Usage of menstrual products high but hygiene low: survey

Despite a higher percentage of adolescent girls using some form of menstrual products, the hygiene of menstrual practices remains very low among teenagers aged 15-19, revealed the Bangladesh Adolescent Health and Wellbeing Survey (BAHWS) 2019-20. In the survey, 88 percent respondents mentioned they were harassed during commutes.

Ninteen percent of the responses listed their schools as a place where they were sexually harassed.

The survey was conducted in five phases between 25 July 2019 and 10 January 2020 with a nationally representative sample of 72,800 households. A total of 4,926 girls who are or have been married participated in the survey, alongside 7,800 unmarried girls and 5,523 unmarried boys.

The National Institute of Population Research and Training (NIPORT) with technical assistance from Research for Decision Makers (RDM) project of icddr,b and Data for Impact (D4I) of the University of North Carolina at Chapel Hill conducted the research, which is the first of its kind in Bangladesh.

They found that only one in every 11 married adolescents and one in eight unmarried adolescents have hygienic menstrual practice.

On the other hand, 98 percent of both married and unmarried adolescents reported using either disposable products or reusable materials cleaned with water and soap or detergent during menstruation.

The study also revealed that one in every four married and unmarried in-school adolescents missed at least one day of school during their last period.

The survey also revealed that, 73 percent of unmarried female adolescents and 66 percent of unmarried male adolescents want to learn about puberty and physical changes.

While adolescent girls rely on books for getting information, internet is the most available medium for information among male adolescents. Nationally, a majority of female adolescents had no prior knowledge about menstruation before they experienced it for the first time.

The survey also revealed some progress on eliminating the traditional concept of gender roles and gender-based discrimination in families.

As per the survey, around one in every ten unmarried adolescents are under weight and another one tenth are overweight.

Some 76-85 percent of adolescents consume adequate dietary diversity, which is more than four food groups out of five comprised of fruits and vegetables, starchy food, dairy, protein and fat. Most adolescents (70-78 percent) also consume iron-rich food. But only around a quarter are consuming vitamin A-rich food, the survey reveals.

The study also revealed that one in every seven married adolescent suffers from depression.

"We can see some positive changes that the number of school-going girl teenagers is higher than the boys. But unfortunately, those girls who are getting married off are falling away from the stream. Moreover, mental health situation among girls is alarming," Dr Kanta Jamil, Program Co-ordinator for Research, Population, Health and Nutrition Team at the USAID told The Daily Star.

The survey revealed that, among adolescents who have ever been married, 97 percent are currently married, while 3 percent are separated, divorced, or widowed.

Seventeen percent of married girls have been in the marriage for four years or more. Regarding spousal age difference, 30 percent of girls have an age difference of 10 or more years with their husband. The highest proportion of girls with a spousal age difference of 10 years or more is among those in the highest wealth quintile (45 percent) – the survey finds.

Over one third (34 percent) of ever-married girls and about one fifth (18 percent) of unmarried girls said they think a man has the right to beat his wife when she does not listen to him.

Speaking as chief guest, Health Minister Zahid Maleque said that adolescent health and wellbeing has always been a priority for the government.

"It is imperative to prevent early marriage and provide meaningful sexual and reproductive health education and services starting from adolescence to uphold the progress we are making in the health sector," the minister said.

Xerses Sidhwa, director of the Office of Population at USAID said, "We can see from the results that adolescents want more information on reproductive health like menstruation, puberty, and physical changes. Now is the time for us to think how we can reach these adolescents in a more efficient way. For this we would need an effective multi-sectoral approach."