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Ahmed T, Hasan MK, Aunto TK, Ahmed T, Zahid D. Menstrual hygiene knowledge and practices among adolescent schoolgirls in flood-affected rural Bangladesh. Reprod Health 2025; 22:87. [PMID: 40394573 PMCID: PMC12093784 DOI: 10.1186/s12978-025-02041-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2024] [Accepted: 05/12/2025] [Indexed: 05/22/2025] Open
Abstract
OBJECTIVES This study aimed to evaluate the level of knowledge and practices related to menstrual hygiene among adolescent schoolgirls in a flood-affected rural area of Bangladesh and identify the factors influencing their menstrual hygiene knowledge and practices. METHODS A cross-sectional study was conducted in northern Bangladesh between May 25 and June 1, 2023, involving 448 adolescent girls in the flood-affected region. Data was collected through a self-administered descriptive questionnaire. The collected data was entered and analyzed using SPSS 26.0 (IBM SPSS, Chicago, IL, USA). Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine significant variables through multivariate binary logistic regression models. RESULTS The study found that more than half (69%) of the in-school adolescent girls had good knowledge about menstrual hygiene, while only one-fourth (28.6%) demonstrated good menstrual hygiene practices. Remarkably, only 1.6% of the girls disposed of their used sanitary napkins in dustbins. The results also indicated that girls aged 17 to 19 [AOR = 7.78, 95% CI: 1.83-32.99] and those from middle-class families [AOR = 0.51, 95% CI: 0.31-0.85] showed a significant positive association with menstrual hygiene knowledge. Additionally, the study revealed that the respondents' mothers' education level, particularly having secondary or higher education [AOR = 1.69, 95% CI: 1.04-2.77], was significantly associated with better menstrual hygiene practices. CONCLUSIONS The findings underscore the low level of menstrual hygiene practices among the respondents, emphasizing the urgent need for action. This highlights the urgency of enhancing awareness about the significance of adopting good menstrual hygiene practices. Therefore, it is imperative to incorporate menstrual hygiene knowledge and practices into school curricula and to organize meetings and sessions with schoolgirls' parents, stressing the importance of community support in addressing this issue.
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Affiliation(s)
- Tamima Ahmed
- Institute of Disaster Management and Vulnerability Studies, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md Khalid Hasan
- Institute of Disaster Management and Vulnerability Studies, University of Dhaka, Dhaka, 1000, Bangladesh.
- Department of Human Development and Family Sciences, Texas Tech University, Lubbock, TX, 79415, USA.
| | - Tanjin Kabir Aunto
- Institute of Disaster Management and Vulnerability Studies, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Taufique Ahmed
- Institute of Disaster Management and Vulnerability Studies, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Dilara Zahid
- Institute of Disaster Management and Vulnerability Studies, University of Dhaka, Dhaka, 1000, Bangladesh
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Shrestha S, Thapa S, Bucha B, Kunwar S, Subedi B, Singh AR, Chapagain DD, Dhital R, Caws M. Effectiveness of menstrual hygiene management training to enhance knowledge, attitude, and practice among adolescents in Sindhupalchowk, Nepal. PLoS One 2025; 20:e0313422. [PMID: 39775536 PMCID: PMC11706381 DOI: 10.1371/journal.pone.0313422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 10/23/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Menstrual Health (MH) knowledge, attitude and practice (KAP) are highly affected by access to information regarding menstruation. Despite being included in the school curriculum, Sexual and Reproductive Health (SRH) education is often not delivered in practice. School-based educational interventions have been shown to be effective in promoting MH. METHODS A school-based study was conducted in Indrawati rural municipality of Sindhupalchowk district in Nepal. 427 participants (175 boys and 252 girls), aged 11-13, completed a questionnaire evaluating MH KAP before receiving a structured training module on MH provided by experienced trainers from Putali Nepal using the Menstrupedia tool. The questionnaire was repeated one month after the training. Pre and post intervention scores were compared to determine the effect of the intervention. Focus group discussions were also conducted to understand the perceptions of participants toward SRH teaching. Association of independent socio-demographic with dependent variables knowledge and attitude towards menstrual health were analyzed using MANOVA test. The Wilcoxon signed-rank test was used to compare the median outcome of the pre and post-test attitude and knowledge. The maximum possible score was 6 for MH knowledge. The total attitude score ranged 14 to 70. RESULTS The median knowledge score increased by 1 point (p = <0.001) and the median attitude score by 5 points (p = <0.001), one month after delivery of the intervention. Higher knowledge scores were significantly associated with Hindu religion, female gender, higher father's literacy, and mothers in an informal occupation on multivariate analysis. Higher attitude scores were significantly associated with Hindu religion while lower attitude scores were associated with a mother in an informal occupation. CONCLUSION The Menstrupedia comic educational intervention improved knowledge and attitude towards menstruation among Nepali adolescents. A scale-up of the Menstrupedia based intervention would significantly change knowledge and attitude towards menstruation in Nepali adolescents.
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Affiliation(s)
| | - Saki Thapa
- Birat Nepal Medical Trust (BNMT), Lazimpat, Kathmandu, Nepal
| | | | - Safal Kunwar
- Birat Nepal Medical Trust (BNMT), Lazimpat, Kathmandu, Nepal
| | - Bigyan Subedi
- Birat Nepal Medical Trust (BNMT), Lazimpat, Kathmandu, Nepal
| | | | | | - Raghu Dhital
- Birat Nepal Medical Trust (BNMT), Lazimpat, Kathmandu, Nepal
| | - Maxine Caws
- Birat Nepal Medical Trust (BNMT), Lazimpat, Kathmandu, Nepal
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Jahan F, Shuchi NS, Shoab AK, Alam MU, Bashar SMK, Islam K, Jahan H, Hasan M, Alam MM, Rahman M. Changes in the menstrual hygiene management facilities and usage among Bangladeshi school girls and its effect on school absenteeism from 2014 to 2018. Glob Health Action 2024; 17:2297512. [PMID: 38230656 PMCID: PMC10795776 DOI: 10.1080/16549716.2023.2297512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/12/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND The lack of menstrual hygiene management (MHM) information and facilities in schools is a major contributor to adolescent girls' school absenteeism in low- and middle-income countries like Bangladesh. OBJECTIVES This paper examines the changes over time in school MHM facilities, knowledge and perceptions among adolescent girls, in relation to school absenteeism between 2014 and 2018 in Bangladesh. METHODS We examined changes in MHM and school absenteeism among schoolgirls using nationally representative data from the Bangladesh National Hygiene Baseline Survey 2014 and National Hygiene Survey 2018. Given the repetitive nature of our data and its clustering within participants, our method included performing descriptive analysis, bivariate analysis, and multivariate Generalised Estimating Equation (GEE) modelling to analyse these changes. RESULTS Results showed that adolescent girls' menstruation-related absenteeism decreased between 2014 and 2018. Percentage of adolescents who missed school decreased from 25% to 14% (PD: -11; CI: -16 to -6.1), while the average number of missed days reduced from 2.8 to 2.5 (PD: -0.33; CI: -0.57 to -0.10). In the GEE model, we found that living in rural areas (coef: -5.6; CI: -10.06 to -1.14), parental restrictions on going outside (coef: 4.47; CI: 0.75 to 8.2), education levels of girls (coef: -9.48; CI: -14.17 to -4.79), girl's belief that menstruation affects school performance (coef: 23.32; CI: 19.71 to 26.93), and using old cloths (coef: -4.2; CI: -7.6 to -0.79) were significantly associated with higher absenteeism. However, participant's age, type of school, knowledge of menstruation before menarche, receiving information regarding MHM, separate place for changing absorbents, and separate latrine and urine facility were not significantly associated with the changes in absenteeism over time. CONCLUSION This paper emphasised the associations between changes in school absenteeism, parental restrictions on students, students' education levels, and menstruation-related misperceptions. Ongoing research, policy reviews, and targeted interventions to improve MHM perceptions among girls are required to provide long-term benefits for adolescent girls in Bangladesh.
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Affiliation(s)
- Farjana Jahan
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Noshin Sayiara Shuchi
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Abul Kasham Shoab
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mahbub-Ul Alam
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- School of Civil Engineering, University of Leeds, Leeds, UK
| | - Sk. Md. Kamrul Bashar
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Khairul Islam
- WaterAid, South Asia Region Bangladesh, Dhaka, Bangladesh
| | - Hasin Jahan
- WaterAid, South Asia Region Bangladesh, Dhaka, Bangladesh
| | - Mahadi Hasan
- WaterAid, South Asia Region Bangladesh, Dhaka, Bangladesh
| | - Md. Masud Alam
- Demography and Health Wing, Bangladesh Bureau of Statistics, Dhaka, Bangladesh
| | - Mahbubur Rahman
- Environmental Health and WASH, International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Shanza Afzaal S, Lnu S, Tahir S, Javed H, Saeed A, Ashal Pal MH, Islam M, Qammar B. Awareness and Practices of Menstrual Hygiene Among Rural Adolescent Schoolgirls in Lahore, Pakistan: A Cross-Sectional Study. Cureus 2024; 16:e73899. [PMID: 39697906 PMCID: PMC11655083 DOI: 10.7759/cureus.73899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2024] [Indexed: 12/20/2024] Open
Abstract
Background Empowering adolescent girls with accurate data, a supportive environment, and access to resources is crucial for promoting their dignity and educational success, thereby enabling gender equity and social development in rural communities. Aim This research aims to assess the knowledge and practices of menstrual hygiene among adolescent girls in schools within the rural community of Lahore, Pakistan. Methodology This research employed a quantitative, cross-sectional design, with a survey conducted among 108 participants in Lakhodair Sharif Bakra Mandi, Lahore, Pakistan. Purposive sampling was used to select participants within the specified age range (e.g., 12-19 years old). Results The results indicate that 91 participants (84.25%) were aged 13-15 years, followed by 12 participants (11.11%) in the 16-18 age range. Four participants (3.70%) were aged 10-12 years, and only one participant (0.92%) was aged 19 or older. In terms of grade level, 71 participants (65.74%) were in grade 8, 29 participants (26.85%) were in grade 7, six participants (5.55%) were in grade 6, and two participants (1.85%) were in grade 5. Correlation analysis revealed a strong, positive correlation between menstrual hygiene knowledge and practice, with a correlation coefficient of 0.649 (p < 0.001). Conclusions This research found that individuals from rural areas of Lahore demonstrated a strong understanding of menstrual hygiene, reflecting high levels of knowledge. A positive relationship was observed between knowledge and hygiene practices. Additionally, the findings revealed that participants held positive attitudes toward menstrual hygiene, although they expressed concerns about abdominal pain, as well as challenges related to accessing facilities and ensuring privacy at schools.
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Affiliation(s)
| | - Shahzeb Lnu
- Obstetrics and Gynecology, Lahore General Hospital, Lahore, PAK
| | | | - Hamna Javed
- Forensic Medicine, University Medical & Dental College, Faisalabad, PAK
| | - Adil Saeed
- Internal Medicine, Jinnah Hospital, Lahore, PAK
| | | | - Maryyam Islam
- Research and Innovation, Shalamar Medical and Dental College, Lahore, PAK
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Roy D, Kasemi N, Halder M, Majumder M. Factors Associated with Exclusive Use of Hygienic Methods during Menstruation among Adolescent Girls (15-19 Years) in Urban India: Evidence from NFHS-5. Heliyon 2024; 10:e29731. [PMID: 38681554 PMCID: PMC11046189 DOI: 10.1016/j.heliyon.2024.e29731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024] Open
Abstract
Background Menstrual hygiene is a critical public health concern for adolescent girls in urban India. However, there is a paucity of research on this subject, particularly on a national scale. To the best of our knowledge, this study diverges from previous research, as the majority of prior investigations in India have centered on rural locales, married individuals, and those aged between 15 and 24 years. Thus, this study aims to fill this gap by investigating the factors associated with the exclusive use of hygienic methods during menstruation among urban adolescent girls (15-19 years) in India. Method A total of 25136 samples were included in this analysis from the National Family Health Survey 5 (NFHS-5). The Binary logistic regression model has been administered to determine the associated factors of the exclusive use of hygienic methods among adolescent girls. Results The results of the multivariate model revealed significant positive associations between higher education levels and usage of menstrual hygiene management products (AOR: 1.860; 95 % CI: 1.418-2.439), (AOR: 2.110; 95 % CI: 1.553-2.867). Additionally, individuals in higher wealth quintiles were more likely to use MHM products, with the richest quintile showing the highest likelihood (AOR: 5.310; 95 % CI: 4.494-6.275). Attendance at cultural events such as cinema or theater was positively associated with MHM product utilization (AOR: 1.338; 95 % CI: 1.181-1.517).Conversely, Lack of access to sanitation facilities was inversely associated with MHM product utilization (AOR: 0.742; 95 % CI: 0.628-0.877). Muslim girls had lower odds than Hindus (AOR: 0.576; 95 % CI: 0.520-0.637). Substantial regional variations were evident, with the Western (AOR: 0.879; 95 % CI: 0.759-1.019), Eastern (AOR: 0.747; 95 % CI: 0.654-0.854), Central (AOR: 0.349; 95 % CI: 0.313-0.388), and North-eastern regions (AOR: 0.597; 95 % CI: 0.490-0.727) displaying diminished odds of MHM product usage relative to the southern region. General caste had higher odds compared to scheduled caste (AOR: 1.255, 95 % CI: 1.103-1.429), while other backward caste had lower odds (AOR: 0.858, 95 % CI: 0.771-0.955). Conclusion These findings underscore the importance of addressing inequalities in access to menstrual hygiene products among urban adolescent girls in India. Targeted interventions and educational programs are essential to ensure equitable access and promote overall health and well-being.
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Affiliation(s)
- Doli Roy
- Department of Geography, Raiganj University, Raiganj, 733134, West Bengal, India
| | - Nuruzzaman Kasemi
- Department of Geography, Raiganj University, Raiganj, 733134, West Bengal, India
| | - Manik Halder
- Department of Geography, Raiganj University, Raiganj, 733134, West Bengal, India
| | - Malasree Majumder
- Department of Political Science, Raiganj University, West Bengal, India
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Adane Y, Ambelu A, Azage Yenesew M, Mekonnen Y. Menstrual hygiene management practices among schoolgirls in resource-limited settings of Bahir Dar City administration, Northwestern Ethiopia. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241308343. [PMID: 39691973 PMCID: PMC11653455 DOI: 10.1177/17455057241308343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 11/19/2024] [Accepted: 12/03/2024] [Indexed: 12/19/2024]
Abstract
BACKGROUND Schoolgirls in resource-limited settings encounter significant challenges in maintaining proper menstrual hygiene management practices. Studies on associated factors in menstrual hygiene management practices among schoolgirls in Bahir Dar City are limited. OBJECTIVES The study aimed to evaluate the menstrual hygiene practices of schoolgirls and identify factors that influence these practices in the limited settings of Bahir Dar City. DESIGN This study was a school-based, analytical, cross-sectional study conducted among schoolgirls between the ages of 11 and 25. METHODS A total of 701 schoolgirls, selected at random based on their consent, participated in this school-based, analytical, cross-sectional study. The data collection process was comprehensive, involving a self-administered questionnaire and 5 rounds of observations at 10 schools using the Joint Monitoring Program for Water, Sanitation, and Hygiene monitoring tool. The study used a binary logistics regression model to determine the strength of the association between predictor and outcome variables, ensuring a rigorous analysis with a p-value < 0.05. RESULTS In this study, 375 (53.50%) participants were found to have good menstrual hygiene practices. Factors such as the mothers' education (diploma and above vs not read and write (AOR = 26.29, 95% CI: 11.69-59.12), fathers' education (diploma and above vs not read and write (AOR = 19.21, 95% CI: 8.51-43.32), having access to basic water service (AOR = 14.62, 95% CI: 5.12-41.73), having access to basic sanitation services (AOR = 21.02, 95% CI: 7.87-56.15), being older among the schoolgirls (AOR = 19.69, 95% CI: 10.18-38.07), having private work (AOR = 15.58, 95% CI: 6.99-34.73), having open discussions with sisters (AOR = 27.01, 95% CI: 11.45-63.73), having friendly discussions about menstrual hygiene with schoolgirl friends (AOR = 18.67, 95% CI: 8.45-41.24), and residing in urban areas (AOR = 6.43, 95% CI: 3.52-11.73)) were significantly associated with good menstrual hygiene practices. CONCLUSION The schoolgirls in the study area had good menstrual hygiene practices. However, uneducated parents, inadequate facilities, limited access to absorbent materials, and lack of support were challenges that affected proper menstrual hygiene management practice. To improve menstrual hygiene practices, it is crucial to address these identified modifiable factors and consider education programs, better facilities, community support, and policy changes that prioritize menstrual hygiene management in schools for schoolgirls to manage menstruation.
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Affiliation(s)
- Yimenu Adane
- Water and Health Division, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
| | - Argaw Ambelu
- Water and Health Division, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
| | - Muluken Azage Yenesew
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yalemtsehay Mekonnen
- College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Onubogu CU, Umeh UM, Mbachu CNP, Nwazor OC, Ofiaeli OC, Nwagbara NE, Chilaka UJ, Ijezie NA, Ajator CC. Menstrual hygiene practices of adolescent secondary school girls in rural Anambra communities. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241228204. [PMID: 38318680 PMCID: PMC10846034 DOI: 10.1177/17455057241228204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/29/2023] [Accepted: 01/08/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Adolescent girls face numerous challenges which hinder their ability to manage menstruation in a healthy and dignified manner. OBJECTIVES To examine the menstrual hygiene practices of adolescent girls schooling in rural Anambra communities. STUDY DESIGN Cross-sectional descriptive study. METHOD Participants were selected using multistage stratified random sampling technique and interviewed using self-administered semi-structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22.0. RESULTS Mean age of all, pre-menarche and post-menarche girls were 14.7 ± 1.84, 12.8 ± 1.09 and 15.1 ± 1.73 years, respectively. About 46% of the pre-menarche girls had not received any information on menstruation. Common sources of initial menstruation information were mother (87.3%), school (52.2%) and peers (20.0%). Among the 1091 (85.0% (1091/1283)) post-menarche girls, last menstrual period, last menstrual period duration and cycle length could not be recalled by 53.9%, 34.4% and 39.3%, respectively. Majority (98.3%) who could recall last menstrual period had a cycle length of ⩽30 days and the mean duration of menses was 4.4 ± 0.84 days. Disposable sanitary pad was mostly (60%) cited as recommended product, but cloth/rags (40.6%) or tissue paper (32. 3%) were predominantly used. Majority (88.6%) took their bath ⩾twice/day, 50.9% changed sanitary product ⩽twice/day while 72.5% exhibited poor hand washing. Sanitary products were mostly discarded by burning (45.4%). Fifty-one percent could not change in school predominantly due to lack of functional toilets/changing rooms (84.2%) while 72.5% of those who changed did so in bushes or unused spaces. Challenges faced during menstruation include restriction from holy places (38.9%), waist pain (74.9%), blood stains (36.1%) and lack of money to buy pad (27.0%). Factors significantly associated with using commercial pads were age (p = 0.047), class (p = 0.006), mother's educational status (p < 0.001), social class (p < 0.001), ability to recall last menstrual period date (p = 0.029) or duration (p = 0.001). CONCLUSION Menstrual hygiene management was unsatisfactory among studied adolescents. Continuous education of adolescent girls on menstrual hygiene management and advocacy for adequate menstrual hygiene management support are imperative.
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Affiliation(s)
- Chinyere Ukamaka Onubogu
- Paediatrics Department, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
- Paediatrics Department, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Uche Marian Umeh
- Community Medicine Department, Chukwuemeka Odumegwu Ojukwu University, Awka, Nigeria
- Community Medicine Department, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | - Chioma Ngozichukwu Pauline Mbachu
- Paediatrics Department, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
- Paediatrics Department, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Onyinye Chinenye Nwazor
- Community Medicine Department, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | - Ogochukwu Chioma Ofiaeli
- Paediatrics Department, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
- Paediatrics Department, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
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Siddique AB, Deb Nath S, Mubarak M, Akter A, Mehrin S, Hkatun MJ, Parvine Liza A, Amin MZ. Assessment of knowledge, attitudes, and practices regarding menstruation and menstrual hygiene among early-reproductive aged women in Bangladesh: a cross-sectional survey. Front Public Health 2023; 11:1238290. [PMID: 38089036 PMCID: PMC10713719 DOI: 10.3389/fpubh.2023.1238290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Background Poor menstrual hygiene practices during menstruation increases the risk of reproductive tract infections, absenteeism, and negative impact on school performance. Despite being a global problem, there is a lack of knowledge and misconceptions about menstrual hygiene among women of all ages, especially in developing countries like Bangladesh. The study aims to assess the knowledge, attitudes, and practices toward menstrual hygiene among early reproductive-aged women in Bangladesh to help policymakers and planners take effective initiatives. Methodology A cross-sectional survey was conducted between July and December 2022 in Dhaka, Rajshahi, Chittagong, Sylhet, and Barisal regions of Bangladesh. A convenience sampling technique was utilized to recruit a total of 1,214 participants (100% female; mean age: 22.87 ± 2.64 years). A semi-structured questionnaire including informed consent, socio-demographic information, as well as questions regarding knowledge (6-item), attitudes (7-item), and practices (6-item) toward menstruation and menstrual hygiene practices, was used to conduct the survey. All analyses were performed using the STATA (Version 15.0) and Statistical Package for the Social Sciences (SPSS version 25.0). Result The mean scores of the knowledge, attitudes, and practices were 4.9 ± 1.51 (out of 6), 12.58 ± 1.58 (out of 14), and 8.80 ± 1.87 (out of 12), respectively. The higher scores of knowledge, attitudes, and practices were significantly associated with several socio-demographic and menstruation-related factors (education, family type, type of menstruation, duration of menstruation, etc.). Conclusion This study identified several key factors associated with improved knowledge, attitudes, and practices related to menstrual hygiene, including higher education levels, student status, younger age, non-alcohol consumption, and regular menstrual cycles. To enhance menstrual hygiene practices among women, it is crucial to implement targeted interventions that address knowledge disparities and tackle social and environmental influences.
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Affiliation(s)
- Abu Bakkar Siddique
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, Bangladesh
- International Centre for Research, Innovation, Training and Development (ICRITD), Dhaka, Bangladesh
| | - Sudipto Deb Nath
- Army Medical College Jashore, Jashore, Bangladesh
- Department of Genetic Engineering and Biotechnology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Mahfuza Mubarak
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Amena Akter
- Department of Genetic Engineering and Biotechnology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Sanjida Mehrin
- Department of Political Studies, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Mst Jemi Hkatun
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | | | - M. Ziaul Amin
- Department of Genetic Engineering and Biotechnology, Jashore University of Science and Technology, Jashore, Bangladesh
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Saleh F, Ahmed KR, Khatun T, Roy N, Uddin S, Kabir MR. Effects of behavioural change communication (BCC) on menstrual hygiene practices among urban school adolescent girls: a pilot study. BMJ Nutr Prev Health 2023; 6:416-418. [PMID: 38618536 PMCID: PMC11009528 DOI: 10.1136/bmjnph-2023-000754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/25/2023] [Indexed: 04/16/2024] Open
Abstract
Background Research on menstrual hygiene management practices (MHMP) has yet to be conducted among adolescent girls in Bangladesh who have gained services from the Urban Primary Health Care Project (UPHCP). This study aimed to assess the effects of behavioural change communication activities on MHMP among urban school adolescent girls. Methods A convenience sample of 270 adolescent girls (aged 10-19) who had no chronic diseases from 5 schools in Dhaka city was selected using a descriptive cross-sectional design from February to May 2018. A semistructured (interviewer-administered) questionnaire was used. Frequencies were calculated for descriptive analysis. Results About 17% of girls had irregular menstrual cycles, 57% felt uneasy and 27% had >7 days of menstrual flow. Fifty-five per cent of the girls used sanitary napkins. Most (95%) and 26% of the girls did not change their pads during school and at night, respectively. Sixty-five per cent of girls disposed of the used pads at the public dustbin, and 83% bathed during menstrual. Only 4% of girls were aware of the iron folic acid tablets. Conclusions Despite the availability of services from UPHCP, the acceptance and adherence to MHMP among adolescent girls still need to be improved.
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Affiliation(s)
- Farzana Saleh
- Community Nutrition, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Kazi Rumana Ahmed
- School of Health & Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Health Promotion & Health Education, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Taslima Khatun
- Community Nutrition, Bangladesh University of Health Sciences, Dhaka, Bangladesh
- Public Health, National Cheng Kung University (NCKU), Tainan, Taiwan
| | - Nandini Roy
- Community Nutrition, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Sadia Uddin
- Community Nutrition, Bangladesh University of Health Sciences, Dhaka, Bangladesh
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Malik M, Hashmi A, Hussain A, Khan W, Jahangir N, Malik A, Ansari N. Experiences, awareness, perceptions and attitudes of women and girls towards menstrual hygiene management and safe menstrual products in Pakistan. Front Public Health 2023; 11:1242169. [PMID: 37744511 PMCID: PMC10513424 DOI: 10.3389/fpubh.2023.1242169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/16/2023] [Indexed: 09/26/2023] Open
Abstract
Background The taboo of menstruation, lack of discussion on puberty, misinformation and poor awareness on menstrual hygiene management and limited access to safe menstrual products can negatively impact the physical and mental health of women and girls residing in low middle income countries. Aim The aim of the study was to explore the experiences, awareness, perceptions and attitudes of women and girls towards menstrual hygiene management in Pakistan. Moreover, the study also assessed consumer satisfaction towards locally manufactured organic menstrual products. Methods A descriptive cross-sectional study design was used with a sample of 400 women and girls selected through convenience sampling from high schools, universities, outpatient department and gynaecological clinics located in 2 cities, i.e., Islamabad and Rawalpindi, Pakistan. A pre-structured questionnaire was used to explore experiences, awareness, perceptions and attitudes of women and girls towards menstrual hygiene management. Moreover, each respondent was provided with sample of locally designed and manufactured organic menstrual hygiene & wellness kit by a group of women researchers named "FemPure" including organic sanitary pads, feminine wellness mist and feminine wellness wash. The respondents were asked to use the products and a telephonic follow-up was conducted to assess consumer satisfaction for the products after a period of 1 month. Data was analyzed statistically using SPSS 21. Results The results of the study reported that 86.2% (n = 345) of the respondents had normal periods. Out of 400 respondents, 58.5% (n = 234) knew about any health conditions related to abnormal menstrual cycle while 88.3% (n = 353) were aware of female menstrual hygiene. Majority of the respondents 78.7% (n = 315) felt ashamed while buying sanitary pads. Out of 400 respondents, 5.4% (n = 22) were interested in getting awareness regarding menstrual hygiene. The results of the study showed that all the respondents (100%, n = 400) were satisfied with FemPure organic menstrual products. Conclusion The study concluded that majority of women and girls faced menstrual hygiene issues during and after the cycle and were eager to receive information on MHM and use organic rash free menstrual wellness products which could be ordered via mobile app. The respondents were satisfied after the use of FemPure organic menstrual products.
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Affiliation(s)
- Madeeha Malik
- Cyntax Health Projects, Contract Research Organization & Corporate Firm, Islamabad, Pakistan
| | - Ayisha Hashmi
- Cyntax Health Projects, Contract Research Organization & Corporate Firm, Islamabad, Pakistan
| | - Azhar Hussain
- Pak-Austria Fachhochschule: Institute of Applied Sciences and Technology, Haripur, Pakistan
| | - Waleed Khan
- Cyntax Health Projects, Contract Research Organization & Corporate Firm, Islamabad, Pakistan
| | - Nabia Jahangir
- Cyntax Health Projects, Contract Research Organization & Corporate Firm, Islamabad, Pakistan
| | - Anam Malik
- Cyntax Health Projects, Contract Research Organization & Corporate Firm, Islamabad, Pakistan
| | - Naima Ansari
- Islamabad Women Chamber of Commerce & Industry, Islamabad, Pakistan
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Talukdar IH, Rifat MA, Sarkar P, Saha N, Tessma MK, Miah MI. Perceived difficulties in maintaining menstrual hygiene practices among indigenous adolescents during seasonal water scarcity periods in Bandarban hill district of Bangladesh: A cross-sectional study. Int J Hyg Environ Health 2023; 254:114268. [PMID: 37778165 DOI: 10.1016/j.ijheh.2023.114268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/30/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Access to clean water is important for menstrual hygiene practices, an important aspect of health for adolescent girls. In Bangladesh, adolescent girls represent poor menstrual hygiene practices, whereas the practice is worse among vulnerable population groups living in areas experiencing seasonal water scarcity. This study portrays perceived difficulties in menstrual hygiene practices among indigenous adolescent girls during the period of seasonal water scarcity in Bandarban Hill District, Bangladesh. METHOD Data was collected from 242 indigenous adolescent girls through interviews during the period of water scarcity. Backward stepwise regression model was used to identify factors associated with perceived difficulty in maintaining menstrual hygiene (PD) practices. RESULT The study participants, mainly living in hard-to-reach areas, reported difficulty in getting adequate water during the water scarcity period, and the quality of water was reported to be poor. PD due to water scarcity was found to be significantly associated with water source degradation (β = 0.247, < 0.001), the need for boiling/purifying water before use for menstrual hygiene (β = 0.203, p = 0.005), and experience of water availability when it was necessary to maintain their optimal menstrual hygiene practice (β = 0.449, p < 0.001), time required to collect water (β = 0.209, p < 0.001), taking a bath every day (β = -0.228, p < 0.001), and frequency of washing genitals per day (β = - 0.094, p = 0.040). CONCLUSION Indigenous adolescents perceive difficulty in menstrual hygiene practices during the period of water scarcity. Further research could be carried out to observe to what extent the seasonal water scarcity could be attributable to worsen the menstrual hygiene practices and to identify the need for addressing the problems.
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Affiliation(s)
- Imdadul Haque Talukdar
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 17165, Stockholm, Sweden.
| | - M A Rifat
- Department of Global Public Health, Karolinska Institutet, 17176, Stockholm, Sweden.
| | - Plabon Sarkar
- Caritas Bangladesh, 2, Outer Circular Road, Shantibagh, Dhaka, 1217, Bangladesh.
| | - Nobonita Saha
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh.
| | - Mesfin Kassaye Tessma
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 17165, Stockholm, Sweden.
| | - Md Ibrahim Miah
- Department of Microbiology, University of Dhaka, Bangladesh.
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Delanerolle G, Yang XJ, Cavalini H, Kurmi OP, Røstvik CM, Shetty A, Saraswat L, Taylor J, Sajid S, Rathod S, Shi JQ, Phiri P. Exploratory systematic review and meta-analysis on period poverty. World J Meta-Anal 2023; 11:196-217. [DOI: 10.13105/wjma.v11.i5.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/18/2023] [Accepted: 05/06/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Period poverty is a global health and social issue that needs to be addressed. It has been reported that many females compromise their education, employment, and social commitments during their menstruation days due to a number of reasons, including lack of access to toilets or menstrual products.
AIM To provide a comprehensive understanding on period poverty, including outcomes associated with menstruation.
METHODS All observational and randomised clinical trials reporting menstruation challenges, menstrual poverty and menstrual products were included. Our search strategy included multiple electronic databases of PubMed, Web of Science, ScienceDirect, ProQuest and EMBASE. Studies published in a peer review journal in English between the 30th of April 1980 and the 30th of April 2022 were included. The Newcastle-Ottawa Scale was used to assess the risk of bias of the systematic included studies. Pooled odds ratios (ORs) together with 95% confidence intervals (CIs) are reported overall and for sub-groups.
RESULTS A total of 80 studies were systematically selected, where 38 were included in the meta-analysis. Of the 38 studies, 28 focused on children and young girls (i.e., 10-24 years old) and 10 included participants with a wider age range of 15-49 years. The prevalence of using disposable sanitary pads was 45% (95%CI: 0.35-0.58). The prevalence of menstrual education pre-menarche was 68% (95%CI: 0.56-0.82). The prevalence of good menstrual hygiene management (MHM) was 39% (95%CI: 0.25-0.61). Women in rural areas (OR = 0.30, 95%CI: 0.13-0.69) were 0.70 times less likely to have good MHM practices than those living in urban areas.
CONCLUSION There was a lack of evidence, especially from low- and middle- income countries. Further research to better understand the scope and prevalence of period poverty should be considered. This will enable the development of improved policies to increase access to menstrual products and medical support where necessary.
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Affiliation(s)
- Gayathri Delanerolle
- Department of Research & Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
- Nuffield Department of Medicine, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Xiao-Jie Yang
- School of Statistics and Mathematics, Yunnan University of Finance and Economics, Kunming 650221, Yunnan Province, China
- University College London, London WC1E 6BT, United Kingdom
| | - Heitor Cavalini
- Department of Research & Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
| | - Om P Kurmi
- Centre for Intelligent Healthcare, Institute of Health and Wellbeing, Coventry University, Coventry CV1 5LB, United Kingdom
| | - Camilla Mørk Røstvik
- Centre for Contemporary Art, University of St Andrews, Scotland KY16 9AJ, United Kingdom
| | - Ashish Shetty
- University College London, London WC1E 6BT, United Kingdom
- Pain Management Centre, University College London Hospitals NHS Foundation Trust, London W1T 4AJ, United Kingdom
| | - Lucky Saraswat
- Aberdeen Centre for Women’s Health, University of Aberdeen, Aberdeen AB24 3FX, United Kingdom
| | - Julie Taylor
- School of Nursing, University of Birmingham, Birmingham B152TT, United Kingdom
| | - Sana Sajid
- Department of Research & Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
| | - Shanaya Rathod
- Department of Research & Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
| | - Jian-Qing Shi
- Department of Research & Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
- Statistics and Data Science, Southern University of Science and Technology, Shenzhen 518055, Guangdong Province, China
| | - Peter Phiri
- Department of Research & Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom
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Akter M, Jamil S, Kabir H. Recognizing Rohingya adolescent girls' menstrual hygiene in Bangladesh to enhance reproductive health: a commentary. Ann Med Surg (Lond) 2023; 85:1304-1305. [PMID: 37113882 PMCID: PMC10129243 DOI: 10.1097/ms9.0000000000000283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/12/2023] [Indexed: 04/29/2023] Open
Abstract
The Rohingya, an ethnic minority group in Myanmar, have been subjected to decades of persecution and violence, forcing them to flee to neighboring countries such as Bangladesh. The correspondence recognizes Rohingya adolescent girls' menstrual hygiene in Bangladesh to enhance reproductive health. Adolescent girls make up 52% of the Rohingya population in the Cox's Bazar region's refugee camps, and there are few resources to help them manage their menstrual hygiene, posing significant health risks. Inadequate menstrual hygiene can result in sexual and urinary tract infections, infertility, and pregnancy complications. Most of the adolescent girls had poor menstrual hygiene practices. Unfortunately, only 10.89% of Rohingya girls wear underwear without disposable sanitary pads, and 17.82% use disposable sanitary pads. Furthermore, 67% of Rohingya girls do not have access to proper menstrual healthcare. Bangladeshi girls, on the other hand, have better access to menstrual hygiene products and have more good practices. There is a need to develop menstrual hygiene-friendly infrastructure as well as menstrual hygiene understanding and practices among the Rohingya. Authorities can help improve the current situation and promote healthy menstrual hygiene practices among Rohingya girls by implementing specific requirements, such as ensuring menstrual hygiene products.
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Affiliation(s)
| | - Safayet Jamil
- Department of Pharmacy, Khwaja Yunus Ali University, Sirajganj, Bangladesh
| | - Humayun Kabir
- Department of Public Health, North South University, Dhaka
- Corresponding author. Address: Department of Public Health, North South University, Dhaka 1229, Bangladesh. Tel.: +8801785811449; fax: +8801760785082. E-mail address: , (H. Kabir)
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Alkhatib A, Wu W, Alshikh Ahmad H, Pakwan Suwal R, Ni Z, Li X. The experiences of menstrual symptom changes among international students studying in China during the acculturation period: A phenomenology study. Int J Nurs Sci 2023; 10:221-229. [PMID: 37128482 PMCID: PMC10148257 DOI: 10.1016/j.ijnss.2023.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/06/2023] [Accepted: 03/15/2023] [Indexed: 03/28/2023] Open
Abstract
Objectives Menstruation is a normal physiological phenomenon among female which could be influenced by the process of acculturation. Few studies have explored the experience of menstrual symptom changes among international female students studying in China. Therefore, this paper aims to summarize international female students' experiences of menstrual symptom changes when they were studying in China and interpret these changes through considering the influence of acculturation on their social and academic lives. Methods We used a descriptive phenomenology approach. Structured in-depth face-to-face interviews were conducted between May and November 2019 among ten international female students studying in one Province located in south central China. Participants were those who reported having experienced menstrual symptom changes during the acculturation period, which was defined as the first six months of living in China. All interviews were audio-recorded, transcribed verbatim, and analyzed using NVivo 11.0 with the guidance of Colaizzi's seven-step method. Results The international female students' experiences of menstrual symptom changes were summarized and grouped into five main categories and 13 subcategories. The main categories include: 1) demonstration of menstrual symptom changes, 2) challenges of maintaining menstrual function in the new setting, 3) coping styles to take care of menstrual health, 4) consequences of the menstrual symptom changes, and 5) culture-based attitude toward menstruation. Conclusions International female students reported experiences of menstrual symptom changes, including somatic and psychological symptoms during the acculturation period. Culture barriers, academic stress, and sleep patterns are common factors influencing their menstrual symptom changes. More culturally-tailored interventions should be explored to improve the menstrual health of international female students in China.
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Affiliation(s)
- Asem Alkhatib
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- Faculty of Nursing, Hama University, Hama, Syria
| | - Weizi Wu
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
| | - Hoda Alshikh Ahmad
- Faculty of Nursing, Hama University, Hama, Syria
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Ratee Pakwan Suwal
- National Academy of Medical Science, Bir Hospital (NAMS), Mahaboudha, Kathmandu, Nepal
| | - Zhao Ni
- School of Nursing, Yale University, New Haven, CT, USA
- Yale Institute for Global Health, Yale University, New Haven, CT, USA
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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