Menstruation, a fundamental aspect of the reproductive cycle, remains veiled in silence and constrained by societal taboos in diverse regions worldwide. In this context, District Chamba in Himachal Pradesh, India emerges as a compelling area for investigation. The sociocultural milieu of this region profoundly influences the awareness, hygiene practices, and comprehension of menstrual health among women of reproductive age. This study seeks to unravel the silence surrounding menstrual realities in District Chamba, delving into prevailing awareness levels, hygiene practices, and common menstrual disorders among women in the reproductive age group [1-3].

Despite global strides in women's health, menstrual hygiene remains a challenge, especially in rural areas of India. District Chamba, nestled in the scenic landscapes of Himachal Pradesh, offers a unique context requiring nuanced exploration. Cultural intricacies, traditional beliefs, and limited access to resources may contribute to insufficient awareness and suboptimal menstrual hygiene practices in this region [4-5].

This study's significance lies in its potential to unveil the complexities of menstrual health in District Chamba and contribute insights for public health interventions. By evaluating awareness levels, hygiene practices, and identifying common menstrual disorders, the findings can inform targeted interventions, policy formulation, and community-based initiatives. Furthermore, it can serve as a cornerstone for fostering open dialogues, dismantling taboos, and promoting a supportive environment for women's menstrual health [6-7].

Beyond data collection, this study aspires to be a catalyst for change. By addressing nuanced aspects of menstrual health in District Chamba, it seeks to contribute to the broader discourse on women's health in rural India. The findings are anticipated to provide a foundation for tailored interventions, educational programs, and community-based initiatives aimed at fostering a healthier and more informed community.

Objectives of the Study

To evaluate the awareness about Menstrual hygiene practices and Common menstrual disorders among women of reproductive age group in District Chamba, Himachal Pradesh.           

• Research Approach: Descriptive

• Research Design: Cross-sectional survey design

• Study Area: District Chamba, Himachal Pradesh

• Study Duration- between August 2023 to October 2023

• Study Population: All women of reproductive age group who were staying in the District Chamba , Himachal Pradesh for 12 months or more

• Sample Size: 400 women of reproductive age group assuming 50% have adequate knowledge regarding Menstrual hygiene practices and Common menstrual disorders , 5% absolute error, 95% confidence level, and 5% non response rate

• Study Tool: A google form questionnaire consisting of questions regarding socio-demography and Menstrual hygiene practices and Common menstrual disorders was created. The questionnaire was initially pre-tested on a small number of women of reproductive age group to identify any difficulty in understanding by the respondents

 
Description of Tool

• Demographic Data Survey Instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more

• Questionnaire: The questionnaire contains 20 structured questions regarding knowledge about Menstrual hygiene practices and Common menstrual disorders. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero in each category. Scoring was done on the basis of marks as >80%(16-20) = very good,60-79% (12-15) = Good, 41-59% ( 8-11) = Fair,<40% (< 8) = poor

• Validity of Tool: By the experts in this field

• Data Collection: Data was collected under the guidance of supervisors. The google form questionnaire was circulated via online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin among women of reproductive age group in both rural and urban area of District Chamba ,Himachal Pradesh till the 400 responses were collected

• Data Analysis: Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage

• Ethical Considerations: Participants confidentiality and anonymity was maintained

The goal of the current study was to assess the awareness about Menstrual hygiene practices and Common menstrual disorders among women of reproductive age group in District Chamba, Himachal Pradesh through a non-experimental descriptive survey.

A total of 400 respondents including 163 (40.75%) were from urban area and 237 (59.25%) were from rural area were participated in the study (Table 1).

Table 1: Knowledge Regarding Menstrual Hygiene Practices and Common Menstrual Disorders among Study Participants

In the present study 30.75% (123) females had very good knowledge (16-20 marks) towards Menstrual hygiene practices and Common menstrual disorders, 40.5% (162) having good knowledge (12-15 marks), 23.5% (94) having fair knowledge (8-11 marks) and 5.25% (21) having poor knowledge (<8 marks)(Table 2).

Table 2: Knowledge Score Regarding Menstrual Hygiene Practices and Common Menstrual Disorders among Study Participants

Maximum = 20 Minimum = 6

The findings of this study offer a comprehensive insight into the awareness levels and knowledge regarding menstrual hygiene practices and common menstrual disorders among women of reproductive age in District Chamba, Himachal Pradesh. The observed percentage distribution of knowledge levels indicates a substantial gap in understanding, necessitating targeted interventions to address these disparities.

The study reveals a varying degree of awareness among participants concerning essential menstrual hygiene practices. While 80.5% of respondents correctly identified essential practices, there is room for improvement in areas such as the selection and disposal of sanitary products. These findings align with the broader global challenge of inconsistent menstrual hygiene practices, emphasizing the need for culturally sensitive education and awareness campaigns [1].

Furthermore, the results underline the importance of environmental consciousness, with 53.75% of participants showing awareness of the environmental impact of menstrual products. This awareness opens avenues for promoting eco-friendly alternatives, aligning with the global call for sustainable menstruation [7].

The study participants demonstrated varied knowledge levels regarding common menstrual disorders, with 64.75% correctly naming them. However, gaps were evident in understanding conditions such as dysmenorrhea and menorrhagia. These findings resonate with studies emphasizing the need for increased awareness and education on menstrual health issues [8-9].

It is noteworthy that 71.5% of participants correctly identified PCOS and its common symptoms. This aligns with the growing recognition of PCOS as a prevalent health concern, especially in the Indian context [10].

Comparing the findings with studies conducted in India, similarities and differences emerge. A study in rural Rajasthan reported a higher prevalence of poor menstrual hygiene practices, emphasizing the need for targeted interventions [11]. Similarly, studies in urban areas of Delhi highlighted gaps in awareness and knowledge, echoing the present study's emphasis on the importance of education [8].

However, notable differences may stem from regional variations, cultural influences, and differing levels of access to education and healthcare. The present study underscores the significance of tailoring interventions to the specific sociocultural context of District Chamba.

The study's findings underscore the urgent need for multifaceted public health interventions in District Chamba. Tailored educational programs must address gaps in menstrual hygiene practices and disorders, integrating cultural sensitivity and environmental considerations. Community-based initiatives, engaging local influencers and healthcare providers, can amplify the impact of awareness campaigns.

This study unveils the existing gaps in awareness and knowledge regarding menstrual hygiene practices and common menstrual disorders among women of reproductive age in District Chamba, Himachal Pradesh. The findings provide a foundation for targeted public health interventions, emphasizing the need for culturally sensitive education and community-based initiatives to foster a healthier and more informed community.

1. Sommer, M. et al. “Comfortably, safely, and without shame: defining menstrual hygiene management as a public health issue.” American Journal of Public Health, vol. 105, no. 7, 2015, pp. 1302–1311.

2. UNICEF. Menstrual hygiene management: Good practices. 2018.

3. Jewitt, S. and H. Ryley. “It’s a girl thing: menstruation, school attendance, spatial mobility and wider gender inequalities in Kenya.” Geoforum, vol. 56, 2014, pp. 137–147.

4. George, J. and D. Nair. “Why ‘brave the shame’? A study on menstrual experience and management among adolescent school girls in Kerala.” SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, vol. 10, no. 2, 2013, pp. 34–42.

5. Tegegne, T.K. et al. “Menstrual hygiene management and school absenteeism among female adolescent students in Northeast Ethiopia.” BMC Public Health, vol. 14, no. 1, 2014, pp. 1118.

6. Scott, L. et al. “Impact of water, sanitation, and hygiene interventions on handwashing practices and infectious diseases: a systematic review and meta-analysis.” Tropical Medicine & International Health, vol. 21, no. 7, 2016, pp. 822–833.

7. Bharadwaj, P. and R. Saxena. “Sustainable menstrual practices: awareness and behaviour among urban and rural women in Uttarakhand, India.” Environmental Science and Pollution Research, vol. 28, no. 27, 2021, pp. 34875–34886.

8. Kaur, R. et al. “Menstrual hygiene, management, and waste disposal: practices and challenges faced by girls and women of developing countries.” Journal of Environmental and Public Health, 2018, pp. 1730964.

9. Kumar, N. et al. “Menstrual hygiene practices and their association with reproductive tract infections and abnormal vaginal discharge among women in India.” Journal of Family Medicine and Primary Care, vol. 7, no. 6, 2018, pp. 1433–1439.

10. Sharma, S. et al. “Polycystic ovary syndrome and its association with type 2 diabetes mellitus among Indian women.” Journal of Family Medicine and Primary Care, vol. 9, no. 4, 2020, pp. 1870–1875.

11. Sharma, R. et al. “Menstrual hygiene practices among adolescent girls in a rural area of North India.” Journal of Evolution of Medical and Dental Sciences, vol. 7, no. 21, 2020, pp. 2535–2540.