the females. The onset of menstruation is one

of the most important changes occurring among the girls during the adolescent years. The first
menstruation (menarche) occurs between 10 and 16 years with a mean of 13 years.
 Menstruation is a normal physiological process indicating beginning of reproductive life
but sometimes it is considered as unclean phenomenon in the Indian society. Insufficient, incorrect
information regarding menstruation is often a cause of unnecessary restrictions in the daily normal
activities of the menstruating girls creating various psychological issues. Besides, the lack of
knowledge and awareness also lead to some poor personal hygienic practices during menstruation
leading to many reproductive tract infections².

Adolescent girls constitute a vulnerable group, particularly in India where female child
is neglected one. Menstruation is still regarded as something unclean or dirty in Indian society.
The reaction to menstruation depends upon awareness and knowledge about the subject. The
manner in which a girl learns about menstruation and its associated changes may have an impact
on her response to the event of menarche. Although menstruation is a natural process, it is linked
with several misconceptions and practices, which sometimes result into adverse health outcomes³.

The varied reactions to menarche may depend on the extent to which the girls have been
prepared regarding the same. Fear, panic and other negative reactions to menstruation by
adolescent girls highlights the fact that girls with no previous knowledge about menstruation felt
more scared at menarche". These negative feelings associate with menstruation could be because
of participants not being psychologically prepared for attaining menarche which is an important
milestone in their life.

Menstrual hygiene depends upon the educational, socioeconomic, and cultural statuses
of family. School curriculum also has some role in menstrual health. Today, the number of women
who have regular menstruation periods is increasing in developing countries including India due
to later childbearing and fewer children. But many lack the economic and social conditions to
manage menstruation sanitation satisfactorily. A particularly vulnerable group in this aspect is
young women in poor families. Furthermore, understanding young women's knowledge and
practices related to menstruation is a central element for designing appropriate education
programs".

Hygiene-related practices of women during menstruation are of considerable

importance, as it has a health impact in terms of increased vulnerability to reproductive tract
infections (RTI). The interplay of socio-economic status, menstrual hygiene practices and RTI are
noticeable. Today millions of women are sufferers of RTI and its complications and often the
infection is transmitted to the offspring of the pregnant mother. Women having better knowledge
regarding menstrual hygiene and safe practices are less vulnerable to RTI and its consequences.
Therefore, increased knowledge about menstruation right from childhood may escalate safe
practices and may help in mitigating the suffering of millions of women³.

Poor menstrual hygiene causes great impact in increased vulnerability to reproductive

tract infections (RTI). Currently millions of women sufferers from RTI and infection is transmitted
to the offspring. Women having knowledge regarding menstrual hygiene are less vulnerable to
RTI and its consequences. Therefore, increased knowledge about menstruation from adolescent
period help in decreased suffering of millions of women³,

There is very limited social and health related research on menstruation issues in low
and middle income countries including India. There is also limited research on menstruation as a
social and cultural phenomenon or on the technical and hygienic aspects of sanitary protection in
various socio-economic contexts. The reason might be that menarche and menstruation are
considered a taboo and thus rarely discussed, even between mother and daughter. The reason for
mother's reluctance to discuss menstruation and related issues with their daughters can be partially
related to their own lack of knowledge of the physiology of menstruation.

NEED FOR THE STUDY:-

Approximately 1/5th of the world’s population is adolescent and from this more
than 4/5th is of developing countries. According to Census 2021 in India adolescents accounted for
about 22.8%, of the total population that is about 253 million adolescents in age group of 10-19
years.3 Adolescence belongs to a vital age group not only because it is on the threshold between
childhood and adulthood as adolescents are no longer children, but not yet adults. As they attempt
to cross this threshold, they face various physiological, psychological and developmental changes.5

Adolescence in girls is a turbulent period, which includes stressful events like

menarche, which is considered as a landmark of female puberty. The manner in which a girl learns
about menstruation and its associated changes may have an impact on her response to the event of
menarche (initiation of menstruation). Percent of the body fat is also a factor in the onset of
menarche. A minimal fatness of 17% of body weight is necessary for the onset of menarche. So it
may start late in thin built adolescents which does not warrant any therapeutic intervention. Girls
may start their menstruation as early as 9 years of age and as late as 16 years old with average age
of approximately 12 years which is too early for them to experience these crucial changes as they
would not have prepared physically as well as mentally for this. When they attain menarche, they
feel shy to disclose about this even to their mothers. So there are few chances to maintain hygiene
during menstruation. Many studies revealed that even though many girls have knowledge
regarding menstrual hygiene yet they fail to apply this practically. It is a common observation that
adolescents do not access the existing services, especially girls because they constitute a vulnerable
group, particularly in India where female child is neglected one. Menstruation is still regarded as
something unclean or dirty in Indian society. The reaction to menstruation depends upon
awareness and knowledge about the subject. The manner in which a girl learns about menstruation
and its associated changes may have an impact on her response to the event of menarche. Although
menstruation is a natural process, it is linked with several misconceptions and practices, which
sometimes result into adverse health outcomes. Some varieties of menstrual dysfunctions occur in
about half of the adolescent girls.3- 5

The report of a comparative study carried out by Water Aid Nepal regarding
menstrual hygiene and management among 204 adolescent school girls (12-20 years) from both
urban and rural setting concluded that among adolescent girls both in urban and rural areas, both
knowledge regarding menstruation and its perceptions were poor and their practices were also not
optimal for proper hygiene. Often ignored issues of privacy affected the hygienic practices and
daily life of the adolescent girls particularly school attendance. Their knowledge about availability
and affordability of sanitary products to manage menstruation was not satisfactory. It was
recommended that schools, home, society and organizations of reproductive health as well as water
sanitation and hygiene sectors need to make an effort towards making menstrual hygiene and
management better for adolescent population.5

Menstrual hygiene is important to be practiced by the school girls to promote their

health and prevent illness. Inadequate menstrual hygiene management is connected with the use
of cloth, ashes and husk sand during menstruation, thereby it causes severe reproductive health
problem.
 According to World Health Organization (2015) there are about 74% of school girls had
suffered with reproductive tract infection due to improper menstrual hygiene. The poor menstrual
hygienic practices also leads to several problem among school girls which include dropped out
from the school, inability to continue the education and reduction of self-esteem. It occurs because
the school girls don't practice menstrual hygiene and don't have accessibility for sanitary napkin.
The biggest barrier to adopt the quality of sanitary napkin in India are lack of affordability and
accessibility as reported by Inderjeet Singh (2013) there are about 70% of school girls and their
the family cannot affords sanitary napkin. It is further supported by the report of Times of India
(2014) which unveiled that 50% of the school girls who dropped out the school in secondary
classes are due to lack of sanitary napkin, coupled with lack of separate toilet facilities and water
resources within the school campus. Thus the lack of knowledge on menstrual hygiene are the
major cause for absenteeism among school girls.

The significant problems among school girls which are greatly ignored in schools, in
developing countries are lack of facilities for disposal of menstrual waste. There are about only
46% of school girls have accessibility to water, sanitation at school According to Global Statistics
By WHO (2015) often school toilets for girls don't have bins for menstrual waste collection with
the result that the napkin may be spread all around the school compound area, these pollutes the
environment and also causes embarrassment for the school girls. Many studies have reported that
the girls, who were unable to afford sanitary napkin they miss school in order to avoid the
embarrassment of staining the clothes.

Many studies, across India have reported poor menstrual hygien practice among school
girls in that majority of them are at risk for reproductive tract infections. A study conducted at
Lucknow by Aravind Kumar (2013) among 28 lakha adolescent girls revealed that approximately
19 lakhs school girls quit education because of menstruation related problems and reproductive
tract infections. Another study conducted by Dr.M.Tripurasundari (2014) reported that
reproductive tract infection occurs among girls due to unhygienic menstrual practices. A study
which was conducted in India by Arumugam et.al., (2014) revealed that as many as 42% of women
who participated in the study did not know about sanitary napkin and from where in the anatomy
menstruation originated and most of them were scared and worried on menstruation. Worldwide
many school girls don't have accessibility to toilet facilities, privacy and menstrual hygienic
management issues are greatly ignored by professionals in the health and education sector too.

Another major factor that is to be considered among school girls is early menarche,
which is the growing trend across Globe especially in urban areas. Since many school girls attain
menarche between 12 to 14 years they don't have adequate knowledge about the onset of
menstruation, physical and physiologically development. In addition to their early puberty may
cause emotional pressure among school girls which may reduce their academic performance. The
study which conducted by Esreal Ayele et.al. (2015) revealed that the yearly menarche is a major
cause for poor menstrual hygienic practices. A study conducted by Dr.Neelam Singh, Rierdan
(2013) have reported that school students don't have adequate knowledge and practice on
menstrual hygiene. Further Rierdan (2013) concluded that only 40.6% of girls have knowledge
regarding menstruation and among them only 12.9% of school girls practice the same. Thus these
findings paved the way for the investigator to impart knowledge regarding sanitary napkin during
menstruation, thereby to enhance the practice of menstrual hygiene.

It is evident from the above information that many school girls aged between 12 to 14 years
don't have awareness regarding sanitary napkin as an menstrual hygienic practice, and they are not
practicing good menstrual hygiene. Hence it is important for community health nurse to impart
knowledge about sanitary napkin during menstruation and help them to adhere to their menstrual
hygienic practices.

Menstrual practices are still clouded by taboos and socio culture restrictions result in
adolescent girls remaining ignorant of the scientific facts and hygiene health practices, which
sometimes result into adverse health outcomes. Hygiene practice is neglected by girls especially
in the rural areas, due to lack availability and inability to afford sanitary napkins. Rural school
girls are still treated as untouchables during menstruation, resulting in health problems and
growing absenteeism's in schools. Schools girls refrain from going to toilets because there is no
lock, no water supply, and no disposal facility. They also seem to avoid going to toilets during
menstruation as most schools do not have separate toilets for girls. Thus the researcher felt the
need to educate the rural school girls regarding sanitary napkin during menstruation and teach
them to practice the same by promoting favourable attitudes towards menstrual hygienic practice.
 The role of community health nurse is important to inculcate the concept of use of sanitary
napkin during menstruation among school girls because it prevents, fungal infection, reproductive
tract infection and urinary tract infection which might leads to cervical cancer, according to the
report by the Cervical Cancer Free Coalition (May 2013) in order to increase the menstrual
hygienic practice among women. The Indian government proposed a new scheme towards
menstrual hygienic practice to rural adolescent girls. The main goal of these schemes was
awareness, availability and quality of napkin, regular supply, privacy, water supply, proper
disposal of napkin, reproduce health education and family support

STATEMENT OF THE PROBLEM:-

A Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge
Regarding Menstrual Hygiene Among Adolescent Girls in Selected Higher secondary schools of
Kakanpur, Godhra.

OBJECTIVES OF THE STUDY:

1. To assess the pre-test knowledge on menstrual hygiene among adolescent girls in selected
school.

2. To evaluate the effectiveness of planned teaching programme on menstrual hygiene among

adolescent girls in a selected school.

3. To find out the association between the pre-test and post-test knowledge score with selected
demographic variable.

Hypotheses:
H1: The mean post-test knowledge score of students regarding menstrual hygiene will be
significantly higher than the mean pre-test knowledge score.
H2: There will be significant association between levels of knowledge of students regarding
menstrual hygiene with a selected demographic data.
Assumptions :

• The adolescent girls will not have adequate knowledge regarding menstrual hygiene.
• The planned teaching programme will help the adolescent girls to improve their knowledge about
menstrual hygiene.

OPERATIONAL DEFINITIONS :-

1. Assess :- In this study, it relers to find out the knowledge of adolescent girls
2. Knowledge :- refers to understanding of adolescent girl’s on menstrual hygiene as elicited by
the structured questionnaires devised by the questionnaire.
3. Effectiveness :- It refers to determine the extent of significant knowledge among adolescent
girls.
4. Menstrual hygiene :- Includes all those measures taken by the individual to keep the genital
area clean and dry during the menstrual periof/cycle.
5. Adolescent girls :- Refers to the girls who had attained menarche between 13-17 years and
who are studying in 8th abd 12th standards of selected schools.
6. Planned teaching programme :- it is a well prepared teaching programme with
systematically developed instruction for a group of adolescent girls on menstrual hygiene
knowledge for one hour.

CONCEPTUAL FRAME WORK

Conceptual framework is a set of global ideas about the concepts in relation to a specific
discipline. A conceptual framework in the network of interrelated concepts that provide a structure
for organizing and describing the phenomenon of interests. A concept is a thought idea or mental
image framed in the mind, in response to learning something new. A frame work is a basic structure
supporting anything. It guides an investigator to know what data needs to be collected and gives
the right direction to the research process.

The present study aim the effectiveness of Planned teaching programme for school girls
regarding Menstrual hygiene. The Framework of the present study is based on J.W.Kenny' Open
System model, 1990.
 A system consists of a set of interacting components within a boundary that filters the type
and rate of exchange with the environment. All living system is open in that there is a continuous
exchange of matter, energy and information. In open system, there are varying degrees of
interaction with the environment, from which the system receives input and gives output in the
form of matter, energy and information.

According to system theory, for survival all systems must receive certain amount of matter,
energy and information from environment. The system regulates the types and amount of input
received through the process of selection. To maintain the system equilibrium or homeostasis, the
system uses input through self-regulation. Through system matter, energy and information are
continuously maintains itself and environment to guide its operation. Feedback may be positive,
negative or neutral. In this present study these concepts are explained as below.

Input

Based on J.W. Kenny's open system model, input can be a matter, energy and information that
enter into the system from the environment through its boundaries. In this study input consist of
demographic data of the school girls such as Age, Religion, education status, Type of family,
monthly income of your family, Age of menarche, Menstruation, Do you know about information
of menstruation before menarche, Education status of mother, Do you have sanitary latrine at
home. The assessment of the existing knowledge of School girls.

Throughput (Process)

Through put is the operation phase or manipulation and activity phase. It is the process that allows
the input to be changed so that it is useful to the system. In this study throughput is the construction
of planned teaching programme and administration of teaching programme based on the learning
needs.

Output

Output is any information that leaves the system and enters the environment through system
boundaries. It refers to the ultimate results, which are expected following health education
programme. In this study output refers to the knowledge gained by the school girls on Menstrual
hygiene. It also depicts whether the knowledge of school girls on menstrual hygiene is varying
with demographic variables and health related variables. After processing the input, the system
returns to the output environment, in the form of change in behavior. These may be adequate,
moderately adequate and inadequate knowledge.

Feedback

Feedback is the result of throughput, it allows the system to monitor its interval function, it is the
process whereby the output of the system is rectified as part of the input of the same system.
 INPUT THROUGHPUT OUTPUT

POSITIVE
demographic data of the school OUTCOME
PROCESS
girls such as
Significant
Pre-test · Assessment
improvement in level
• Age of knowledge
of knowledge
• Religion regarding menstrual
Post-test
• education status hygiene
• Type of family Assessment of
• monthly income of your knowledge
family regarding
NEGATIVE
• Age of menarche Menstrual hygiene
OUTCOME
• Menstruation
• Do you know about Planned teaching
No significant
information of improvement in level
programme regarding
menstruation before of knowledge
Menstrual hygiene
menarche
• Education status of
mother
• Do you have sanitary
latrine at home

Conceptual framework based on JW Kenny’s open system model (1990)

FEEDBACK
CHAPTER : II
 II-REVIEW OF LITERATUTRE

Review of literature is very important in any research study, as it is the connecting

link between what has been done in a particular subject in the past and what the researcher
proposes to do in the present piece of research. This also helps the researcher to attain a wider and
deeper perspective of the problem of the study.
In other words, it’s a body of literature in which a researcher tries to summaries the
most important aspects of current knowledge, including substantive results as well as theoretical
and methodological contributions. In this chapter, an attempt has been made to review the
literature that is connected to the current research problem, either directly or indirectly. To
understand the gaps in existing information or literature on menstrual health and hygiene, the
reviewed literature is presented about knowledge about menstruation.

● Studies on knowledge about menstruation

Chandra M & Patel S.V.,(2017) are attempting to map the current state of knowledge,
attitudes, beliefs, and practices surrounding menarche, menstrual hygiene, and menstrual health
among adolescent girls through their ―study on the knowledge 13 of school girls regarding
menstrual and reproductive health and their perceptions about family education program‖ in low
and middle-income countries to better understand the future policy and programming design. For
the review, the researcher used Google Scholar, Pub Med, and EBSCO's Global Health databases
to look for publications published in peer-reviewed journals between 2000 and 2015. A total of 81
articles were found from 25 different nations. In any sample size, descriptive overviews and
interventions such as quantitative, qualitative, or mixed approaches were applied. Adolescent girls
in LMIC were found to be misinformed and unprepared for menarche as a result of the study, and
mothers who found the first informant were found to be uninformed about the matter themselves.
The key variables that lead to misconceptions and unsanitary practices during menstruation have
been recognized as shame and exclusion. The researcher went on to say that the above findings
should be recognized by Low Middle-Income Countries since inadequate menstruation practices
and knowledge are major hurdles not just to girls' education, but also to personal growth and self-
confidence
 Maji S., (2016) conducted ―a study on menstrual knowledge and practices among rural
adolescent girls in Burdwan district, west Bengal‖. The goal of the study is to look at the current
cultural taboos and socio-cultural constraints that are put on teenagers during their menstrual
periods, which causes them to be unaware of scientific facts and hygienic health practices, which
can lead to negative health effect. The research was carried out on adolescent girls in Dig Nagar
village between the ages of 13 and 16. Purposive sampling was used to choose a total of 100
sample adolescent girls. The information was gathered through personal interviews with the
respondents. The researcher concluded that adolescent girls in the study region have little
awareness of menstruation and that menstruation practices are frequently unsanitary. The findings
of the study also indicate the importance of encouraging safe and hygienic habits among rural
adolescent girls, as well as breaking them free from conventional ideas, misconceptions, and
restrictions about menstruation.

Oster et al., (2010) have conducted a cross-sectional descriptive study to determine the
prevailing knowledge and experiences of menstrual hygiene, management, implications in the
daily lives and routines among adolescent school girls in rural and urban settings of Nepal. The
survey was conducted among 204 school girls. The study shows that the respondents had attained
menarche between 10 and 16 years and the mean age of menarche being 13.3 years. The study
concluded that knowledge and perception about the menstruation and 26 hygienic practices were
very poor among the adolescent girls in both rural and urban areas of Nepal.

Dhingra & Kour., (2009) analysed in their study ―Knowledge and Practices Related to
Menstruation among Tribal (Gujjar) Adolescent Girls' ' The girls from the tribal community (in
Jammu) have a low level of understanding about menstruation. Using a random sampling
procedure, 200 females between the ages of 13 and 15 were chosen for the study. An interview
guide was created and utilised to investigate adolescent girls' menstrual knowledge and habits.
According to the findings, adolescent girls lacked conceptual clarity concerning the menstrual
cycle. Friends were the most prevalent source of knowledge about menstruation for the girls (83
per cent). Menstruation was associated with many social and cultural taboos. During menstruation,
the degree of personal hygiene and hygienic behaviours was also found to be quite poor.
 Vidhi Parikh1 , Shashwat Nagar2 (2022) “ Menstrual hygiene among adolescent girls
studying in a university of Gujarat” A descriptive cross-sectional study carried out by directly
interviewing the subjects using the interviewer-administered questionnaire – pre-tested and pre-
designed proforma. The data were analysed statistically by simple proportions. Results: Among
the study subjects, 79% had proper knowledge about menstruation. 82% had a normal menstrual
pattern. Nearly 96% used sanitary pads, and 2.36% used reusable cloths. Regarding restrictions,
74.80% restrained themselves from visiting the places of worship, 21% avoided physical exercise,
and 7.87% had to remain isolated with minimal social contact. Nearly 19% made conscious efforts
for dietary changes during menstruation. Conclusion: A majority of the subjects had a regular
menstrual cycle, but menstrual problems were found to be more among those having irregular
periods, those changing absorbents infrequently, with an inadequate frequency of cleaning, and
those using plain water for cleaning. The study however does reflect the fact that menstrual hygiene
was unsatisfactory among adolescent girls. Therefore, they need to be educated about the facts of
menstruation and proper hygienic practices.

A study was conducted by Shukla .S (2005). "working on menstruation with girls in

Mumbai, India". Menstruation is considered a polluting factor among Hindus. In many places
menstruating girls and women are considered untouchable. Such attitudes and practices are
unlikely to create a positive self image with in girls. Shukla found that girls and women teachers
were very knowledgeable about the intricate system of taboos and sanctions that pertained to
menstruation but had very little actual knowledge about the biological process of maturation and
normal physiology. This is lack of factual information, compounded by the prevalence of myths,
means that girls practical needs related to managing menstruation are often not appreciated (or)
appropriately addressed, e.g. of the provision of adequate sanitary protection .Most girls are left to
cope as they can with rags (or) other insufficient protection.

A study was conducted by Ei-Gilany AH, Badawai K, (2005). "Menstrual hygiene

among adolescent schoolgirls in Mansoura, Egypt". This study among 664 schoolgirls aged 14-18
in Egypt, asked about type of sanitary protection used, frequency of changing pads or cloths, means
of disposal and bathing during menstruation. Girls were selected by cluster sampling technique in
public secondary schools in urban and rural areas. Data were collected through an anonymous,
self- administered, open-ended questionnaire during class time. Use of sanitary pads may be
increasing, but not among girls from rural and poor families and other aspects of personal hygiene
were generally found to be poor, such as not changing pads regularly or at night, not bathing during
menstruation. Lack of privacy was an important problem. But a large majority of girls said they
needed more information.

A study was conducted by Bista, M.B(2004) "A review of research literature on girls
education in Nepal". Bista reports, local cultural expectations that menstruating women should
remove themselves from public spaces has led to classes taught by female teachers being
discontinued for several days at a time (or) to women teachers who continue to teach during
menstruation being viewed negatively by the community not only does this disrupt the learning
process, but it may simultaneously very negative messages about what is expected of women and
girls.
CHAPTER : III
 III. Methodology

According to Sharma (1990) research methodology is a systematic procedure which the

researcher starts from the initial identification of the problem to its final conclusions. The role of
methodology consists of procedures and techniques for conducting a study.

This chapter deals with the type of research approach, research design, setting of the
study, population, sample technique, sample selection, inclusion criteria, exclusion criteria,
description of the tool, pilot study, data collection procedure and plan for data analysis.

Research Approach: for the present study to assess the effectiveness of planned teaching
programme on knowledge regarding menstrual hygiene among adolescent girls in selected school
and for the objectives to be accomplished, an Quantitative research was considered appropriate
for the present study.

Research design :-Pre- experimental with one group pre-test and post- test design was
adopted for the present study.

Setting of the study: The setting is the location where a study is conducted and it was a natural
setting. The study was undertaken in school of kakanpur.

Sample :- Students of 8th and 12th standard girls students studying in

Sampling technique :- convenient sa

mpling

Sample size :- 40 students of 8th to 12th standard girls students studying in

Inclusion criteria :-

1. Adolescent girls who are studying 8th to 12th standards who are willing to participate.
2. Adolescent girls who are studying 8th to 12th standards who are available during the period
of data collection.
3. Adolescent girls who are studying 8th to 12th standards who are able to speak and read.
4. Adolescent girls who are studying 8th to 12th standards the age between of 13 to17 years.
Exclusion criteria :-

1. Adolescent girls who are studying 8th to 12th standards who are not available during the
data collection.
2. Adolescent girls who are studying 8th to 12th standards are above 17 years.

Tool :- Data was collected with the help of demographic data and structured knowledge
questionnaires. Plan for data analysis Descriptive statistics (frequency, percentage, range,
mean, median and standard deviation) and inferential statistics (t-test) were used for the
analysis and interpretation of data.

Description of the Research Tool: The tool consists of following section:

Section-A: Personal data consists of 10 items which includes Age, Religion, education status,
Type of family, monthly income of your family, Age of menarche, Menstruation, Do you
know about information of menstruation before menarche, Education status of mother, Do
you have sanitary latrine at home.

Section-B: A Structured Knowledge Questionnaire was prepared consisting of 20 of

knowledge about Menstrual Hygiene.

Which distributed in two aspects:

Aspect I- General awareness regarding reproductive system and menstruation; 10 items.

Aspect II- Regarding menstrual hygiene; 10 items..

Content Validity: Content validity of the tool was established by 3 experts. The experts
were requested to give their opinions and suggestions regarding the relevance of the tool
for further modification to improve the clarity and content of the items. Later the tool was
edited by an English expert and translated into Guajarati by language expert without
changing the meaning of the tool. It was found to be valid and suitable for Adolescence
girls .
Reliability of the Tool: The reliability of the tool was computed by using test re-test
method . The reliability obtained for knowledge tool was r = 0.80. Hence, the tool was
found to be reliable. Procedure for Data collection: Prior permission was obtained from
the concerned authority and obtained informed concerned from the students personally.
Then assessed the knowledge of menstrual hygiene in adolescent girls by used a structured
questionnaire. On the same day the investigator has given a planned teaching program to
the adolescent girls regarding menstrual hygiene. Then after three days the investigator
personally assessed the knowledge of adolescent girls regarding menstrual hygiene by used
the same structured questionnaire. Data was collected with the help of knowledge
questionnaire.

Analysis of data: The collected information was organized, tabulated, analyzed and
interpreted using descriptive and inferential statistics. The analysis and interpretation of
data of this study are based on data collected through Planned Teaching Program on
Menstrual Hygiene from adolescent girls(N = 40). The results were computed using
descriptive and inferential statistics based on the objectives of the study. The analyzed data
has been organized and presented in the form of tables and graphs.
SECTION A :DISTRIBUTION OF SOCIO- DEMOGRAPHIC VARIABLE OF
ADOLESCENT GIRLS:-

Sr. Questions Answer

no
1) Age in Year’s :-

a)12-13 ( )
b)14-15 ( )
c)16-17 ( )
2) Religion :-
a)Hindu ( )
b)Muslims ( )
c)Christian ( )
d)Others ( )
3) Educational status :-
a)7-8 ( )
b)9-10 ( )
c)11-12
4) Type of Family :-
a)Nuclear Family ( )
b)Joint Family ( )
5) Monthly Income of your family
a)Below 5000 ( )
b)5001-10000 ( )
c)10001-15000 ( )
d)Above 15000 ( )
6) Age of menarche:-
a)Before 12 years ( )
b)12-14 years ( )
c)14-16 years ( )
Source of information regarding
7) menstruation
a)Elders in the family ( )
b)Friends or teacher ( )
c)Printed aids ( )
d)Mass media ( )

8) Do you know about information

of menstruation before menarche
 a)Yes ( )
b)No ( )
9) Educational status of mother
a)Primary and middle school ( )
b)Secondary and higher secondary ( )
c)Diploma and graduation ( )
d)Illetrate ( )
10) Do you have sanitary latrine at
home
a)Yes ( )
b)No ( )
 SECTION B :- ASSESSMENT OF KNOWLEDGE REGARDING MENSTRUAL
HYGIENE AMONG ADOLESCENT GIRLS

1……………. Is the female reproductive organ.

a) Kidney ()
b)Uterus ()
c)Urethra ()
d)Intestine ()
2. What is Menstruation
a). Formation of ovum ()
b). Shedding of endometrium ()
c). Conception ()
d). Thickening of endometrium ()
3. The ovum is produced in the -------
a. Uterus ()
b. fallopian tube ()
c. ovaries ()
d. vagina ()
4. The number of eggs normally released from ovary per month is -------
a) One ()
b) Two ()
c) Three ()
d) more than tree ()
5. Puberty means --------
a) Bleeding from vagina ()
b) Bleeding from nose ()
c) Bleeding from ears ()
d) Bleeding from mouth ()
6. The normal interval between two menstrual cycle is
a) 18-22 days ()
b) 23-27 days ()
c) 28-32 days ()
d) 33-37 days ()
7. What do you think is the frequency of menstrual cycle ?
a) once a month ()
b) 2-3 weeks ()
c) 4-5 weeks ()
d) Don't know ()
8. Unhygienic menstrual practice leads to ---------
a) Reproductive tract infection ()
b) Hernia ()
c) Appendicitis ()
d) cancer ()
9. What is the normal haemoglobin level for adolescent girls?
a) 10-12 gm/dl ()
b) 12-14gm/dl ()
c) 14-16gm/dl ()
d) 16-18gm/dl ()
10. How many phase during menstruation?
a) 1 ()
b) 2 ()
c) 3 ()
d) 4 ()
11. What is Menorrhagia?
a) Abortion ()
b) Pain during menstruation ()
c) Excessive bleeding with clots ()
d) White discharge ()
12. The Technique of washing the perineal area during menstruation is ---------
a) Vagina to anus ()
b) Anus to vagina ()
c) Only perineal area ()
d) All the above ()
13. What is the common complication which will occur if the menstrual hygiene is not practiced?
a) Constipation ()
b) Back ache ()
c) Loss of appetite ()
d) Infection ()
14. The appropriate diet that can be consumed during menstrual period is -----
a) Spicy diet ()
b) Soft diet ()
c) High calorie diet ()
d) Fat diet ()
15. Which method is suitable to practice during menstruation?
a) Clean napkins ()
b) Old clothes ()
c) Tampoons ()
d) Menstrual cup ()
16. How many times a day the napkin must be changed during menstruation?
a) Once ()
b) Twice ()
c) Thrice ()
d) Four times ()
17. The inner garments [panties] can be cleaned by ---------
a) Wash and dry in wet area ()
b) Wash and dry in closed room ()
c) Wash and dry under sunlight ()
d) Wash and dry in unhygienic place ()
18.The sanitary napkin is frequently changed to prevent ---------
a) Anemia ()
b) Diarrhea ()
c) Wound ()
d) Rashes and infection ()
19. The Frequency at which the sanitary napkin has to be changed is ---------
a) Once in a day ()
b) Every 4-6 hours ()
c) Every 8-10 hours ()
d) Every 12 hours ()
20. The proper disposal of sanitary napkin is through ---------
a) Drainage ()
b) Toilet ()
c) Open throw ()
d) Dustbin ()