Relationship between Menstrual Hygiene Management and Lower Reproductive Tract Infections among Adolescent Girls in Informal Settlements in Nakuru County, Kenya
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Date
2023
Authors
Ngaruiya, Virginia Wanjiku
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Menstruation is an important aspect experienced by healthy adolescent girls, premenopausal adolescents and women monthly. Its management is influenced by the economic status of individuals, personal preferences, local beliefs, and education status. In Kenya 2019, more than 47 million (50.2%) of the population was females, with a significant percentage of these females’ facing challenges on sanitation and menstruation hygiene which makes it insufficient and hazardous to girls and women well-being. Infections of the lower reproductive tract are still public-health concerns. However, in Sub-Saharan Africa, the relationship between menstrual hygiene, water, sanitation and hygiene variables and lower reproductive tract infection have not been appropriately explored. The main objective of this study was therefore, to ascertain the relationship between menstrual hygiene management and the occurrence of lower reproductive tract infections among the adolescent girls in informal settlements in Nakuru County. Specific objectives were; determine the proportion of adolescent girls reporting lower reproductive tract infections, determine the menstrual hygiene management practices associated with occurrence of lower reproductive tract infections, establish environmental factors associated with the occurrence of lower reproductive tract infections among adolescent girls in the Informal settlements of Nakuru County. The study used a community-based cross-sectional design targeting adolescent girls in informal settlements in Nakuru County. Multi-stage and simple random sampling methods were used to obtain a sample size of 385 adolescent girls. Focus group discussions (FGDs), semi-structured questionnaires were used to obtain information from the adolescent girls, teachers, mothers and community gatekeepers on menstrual hygiene management while self-report symptoms according to the questionnaire were used to determine the presence of lower reproductive tract infections. Data was entered and analyzed using statistical software, SPSS v24. The relationship between menstrual hygiene management and lower reproductive tract infections were tested using Odds Ratio at a 95% confidence interval and statistical significance was set at p < 0.05. The findings showed the mean age of participants ranged from 14-16years, the mean menarche age 12.5 years. Majority of participants were in primary schools with most of their guardians, mothers had attained secondary education. Most participants identified as Christians. The proportion of lower reproductive tract infections (LRTIs) among the participants was 59.71%. Teenagers who changed their reusable absorbent material more than twice a day were 0.22 times less likely to report experiencing an LRTI compared to those who changed once a day, (p=0.005); those who dried their reusable absorbent material outside the house were 0.26 times less likely to be infected with LRTI compared to those who dried inside the house; and those who reported bathing three times during menstruation were 0.27 times more likely. Lower Reproductive Tract Infections and the presence of anal cleansing material had a strong correlation with environmental conditions (P-value 0.046), as did the availability of working hand washing facilities with water and soap (P-value 0.019). The study established that there was a strong correlation between lower reproductive tract infections and the kind of absorbent material, the frequency of changing absorbent material, the frequency of bathing, the presence of hand washing equipment, and the presence of anal cleansing materials in restrooms. The research recommends that the government focus on strengthens programs related to that menstrual hygiene management, women reproductive health and girls’ education especially in the informal settlements. Future studies needs to incorporate comprehensive microbiological and clinical assessments so as to get a better estimate of the prevalence of LRTI in this population.
Description
A Research Proposal Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology and Disease Control) in the School of Health Sciences of Kenyatta University, October, 2023.
Keywords
Relationship, Menstrual Hygiene Management, Lower Reproductive, Tract Infections, Adolescent Girls, Informal Settlements, Nakuru County, Kenya