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ASSESSING THE QUALITY OF TEACHING OF THE GIRLS' HYGIENE TOPIC IN HEALTH EDUCATION CLASS IN
MONGOLIA
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Saruul P. , Ariuntsetseg E. , Bayarmaa N. Email: [email protected]
1Saruul Purev - Master of Education Sciences; 2Ariuntsetseg Erhembayar - Master of Medical Sciences, DEPARMENT OF PUBLIC HEALTH; 3Bayarmaa Natsag - Master of Education Sciences, DEPARMENT OF BASIC SCIENCES, DARKHAN MEDICAL SCHOOL MONGOLIAN NATIONAL UNIVERSITY OF MEDICAL SCIENCES, DARKHAN-UUL, MONGOLIA
Abstract: menstrual hygiene is a personal hygiene routine during menstruation that involves frequent changes of sanitary pads, regular hand washing and showering, consumption of nutritious meals, sufficient rest, and stress avoidance. Poor hygiene during menstruation may cause bacterial vaginitis and endometriosis, the conditions that have multiple negative consequences for adolescent girls' health.
Educating girls about menstrual hygiene and teaching them essential skills for maintaining a healthy menstrual hygiene is the simplest way of preventing infections and addressing potential health risks.
The study sample consisted of 86 adolescent girls ' representative of 267 girls in the 8th grade at two selected two schools School # 1 and "Od" school in Darkhan-Uulprovince of Mongolia. A multi-stage random sampling method was used to select the schools and the participants. The study took place during the period of September 20 to October 15, 2020. 74(86%) of all study participants and 63(88.7%) girls of the subset who reached menarche reported having been taught the Girls ' Hygiene topic as part of the Health Education class. The percentage of adolescent girls who expressed the need for improving the quality of the Health Education class was similar - 67.4% and 67.6% in the total group and its subset, respectively. As a part of the study, a training was organized for participants (n=86) and pre and post-training tests were administered. The mean pre- and post-training grades were 50.7% (F) and 82.1% (B), respectively.
Adolescent girls have insufficient knowledge about the frequency of changing sanitary pads and personal hygiene during menstruation. Therefore, we recommend improving the quality of teaching and increasing the hours for the Health Education class. The pre-training and post-training testing results demonstrate that it is possible to improve girls' health education by providing additional training.
Keywords: hygiene, menstruation, adolescent girls', pre- and post-training.
ОЦЕНКА КАЧЕСТВА ПРЕПОДАВАНИЯ ТЕМЫ ГИГИЕНЫ ДЕВОЧЕК В КЛАССЕ САНИТАРНОГО ПРОСВЕЩЕНИЯ В
МОНГОЛИИ
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Саруул П. , Ариунцэцэг Э. , Баярмаа Н.
1Саруул Пурэв - магистр образовательных наук;
2Ариунцэцэг Эрхэмбаяр - магистр медицинских наук, кафедра социальной медицины;
3Баярмаа Нацаг - магистр образовательных наук, кафедра фундаментальных наук, Дарханская медицинская школа Монгольский национальный университет медицинских наук, г. Дархан-Уул, Монголия
Аннотация: менструальная гигиена — это рутина личной гигиены во время менструации, которая включает в себя частую смену гигиенических прокладок, регулярное мытье рук и принятие душа, потребление питательных блюд, достаточный отдых и избежание стресса. Плохая гигиена во время менструации может вызвать бактериальный вагинит и эндометриоз, состояния, которые имеют многочисленные негативные последствия для здоровья девочек-подростков. Обучение девочек правилам гигиены во время менструации и обучение их основным навыкам поддержания здоровой гигиены во время менструации является самым простым способом предотвращения инфекций и устранения потенциальных рисков для здоровья.
Выборка исследования состояла из 86 представительниц девочек-подростков из 267 девочек 8-го класса в двух выбранных школах: школе № 1 и школе «Од» провинции Дархан-Уул Монголии. Для отбора школ и участников использовался метод многоэтапной случайной выборки. Исследование проходило в период с 20 сентября по 15 октября 2020 года.
74 (86%) всех участниц исследования и 63 (88,7%) девочки из подгруппы, достигшие менархе, сообщили, что им преподавали тему «Гигиена девочек» в рамках занятий по санитарному просвещению. Процент девочек-подростков, выразивших потребность в повышении качества занятий по санитарному просвещению, был одинаковым -67,4% и 67,6% в общей группе и ее подмножестве соответственно. В рамках исследования для участников (n=86) было организовано обучение, а также проведено до- и послетренировочное тестирование. Средние оценки до и после тренировки составили 50,7% (F) и 82,1% (B) соответственно.
У девочек-подростков недостаточно знаний о частоте смены прокладок и личной гигиене во время менструации. Поэтому мы рекомендуем улучшить качество преподавания и увеличить количество часов занятий по санитарному просвещению. Результаты тестирования до обучения и после обучения показывают, что можно улучшить санитарное просвещение девочек путем дополнительного обучения. Ключевые слова: гигиена, менструация, девочки-подростки, до и после тренировки.
RATIONALE: Menstrual hygiene is a personal hygiene routine during menstruation that involves frequent changes of sanitary pads, regular hand washing and showering, consumption of nutritious meals, sufficient rest, and stress avoidance. Maintaining personal hygiene during menstruation is an important measure for preventing the risk of infections as menstrual blood may become a favorable breeding ground for potentially dangerous microbes.
Poor hygiene during menstruation may cause bacterial vaginitis and endometriosis, the conditions that have multiple negative consequences for adolescent girls' health4. The government of Mongolia recognized the importance of health education, and it was included
into the general education curriculum by a joint order of Ministers of Health and Education, Culture and Science on July 31, 2018. Currently Health Education starts in the 7th grade of general education schools and Chapter 5 of the Health Education textbook covers the topic on Puberty and Reproductive Health.
There are 4493 adolescents in 26 general education schools in Darkhan-Uul province1.
GOAL: To evaluate the quality of teaching health education in general education schools, assess the knowledge of adolescent girls about menstrual hygiene and explore their needs for further training.
OBJECTIVES:
1. To assess the level of readiness and knowledge of menstrual cycle, and knowledge about the choice and use of sanitary pads, and personal hygiene among adolescent girls.
2. Compare and assess the quality of teaching of health education classes at selected schools.
3. Organize a training titled "Menstrual Hygiene" among adolescent girls who participated in the study. Administer pre- and post-training surveys to explore their knowledge and need for training.
INNOVATIVENESS OF THE STUDY: The study aims to determine the adolescent girls' knowledge about menstrual hygiene, assess the quality of health education classes and determine the need for further training.
PRACTICAL IMPORTANCE: Educating girls about menstrual hygiene and teaching them essential skills for maintaining a healthy menstrual hygiene is the simplest way of preventing infections and addressing potential health risks.
STUDY METHODS: The study sample consisted of 86 adolescent girls' representative of 267 girls in the 8th grade at two selected two schools School # 1 and "Od" school in Darkhan-Uul province of Mongolia. A multi-stage random sampling method was used to select the schools and the participants. The study took place during the period of September 20 to October 15, 2020.DATA COLLECTION METHODS AND PROCEDURES:
1. A questionnaire consisting of 29 specially designed questions was used to determine the adolescent girls' readiness and knowledge of menstrual cycle, choice of hygienic pads, their use, and knowledge of personal hygiene during menstruation.
2. A test with 10 questions aimed to determine the participants' knowledge about menstrual hygiene was developed and administered pre- and post- training.
3. Researchers organized a training on menstrual hygiene among participants that used a PowerPoint presentation reviewed and approved by Health Education teachers. The training was attended by the adolescent girls participating in the study.
STATISTICAL ANALYSIS:
Statistical analysis of the data was performed using SPSS 23.0. Data spreadsheets and graphics were developed using Microsoft Excel 2010 software.
RESULTS
Table 1. General information about participants (N=86)
n %
Number of girls who reached menarche
Yes 71 82.5%
Not yet reached 15 17.5%
Use of calendar to track menstrual cycle
Use regularly 30 42,3%
Use sometimes 13 18,3%
No, do not use 28 32,6%
Number of girls using the calendar tracking who carry extra sanitary pads in person
Always 24 82%
Sometimes 2 6,7%
Never 4 13,3%
The majority or 71 (86%) adolescent girls participating in the study reported having reached menarche. Of those girls, 30 (42.3%) use the calendar method to track menstrual cycle and 24 (82%) girls who use calendar, also carry sanitary pads during menstruation (see Table 1).
Table 2. The effects of menstruation on the adolescent girls' emotional state (N= 71)
n %
Common concerns about menstruation
Fear of leaking through clothing when in public, permanent stains in clothes, and unpleasant odor 64 90,1%
Trying to keep private, especially from boys 7 9,9%
Concerns in the event of sudden/unexpected menstruation
Fears of leaking, staining and odor 39 54,9%
Stressful 20 28,2%
Nervous of telling others 12 16,9%
Out of 71 adolescent girls who reported having reached menarche, 64 (90.1%) confessed that they feel concerned about blood leaking through or staining clothing, and about unpleasant smell. The majority or 39 (54.9%) girls were fearful that unexpected onset of menstruation and the lack of sanitary pads may result in leaking through, staining and odor (see Table 2).
Table 3. Choice and use of sanitary pads (N=71)
n %
Factors determining the choice of sanitary pads
Price 6 8,5%
Absorption capacity 57 80,3%
Commercial advertisement 8 11,3%
Frequency of changing sanitary pads
Ever 1-2 hours 18 25.4%
Every 2-3 hours 33 46,5%
Every 3-4 hours 15 21,1%
Every 4-5 hours 4 5,6%
I change when it feels full 1 1,4%
80% of the girls in the study reported that their choice of sanitary pads was determined by their absorption capacity, while 12% were influenced by product commercials and 7% by price. About 47% of girls reported that they change sanitary pads every 2-3 hours.
Table 4. Adolescent girls' menstrual hygiene (N=71)
n %
Frequency of showering during menstruation
Every day 19 26,8%
Every now and then 45 63.4%
Do not take shower 7 9.9%
The direction of washing private parts
Front to back 33 46,5%
Back to front 24 33,8%
In a circular motion 14 19,7%
Handwashing after changing sanitary pads
Always 45 65,3%
Sometimes 24 33,8%
Never 2 2,8%
Which of the following can be prevented by proper menstrual hygiene?
Ascending infections 16 22,5%
Growth of bacteria 34 47,9%
Unpleasant feelings 16 22,5%
Gastrointestinal diseases 3 4,2%
Airborne diseases 2 2,8%
Among adolescent girls who reported having reached menarche, 45(63.4%) take shower every day during menstrual cycle, and only 33 (46.5%) clean their genitals in the front to back direction. Forty-five (65.3%) girls reported washing hands every time after changing sanitary pads, and 50 (70.4%) girls demonstrated appropriate knowledge of the benefits of maintaining menstrual hygiene.
Table 5. Quality of teaching the topic Girls' Hygiene in the Health Education class
Assessment by all Assessment by the
participants (N=86) subset of reached girls who menarche
(N1=71)
n % П1 %
Whether the topic has been taught as part of the Health education class
Yes, the topic was taught 74 86% 63 88.7%
No, the topic has not been taught 1 1,2% 1 1,4%
Don't remember 11 12,8% 7 9,9%
The amount of information provided about menstrual hygiene
Sufficient 50 58,1% 43 60,6%
Somewhat sufficient 32 37,2% 24 33,8%
Insufficient 4 4,7% 4 5,6%
Do you need more hours of Health Education?
Yes 48 55.8% 32 66.6%
No 38 44.2% 16 33.4%
Quality of teaching the Health Education class
The quality needs to be improved 58 67.4% 48 67,6%
No need to improve the quality of teaching 28 32.6% 23 32,4%
Results: 74(86%) of all study participants and 63(88.7%) girls of the subset who reached menarche reported having been taught the Girls' Hygiene topic as part of the Health Education class. Also, 50 (58.1%) girls in the total sample, including 43 girls (60.3%) who reached menarche, reported having received sufficient knowledge about menstrual hygiene in Health Education class. At the same time, 48 (55.8%) all participants including 32(66.6%) girls in the subset who reached menarche, expressed a desire for more Health Education. The percentage of adolescent girls who expressed the need for improving the quality of the Health Education class was similar - 67.4% and 67.6% in the total group and its subset, respectively.
Test Grade Grade Grade Grade Grade Me SD SEM t
results А B C D F an
Pre-training 5.8% 14% 0 19.8% 60.5% 50.7 25.2 2.7 -12.262
Posttraining 33.7% 33.7% 0 24.4% 8.1%) 82.1 6 15.9 1.7
**p<0.001.
As a part of the study, a training was organized for participants (n=86) and pre and posttraining tests were administered. The mean pre- and post-training grades were 50.7% (F) and 82.1% (B), respectively. The t-test revealed a significant difference in the pre-training (M=50.7, SD=25.2) and post-training (M=82.16; SD=15.9), where t (df)= -12.262, p<0.001 CONCLUSION
1. The majority of adolescent girls in the 8th grade have reached menarche but they do not use calendar for tracking menstrual cycle. Adolescent girls have insufficient knowledge about the frequency of changing sanitary pads and personal hygiene during menstruation.
2. The findings reveal that adolescent girls have insufficient knowledge about menstrual hygiene after attending Health Education class and demonstrate the need for more education. Therefore, we recommend improving the quality of teaching and increasing the hours for the Health Education class.
3. The pre-training and post-training testing results demonstrate that it is possible to improve girls' health education by providing additional training.
GRATITUDE
The study team wants to thank social workers at "Od" complex school and the school # 1 for their help in administering the study and organizing the training. We also thank the 8th grade girls for their participation in the study.
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5. Health Education textbook, 7th grade. Mongolia. [Electronic Resource]. URL: https://econte nt.edu.mn/book/7rangi/ (date of access: 20.11.2020).
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