Knowledge and practices related to menstruation among Lucknow college students in North India: results from a cross-sectional survey

Abstract

Background: Girls in many low and middle-income countries enter puberty with knowledge gaps and misconceptions about menstruation may lead to unsafe hygienic practices that increase health risk. Despite such importance, educated girls' knowledge and hygienic practice towards menstruation are not well addressed in India. Consequently, the present study attempted to assess menstrual hygiene knowledge and practice among college students in Lucknow city in north India. Method: An online college-based cross-sectional study design was employed in Lucknow, the capital of Uttar Pradesh in India. Data collection was carried out from September 11 to September 25, 2020, using a google form among undergraduate and Postgraduate students. All variables that were significant at bivariate level (at P-value < 0.05) were entered into multivariate analysis using a logistic regression model to control for confounding factors. In the final model, P-value of less than 0.05 was used as a base to identify factors having a statistically significant association with poor knowledge and hygiene practice at corresponding 95% confidence interval. Results: More than half of students' ages of menarche were between 12-15 years, and duration of menses flow was between 3-5 days. The most common premenstrual symptom was abdominal pain (67%) and back pain (50.5%). Majority of the students had first time discussed menstrual problems with their mothers (69.2%). Around 94% of students were currently using a sanitary pad as an absorbent. Regarding cleanliness, about (90.9%) girls clean their genitals after urinating during mensuration. Around 18.9% used medication during menstruation. Multivariate analyses reveal that students of Science and Technology (vs Commerce and Management Students) and monthly family income 50-100 thousand (vs < 25 thousands) were associated with good knowledge about menstruation. In contrast, students' fathers were graduates (vs school educated); the occupation was 'Other'(vs Farmer) ; living in a nuclear family(vs Joint family) and residing in urban areas(vs Rural) were less likely to have good menstruation knowledge. Besides, good hygiene practices are less likely to have with 'Other' Religion(vs Hindu), working mother(vs Housewife), monthly family income between 25 to 50 thousand(vs <25 thousands), and Nuclear family(vs Joint family) (p<0.05). Conclusions Most college students had poor knowledge but followed hygienic practices correctly. It demonstrates a need to design acceptable awareness creation and advocacy programs to improve college students' knowledge during menstruation. Of all the sociodemographic factors, monthly income and types of family influenced students' knowledge and practices related to menstruation.