INTRODUCTION

The Word adolescent is derived from the Latin word “adolescere”, which means to grow into maturity. The World Health Organization (WHO) defines adolescents as individual between 10-19 years of age group [1]. Adolescent population occupies 1/5^th of world’s population and in India 20.9% of the population falls into this age group [2]. Current population of India is 1.21 billion and among those people 253.2 million of population lies between 10-19 years [3]. The onset of menstruation is called “Menarche” and it is the hallmark of female pubertal development [4]. Menstruation is generally considered as unclean in India. Social prohibitions and strong bondage with the taboos and traditional beliefs during menstruation and hesitation of parents not discussing the related issues openly to their adolescent daughters has blocked the access to get the right kind of information regarding menstrual hygiene [5]. Because of the lack of knowledge, they end-up with repeated use of unclean menstrual absorbent results in harboring of micro-organisms that increases susceptibility to urinary, perineal, vaginal and pelvic infections [6]. If these infections left untreated that will lead to several consequences like infertility, ectopic pregnancy, prenatal infection, low birth weight babies, and toxic shock syndrome [7]. The lack of attention to this issue is striking as still we cannot achieve several Millennium Development Goals (MDGs), that is, 2, 3, 4, 5 and 5B. The MDG 2, achieving universal primary education and MDG 3 on promoting gender equality and empowering women are vital for achieving almost all the other MDGs. The best place to translate the plans concerning menstrual hygiene is in the context of educational institutions [8]. By giving more emphasize to the menstrual health, a day is being celebrated on May 28^th as ‘Menstrual Hygiene day’ by WASH United [9]. By recognizing the importance of promotion of menstrual hygiene, government of India started a scheme of making available subsidized sanitary napkins to adolescent girls in rural part of India since August 2011 [10]. These younger generations are tomorrow’s parents. The reproductive health decisions that they make today will affect the health and wellbeing of their upcoming generations and their community. Even though all initiatives took place, by government of India, a major section of the adolescent girls do not have a prior awareness about the menstrual cycle and its hygienic practices leading to poor menstrual hygiene.

An Indian study has reported that young girls are generally told nothing about menstruation until their first experience. It is even more dangerous when the source of information is itself ignorant [11].

Menstrual hygiene is personal hygiene during menstruation that includes bathing and washing, the use of clean, dry sanitary material to absorb the flow and hygienic and environmentally preparation of material for reuse or safe disposal [12].

To manage menstruation hygienically, it is essential that women and girls have access to water and sanitation. They need somewhere private to change sanitary cloths or pads; clean water for washing their hands and used cloths; and facilities for safely disposing of used materials or a place to dry them if reusable.

In a study carried out by Nielsen in rural areas of Bihar and Jharkhand, a framework was created on the understanding that increased communication on the subject could lead to increased awareness. This in turn would lead to change in practices and eventually benefit the lives of entire rural societies. Little is known in these girls about the importance of practicing hygiene during menstruation. They are like that because they have never been taught the do’s and do not’s for this period [13].

CONCLUSION

It is important to educate girls regarding the need for bathing and general  hygiene  during  this  time.  There  are places  in India where girls refrain from bathing which poses serious health and reproductive problems in later life. Menstrual hygiene management is an integral part of the Swachh Bharat Mission Guidelines (SBM-G). Through awareness programs girls should be educated about the problems associated with menstruation which are dysmenorrhea, heavy bleeding, irregular cycles, premenstrual syndrome, inter-menstrual spotting and other issues. Though these can be physiological also, most of the girls do not understand these can be associated with some underlying pathology. Approaching health care systems for such problems should be encouraged, more so in the rural settings where cultural and social beliefs overpower the logistics. An important cause of absence from school is dysmenorrhea about which young girls are shy of speaking. We need to provide girls with education as well as supply of sanitary pads which are cheap and hygienic. The awareness of menstrual hygiene needs to be spread in the society. Education can bring major changes so strong policies and political reforms are required in which teachers, village level workers, mass media and government organizations and non-government organizations can work together in spreading right information and help to eradicate age old myths and taboos. There is a need to start nationwide awareness and education programs to educate our teenagers so that they grow up into mature and healthy women.

1.       World Health Organisation (2013) Fact sheet on Adolescent health. Geneva: WHO. Available at: http://www.who.int/topics/adolescent_health/en/ (Accessed on 4 April 2017).

2.       Sanyal S, Ray S (2008) Variation in the menstrual characteristics in adolescent of West Bengal. Singapore Med J 49: 542-550.

3.       Chandramouli C (2011) Release of social and cultural tables - Age data highlights. Census of India. Mumbai: IIPS. Available at: www.censusindia.gov.in/2011.../Census_2011_Age _data-final-12-09-2013.ppt (Accessed on 4 April 2017).

4.       Dasgupta A, Sarkar M (2008) Menstrual hygiene: How hygienic is the adolescent girl? Indian J Community Med 33: 77-80.

5.       Mudey AB, Kesharwani N, Mudey GA, Goyal RC (2010) A cross-sectional study on awareness regarding safe and hygienic practices amongst school going adolescent girls in rural area of Wardha district, India. Canadian Center of Science and Education 2: 225-231.

6.       Garg R, Goyal S, Gupta S (2012) India moves towards menstrual hygiene: Subsidized sanitary napkins for rural adolescent girls-issues and challenges. Matern Child Health J 16: 767-774.

7.       Ram R, Bhattacharya SK, Bhattacharya K, Baur B, Sarkar T, et al. (2006) Reproductive tract infection among female adolescents. Indian J Community Med 31: 32-33.

8.       Ten VTA (2007) Menstrual hygiene: A neglected condition for the achievement of several millenium development goals. Europe External Policy Advisors, Brussels, Belgium, p: 22.

9.       WASH United (2017) Menstrual hygiene management. Berlin: WASH United. Available at: http://washunited.org/our-work/issues/menstrual-hygienemanagement/articles/our-work-issues-menstrualhygiene-management (Accessed on 4 April 2017).

10.    Jogdand K, Yerpude P (2011) A community based study on menstrual hygiene among adolescent girls. Indian J Maternal Child Health 13: 1-6.

11.    Narayan KA, Srinivasa DK, Pelto PJ, Veeramal S (2001) Puberty rituals, reproductive knowledge and health of adolescent school girls in south. Asia Pacific Population J 16: 225-238.

12.    Hema Priya S, Nandi P, Seetharaman N, Ramya MR, Nishanthini N, et al. (2007) A study of menstrual hygiene and related personal hygiene practices among adolescent girls in rural Puducherry. Int J Community Med Public Health 4: 2348-2355.

13.    Nilesen AC (2011) Sanitary protection: Every woman's health right. Plan India.