Lahme, A.M. & Stern, R. (2017). Factors that affect menstrual hygiene among adolescent
schoolgirls: a case study from Mongu District, Zambia.
Women's Reproductive Health, 4(3): 198-211.
Factors that affect menstrual hygiene among adolescent schoolgirls:
a case study from Mongu District, Zambia
Anne Mutunda Lahme and Ruth Stern
Menstruation is both a public health concern that requires hygienic management and a
human rights issue that demands dignity and health. We conducted six focus groups with 51
respondents from three secondary schools in Mongu District, Western Province, in Zambia
to explore factors that influence adolescent girls’ understanding, experiences, and practices
of menstrual hygiene. Thematic content analysis was used to identify multiple interrelated
problems that stem from (1) culture and traditional practices, (2) inadequate accurate health
information, and (3) poverty-related conditions. The girls faced menstruation-related
inconveniences, bullying and humiliation, stress, infections, poor school attendance and
performance, and dropped out of school. Policy recommendations are included.
Menstruation is a normal biological process, central to the reproductive health of post-
menarchal girls and women. It is also a public health issue that requires basic prerequisites
(e.g., appropriate absorbents, reliable access to water, sanitation) to manage it hygienically.
Further, menstruation is a health rights issue, insofar as every person has the right to manage
her menses in a dignified and healthy manner, free of insult or mistreatment.
Menstruating women are protected by multiple human rights laws and norms. The Universal
Declaration of Human Rights, for example, states that “all human beings are born free and
equal in dignity and rights” (UN, 1948). This norm protects people from any form of ill
treatment or abuse, whether social, mental, or physical. Zambia is one of the signatory
countries. The concept of a right to health has been enumerated in several international
agreements. These include the International Covenant on Economic, Social, and Cultural
Rights (UN, 1976), the Convention on the Elimination of all Forms of Discrimination
Against Women (UN, 1979), and the Convention on the Rights of the Child (UN, 1989). The
right to health includes the economic, social, and cultural conditions required to attain a
universal minimum standard of well-being. The right to menstruation-related hygiene falls
under the right to health. The UN General Assembly has declared access to clean drinking
water and sanitation a human right and has noted that water is a prerequisite to the
fulfillment of all other human rights (UN, 2010). Sanitation pertains closely to the ability of
schoolgirls to manage their menses in a healthy and dignified manner. The African Charter on
the Rights and Welfare of the Child similarly requires the protection of children’s rights;
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