Effectiveness of Structured Teaching Programme on Menstrual Hygiene among Adolescent Girls

Background: Adolescence is second decade of life marking the transaction from adulthood. These are the premature years where maximum amount of physical, physiological & behavioral changes takes place. In India the female child is neglected and menstruation is still regarded as something unclean or dirty. The menstrual practices are still clouded by taboos and socio cultural restrictions resulting in unhygienic health practices which sometimes results with adverse health outcomes such as reproductive tract infections. Therefore improved knowledge about menstruation from childhood may escalate safe practices and help in mitigating the suffering of millions of women. Materials and Methods: The research design selected for this study was preexperimental one group pretest & post tests design. Forty adolescent girls were selected using convenient sampling technique. The study was conducted at R.L. Jalappa central school, Kolar. The instrument used for the study was self administered structured knowledge questionnaire. Results: The results showed that there was significant difference between pre-test & post test knowledge score and also revealed that there was significant association between mean knowledge score with age, education status of the mother and presence of elder sister in the family. Conclusions: The study concludes that structured teaching programme could be an effective strategy to improve the knowledge of adolescence girls on menstrual hygiene.


Introduction
Adolescence is a period of transition from childhood to adulthood.They are the formative years when maximum amount of physical, psychological and behavioral changes take place.The World Health Organization (WHO) defines adolescents as individuals between 10 & 19 years of age. [1]Adolescent girls constitute about one fifth of the female population in the world.Adolescence in girls has been recognized as a special period in their life cycle that requires specific and special attention.This period is marked with onset of menarche. [2]he girl experiences several problems during adolescence, and menarche is one among them.
Menstruation is generally considered as unclean in the Indian society. [3,4] he silence of menstruation does not allow an open discussion on the subject even today, resulting in adolescent girls remaining ignorant of the scientific facts and hygienic health practices necessary for positive reproductive health. [4]Menstrual hygiene deals with the special health care needs and requirements of women during monthly menstruation or menstrual cycle.
Menstruation Hygiene Management (MHM) focuses on practical strategies for coping with monthly periods.MHM refers to ways women themselves keep clean and healthy during menstruation and how they acquire, use and dispose of blood-absorbing materials.Poor menstrual hygiene is a risk factor for reproductive tract infection and cervical neoplasia. [5,6]Learning about hygiene during menstruation is a vital aspect of health education for adolescent girls as patterns that are developed in adolescence are likely to persist into adult life. [7]The reaction to menstruation depends upon awareness and knowledge about the subject.The manner in which a girl learns about menstruation and its associated changes may have an impact on her response to the event of menarche.With this background the present study was undertaken to assess the knowledge, regarding menstruation Hygiene among the adolescent girls of high school.

Materials and Methods
An evaluative research approach was adopted with an objective to assess the effectiveness of structured teaching programme regarding menstrual hygiene.The research design selected was pre-experimental-one group pre-test and post-test design.Forty teenage girls studying in 7 th & 8 th standard at R.L. Jalappa central school were selected through convenient non probability sampling technique.Data collection tool consisted of a structured questionnaire to elicit Sociodemographic variables of adolescent girls; a structured knowledge questionnaire regarding menstrual hygiene to assess knowledge of adolescent girls.
Data collection procedure consisted of two phases, in the first phase formal permission was obtained from the school authority and written consent was obtained from the study sample followed by pre-test was conducted through structured knowledge questionnaire and on the same day structured teaching programme was given which includes physical and physiological changes during menarche, hygienic practices during menstruation and preventive measures of menstrual problems.In the second phase by using the same tool post-test was conducted on eighth day.

Results
Post test knowledge score was apparently higher than that of pre test mean knowledge score (MD 14.78).Paired t test (table-2) computed to find out the differences between pre and post test scores was statistically significant (p<0.05).Hence it was concluded that structured teaching programme could be an effective method to improve the knowledge of adolescence girls on menstrual hygiene.The study also revealed that there was significant association between knowledge scores of adolescent girls with selected demographic variables such as age, and educational status of mother (p<0.05) based on computation of chi-square (table-3).

Discussion
The study revealed that the adolescence girls' had moderate knowledge regard-ing menstrual hygiene before the intervention.It is possible that structured teaching programme had caused an improvement in knowledge of adolescent girls with regards to menstrual hygiene and this is supported by in a prior study conducted on Impact of Structured Education Regarding Menstrual Hygiene Practices among Adolescent Girls. [8]and A Study to Assess the Effectiveness of Planned Teaching Programme on the Knowledge regarding Menstrual Hygiene among Adolescence Girls Studying in the Selected Schools, Kolhapur. [9]

Conclusion
The study supports the concept that structured teaching programme for adolescence girls are an effective strategy to improve knowledge regarding menstrual hygiene.Education programme with effective teaching strategies motivates adolescence girls to follow   healthy practices in day to day life and prevent morbidity and mortality related to lack of hygienic practices.

Conclusion
The study supports the concept that structured teaching programme for adolescence girls are an effective strategy to improve knowledge regarding menstrual hygiene.Education programme with effective teaching strategies motivates adolescence girls to follow healthy practices in day to day life and prevent morbidity and mortality related to lack of hygienic practices.

Table 1 .
Distribution of Adolescent girls based on their demographic characteristics (n=40)

Table 2 .
Mean, mean difference and 't' value of pre and post test knowledge score among adolescents on menstrual hygiene

Table 3 .
Identification of association between knowledge scores and demographic variable ( n=40)