Tuesday, 16 August 2016

KNOWLEDGE ABOUT MENSTRUATION; SURVEY ANALYSIS

About a month ago as whilst analyzing data for a research I conducted among prison women at Lusaka Central Prison, I decided to conduct a survey among my Facebook family and friends.  The main purpose of this study was to see if there were any differences in the knowledge among prison inmates and my Facebook friends. One of the biggest factors that differentiated the two groups was social economic status and level of education.
My findings
1.1.  Age; A majority of the respondents were between 20 and 29 years old (69%); 22% were between 30-39, 6% were 15-19 while 3% were between 40 and 49 years old.

Figure1. Age of respondents
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 1.2. Source of information; The main source of information about puberty was friends-32% followed by Mother 25%, other responses were as follows; sister/cousins-6%, Aunt-5%, Grandmother-1%, other-17%.
Figure 2. Main source of information about menstruation

There was a concern from a number of respondents who wished that there were more options to choose from or provision for selection of more than one source. The reason for a single answer however was to ascertain the biggest single source of information about menstruation, especially at puberty.

1.3. Purity and menstruation; 57% of the respondents believed that menstrual blood is not impure. 24% said it was impure and 19% didn’t know whether or not it was impure.

Figure 3. Menstruation and purity



1.4. Influence of food on menses; This was the most interesting question. There is very little knowledge about whether or not food has an influence on menstruation, the highest number of respondents (39%) admitted to not knowing the influence of food on their menses. 35% thought it was true while 26% responded false.
Future 4. Influence of food on menses


1.5. Personal hygiene practices during menses; In this survey, the personal hygiene practices during menstruation was assessed by how often a women bathed daily during menstruation. The highest number of women 62% admitted to bathing twice during menstruation. 2% of women believed it was ok not to take a bath. 10% of women selected the option ‘other’ with regards to personal hygiene. The general response was that a woman could bath as frequently as she pleases depending on the flow, incidence of accidents and personal preference.
Figure 5. Bathing during menses


1.6. Drying of absorbent materials; 47% of the respondents believe that absorbent materials should not have to be dried in hidden places. 43% of respondents believed that absorbent materials should be dried in hidden places while 10% of the respondents don’t know.

Figure 6. Drying of absorbent materials


1.7. Openness with Men; Only 3% of the respondents think that menstruation should not be talked about with men, 92% disagree and 3% don’t know.

Figure 7. Openness about menstruation with men


1.8. Menstruation and anemia; this question was to access the respondents knowledge about the relationship between excessive menstrual bleeding and anemia. 20% of the respondents did not know if there was a relationship between the two.

Figure 8. Menstruation and anaemia


1.9. Disposal of sanitary napkins; almost half of the respondents rinse their disposable sanitary napkins before disposal. 45% of respondents did not agree while 3% did not know whether rinsing was important or not.
Figure 9. Rinsing of disposable pads


1.10. Sporting activities during menstruation; 92% of the respondents did not think that it was harmful for a woman’s body if she played sports during her period. 3% thought it was harmful while 5% of the respondents did not know how if there was any harm or not.
Figure 10. Sports and menstruation

My thoughts
Basic knowledge about menstruation among my Facebook friends is inordinately vague. Major determinants of the trends were social economic status and level of education. As opposed to the study I conducted at Lusaka Central prison among the prison inmates, I would say there are slight differences between the knowledge of the inmates and my Facebook friends.
 In this survey it was evident that most of the women heard about menstruation from their friends, contrary to the prisons’ study where grandmothers were the sole and trusted source of information regarding menstruation. Which makes me wonder, what is the role of parents in all this? In old times, mothers were discouraged from talking about menstruation with their children but the same tradition provided an alternative; there were initiation ceremonies for girls to learn all that they needed to. In ethnic groups that did not have these ceremonies, the girls learned from relatives who lived in huts right next to them so they did not lack. Clearly parents of today are not taking it upon themselves to teach their girls about puberty and menstruation and what to expect. If indeed the cultural values of grandmothers and aunts teaching their children was being upheld, we would have seen a greater percentage of those as the source of information but that is not happening either.
A good number of respondents rinsed their sanitary napkins before disposal. I understand the taboos around period blood in Africa and the cultural barriers around leaving your soiled sanitary napkin in public but it is also important to note that it defeats the purpose of using disposable sanitary napkins if we have to rinse them first. What makes matters worse is that the women I've seen rinsing their pads in public toilets do it in the sink thats meant for hand washing without thinking about the next person that may want to freshen up from the same sink. If women want to rinse their pads, let them go ahead but out of courtesy and hygiene carry their sanitary napkins home so that they can wash them in their own sink with soap. 
It’s very interesting to note that 92% of women that took the survey believe that it’s ok to talk about menstruation with men. But there are very few women that actually do talk about menstruation with men. It could be that the ‘men’ they are referring to are not necessarily all men but those they are in relationships with or are married to while to the rest of the male folk it remains top secret. It could also be that women are comfortable talking about it but the men are uncomfortable so they ignore the subject as soon as it comes up. Well, the benefits of both men and women talking about menstruation isn’t to show men how tough it is to be a woman, its so that we can together find solutions to the things that hold women back. Perhaps if more men were interested or aware about what’s going on with us, we would have had eco-friendly, cheap, inexpensive ways to deal with our period long ago! Arunachalam Muruganantham has already shown us that it is possible!
What really struck me in this survey was the percentage of women that selected “I don’t know” as an option. I had to analyze some questionnaires one by one and the trend I found was that a few respondents did not know the answers to half the questions on this survey. Its very alarming how little information women have concerning their own bodies, what’s more alarming is that women on Facebook have access to Internet, how is it that the internet is not used to learn more about what is going on with regards to their own reproductive health? Are online platforms or mobile applications with such services existent? Would it be imperative at this point to create a platform for Zambian women to learn?
One of benefits of adequate knowledge about menstruation is that it will lead to appropriate menstrual hygiene practices among women. Menstrual hygiene practices among women has an impact on the susceptibility to urinary and vaginal infections; If women have repeated vaginal and urinary infections it affects their ability to conceive, this is what makes studies like these relevant. 
I hope that a more thorough study can be conducted with women around the country to give comprehensive a picture about the overall situation on this subject. In addition, more in depth research techniques such as focused group discussions and one-one one interviews would be profitable for advocacy and policy reform around menstrual health and sanitation.

Limitations to this survey
  •  Sample size was insufficient to make any real conclusions about the trends in Zambia. However, this survey was just used as a means to discuss this subject so that other women can learn from the responses of others. 
  • There was no way of controlling who the respondents were. We cannot be sure that all of them were female respondents. Furthermore, some responses could have been obtained from friends outside Zambia, their demographics, culture and other factors that may affect knowledge are different and may not have been considered during analysis.
  • Limited number of questions on the survey portal limited the amount of data collected.
Conclusion
Knowledge about menstruation is very important for our women. It may seem trivial for older women but for teenage girls who are at puberty right now, this very knowledge can change the course of their life due to its impacts on self-esteem and self-awareness. I would like to pass my sincere gratitude to the 130 women that took the survey you are amazing J
 To debunk some myths about menstruation, click the links below.
  1. Effects of Heavy bleeding
  2. Washing and drying of absorbent materials
  3. Effects of hot or cold food
  4. 5 things you didn't know about your period