Teachers as School Health Agents: Exploring Views on School-Based Menstrual Health Management
Creators: name: Shenkman, Julia
Publisher: name: DigitalHub. Galter Health Sciences Library & Learning Center
Year: 2020
Subjects: subject: teachers
subject: school
subject: menstrual education
subject: health management
subject: adolescents
subject: Menstruation
subject: Schools
subject: Education
subject: Adolescent

description: Objective: This study seeks to understand the role that teachers, menstrual education, and school facilities play as mediators and barriers to Menstrual Health Management.Method: Focus groups discussions with teachers were conducted in conjunction with the Menstrual Solutions (MS) study, an open cluster randomized proof of concept study with three treatment arms: usual, pads, and Mooncup. Six schools were randomly selected out of the 30 in the study, two from each study arm. Given the nature of the MS study, focus groups were conducted at three different points, baseline, follow up 1, and follow up 2. Topics focused on: cultural attitudes, menstrual management techniques, impact on education, the role of teachers in assisting adolescent girls, school curriculum on menstruation, the impact of sensitization, and the Mooncup.Results: There were an average of 10 participants per focus group discussion. The teachers primarily spoke on their personal experiences with students in their classes, which informed the following emerging themes: embarrassment and blood, concerns of absenteeism, the role of teachers in MHM, and the impact of sensitization. Teachers noted that prior to the study, adolescent girls would absent themselves for 3-5 days during their menstrual cycle depending on what materials they could use. They would often shy away from teachers when possible, and only speak to them about their menses if it was urgent or they needed to go home. Much of this shyness stemmed from traditional values that dictated that menses be private due to their association with sex, or embarrassment as a result of stains and odor. Sensitization that occurred during the study, in addition to the menstrual items, positively impacted academic performance, according to the teachers. They described the girls as confident and free with them about their menses in follow up discussions.Discussion: Teachers attitude and knowledge of MHM influenced how adolescent girls navigated their menses at school. Teachers who were considered trustworthy were approached by girls more often than those girls felt would tell others about her menses. In the school setting, teachers were sometimes the first to explain what menses were to girls experiencing it, making them an important influencer in how they learned to manage it. Teachers across all treatment arms saw the impact of this on girls' management of their menses and personal hygiene. These girls were also freer with their teachers, who saw them become more confident and open about their menses, improving the teachers ability to support students. The study also saw the creation of the menstrual champion, a girl who shared what she learned in the puberty education classes with her peers so they could more effectively manage their menses. This knowledge may influence changes to school menstrual education, as it is an important mechanism for empowering girls to take control of their menses.