Abstract
Background: Menstruation, a natural and vital aspect of women's health, affects millions worldwide. Yet, 30% experience abnormal uterine bleeding and related symptoms like pain, anxiety, and fatigue, profoundly impacting their lives. Cultural stigmas and inadequate menstrual hygiene management further isolate girls and restrict their daily activities.
Methods: Using a multistage sampling design, UNICEF's 2022-23 Afghanistan MICS survey analysed 23,568 households. The study used IBM SPSS version 29.0 to examine women's absenteeism due to menstruation, focusing on age, residence, education, and wealth index. Chi-square tests and odds ratios determined statistical significance.
Results: The study revealed that menstruation greatly affected women's daily routines in Afghanistan. Many women said they had missed social events, work, or school because of their period. The study also established that absenteeism was significantly associated with demography, age, place of residence, education level and wealth index using chi-square tests and odds ratios. The findings revealed that younger women, women from rural settings, and women with low education or low wealth index were more likely to have missed activities due to menstruation. The present study highlights the importance of intervention focused on MHH and reducing school absenteeism among Afghan women.
Conclusion: This study shows that menstruation has a major effect on women and girls' engagement in social, working, and learning activities in Afghanistan. Menstrual health concerns are not just a one-stop issue but involve education, environments, products, and policies. Interventions effectively improve women's quality of life, decrease absenteeism and increase access to education and employment opportunities.
Keywords:
Menstruation, school attendance, employmen, menstrual hygiene, education, AfghanistanReferences
1. Van Lonkhuijzen RM, Garcia FK, Wagemakers A. The Stigma Surrounding Menstruation: Attitudes and Practices Regarding Menstruation and Sexual Activity During Menstruation. Women S Reproductive Health. 2022;10(3):364–84.
2. Professional CCM. Menstrual Cycle [Internet]. Cleveland Clinic [Cited 2024 Nov 12]. 2024. Available from: https://my.clevelandclinic.org/health/articles/10132-menstrual-cycle
3. Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control. 2020;48(6):592–8.
4. Hennegan J, Winkler IT, Bobel C, Keiser D, Hampton J, Larsson G, et al. Menstrual health: a definition for policy, practice, and research. Sex Reprod Health Matters. 2021 Jan 1;29(1):31–8.
5. Gyasi-Gyamerah AA, Quansah C, Annor F, Gyasi-Gyamerah K. Is cohabitation a prerequisite for marriage?: Exploring Ghanaian emerging adults' attitudes and intentions. Journal of Social and Personal Relationships. 2023;40(12):4176–96.
6. Sakhi R, Jalalzai S, Ahmadi Z, Almaszada R, Zarghoon FN, Mohammadi R, et al. Knowledge, Beliefs, and Practices Related to Menstruation Among Female Students in Afghanistan. Int J Womens Health. 2023;15:1139–49.
7. Mason L, Nyothach E, Van Eijk AM, Obor D, Alexander KT, Ngere I, et al. Comparing the use and acceptability of menstrual cups and sanitary pads by schoolgirls in rural Western Kenya. International Journal of Reproduction Contraception Obstetrics and Gynecology. 201926;8(8):2974.
8. UNICEF Afghanistan. Celebration of Menstruation Hygiene Management Day in Afghanistan. [internet]. [cited on 2024 Nov 12]. Available from: https://www.unicef.org/afghanistan/press-releases/celebration-menstruation-hygiene-management-day-afghanistan
9. UNICEF. Fast facts: Nine things you didn't know about menstruation. [Internet]. [cited on 2024 Nov 12]. Available from: https://www.unicef.org/press-releases/fast-facts-nine-things-you-didnt-know-about-menstruation
10. Facts and Figures: Economic Empowerment. UN Women – Headquarters. UN Women. [cited on 2024 Nov 12];. Available from: https://www.unwomen.org/en/what-we-do/economic-empowerment/facts-and-figures
11. World Bank. Menstrual Health and Hygiene. World Bank. [cited on 2024 Nov 12];. Available from: https://www.worldbank.org/en/topic/water/brief/menstrual-health-and-hygiene
12. Kandpal V, Nautiyal N. Women's empowerment: key for socioeconomic development in India. International Journal of Business Innovation and Research. 2023;32(2):260–79.
13. Behera MR, Parida S, Pradhan HS, Priyabadini S, Dehury RK, Mishra B. Household sanitation and menstrual hygiene management among women: Evidence from household survey under Swachh Bharat (Clean India) Mission in rural Odisha, India. J Family Med Prim Care. 2022;11(3):1100–8.
14. Olson MM, Alhelou N, Kavattur PS, Rountree L, Winkler IT. The persistent power of stigma: A critical review of policy initiatives to break the menstrual silence and advance menstrual literacy. PLOS Glob Public Health. 2022;2(7):e0000070.
15. Mukherjee A, Lama M, Khakurel U, Jha AN, Ajose F, Acharya S, et al. Perception and practices of menstruation restrictions among urban adolescent girls and women in Nepal: a cross-sectional survey. Reprod Health. 2020;17(1).
16. Kpodo L, Aberese-Ako M, Axame WK, Adjuik M, Gyapong M. Socio-cultural factors associated with knowledge, attitudes and menstrual hygiene practices among Junior High School adolescent girls in the Kpando district of Ghana: A mixed method study. PLoS ONE. 2022;17(10):e0275583.
17. WHO. Education and provisions for adequate menstrual hygiene management at school can prevent adverse health consequences. [Internet]. [cited 2024 Nov 12]. Available from: https://www.who.int/europe/news/item/27-05-2022-education-and-provisions-for-adequate-menstrual-hygiene-management-at-school-can-prevent-adverse-health-consequences.
18. Tembo M, Renju J, Weiss HA, Dauya E, Gweshe N, Ndlovu P, et al. Integration of a menstrual health intervention in a community-based sexual and reproductive health service for young people in Zimbabwe: a qualitative acceptability study. BMC Health Ser Res. 2022;22(1).
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Copyright (c) 2025 Muskan Sadik Kaliwala, Ali Davod, Mark Cortnage, Richard Hayhoe, Russell Kabir

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