1.0 Introduction

This chapter examined the background of the study, problem statement, significance of the study, the main objectives, specific objectives, the research questions, and the conceptual framework of the study.

1.2 Background of study

The onset of menstruation is one of the most significant milestones in a woman‟s life (Polat et al., 2009). Menstrual hygiene which is defined as the effective management of menstrual bleeding by females, is a principal aspect of reproductive health, that if not handled properly could facilitate infections of the urinary tract, vaginal thrush and pelvic inflammatory diseases, along with bad odour, unclean garments and extreme shame, causing infringement on the girl’s‟ dignity (Oche et al., 2012).

Worldwide, approximately 52% of the females are of reproductive age; hence menstruation is part of their normal life. Menstrual hygiene therefore is a fundamental aspect of basic hygienic practices (House et al., 2012). 56% of the girls are in and out of school and do not receive any information about menstruation (UNICEF, 2014). In India, for the absorption of menstrual blood, 88% used cloth, 4% used cotton wool, 7% sanitary pads while 3% used ash. In Nepal 75% of the adolescent secondary school girls do not have any idea about what material to use to absorb the flow (Water Aid, 2013). 23% of the adolescent girls in rural areas of India, having their period are one of the reasons to quit school. Nonetheless, not much attention is paid to the specific health needs of the girl‟s (Nagar et al., 2011).

In Africa about 1 in 10 school age adolescent girls absent themselves from school during periods or drop out at puberty because of lack of private, clean and hygienic sanitation facilities in schools (UNICEF, 2014). In Nigeria 91 % of the adolescent girls were aware of menstruation before starting their periods, their use of sanitary protection material was low at

27.6 % and 64.4 % used pieces of cloth and rags, 25% use nothing, and typically isolate themselves during menstruation and 11% of girls in Nigeria change their menstrual cloths once a day. (Abera Y, 2014). 83% of girls in Burkina Faso and 77% in Niger have no place at school to change their sanitary materials (Iliyasu Z, 2012). All the above indicates poor knowledge, attitude and practice as far as menstrual hygiene is concerned.

In Uganda like most resource limited countries, menstruation, though a natural physiological process has been and still dealt with secrecy (Mahon and Fernandes, 2010). Majorly this is because of cultural and traditional taboos associated with sexuality and reproductive health. Cultural beliefs and norms, the physical infrastructure and socio- economic circumstances influence the practices associated with menstrual hygiene, some of which when coupled with lack of or inadequate knowledge are responsible for notably high rate of school absenteeism, along with withdrawal from social activities, illness, poor reproductive health and infections of adolescent girls in Uganda (Jarrah and Kamel, 2012).

Although menstruation is highly valued and significant for womanhood, still very few studies have found positive experiences towards menstruation in girls.

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