Implications for Health Communication Campaigns and Interventions

Running head: PROPOSAL
A public health initiative to improve menstrual health practices, knowledge and attitudes
amid adolescent girls.
Name of the Student
Name of the University
Author Note

PROPOSAL1
Introduction
This research proposal will elaborate on a public health initiative that will advance
menstrual health knowledge, practices, and attitudes amid adolescent girl students, within the
population of Delhi. The proposal will also elucidate the actions that are imperative for
gaining a sound and comprehensive understanding of the underlying factors that govern poor
menstrual health of the target population and the challenges that are faced by the adolescent
girls, in relation to maintenance of menstrual health and hygiene. Public health initiatives
typically encompass strategies that educate the wider population about healthier life choices,
facilitate good lifestyle by delivering community support, and prevent the spread and
outbreak of communicable and infectious diseases (Pate & Dowda, 2019). The proposal will
play a significant role in health promotion since it will enable individuals to gain an increased
influence their health and will foster their wellbeing. The health initiative will commence at
the beginning of the year 2020 and will continue till the end of the year. Assessment and
evaluation of the program will be done during the middle point, with the aim of guaranteeing
that the strategies being adopted are on the right track and will help in accomplishment of the
intended goals and objectives. This will be followed by completion of a summative
assessment during the end stages that will facilitate identification of necessary actions that are
imperative for improving practice.
According to Ray, Goswami and Roy (2016) the commencement and progress of
menstruation often coincides with a range of vulnerabilities and opportunities during the
adolescent years. Menstrual hygiene management (MHM) typically refers to the
circumstance when adolescent girls and women utilise clean materials for collecting or
absorbing their menstrual blood, which can be change in private, as and when required, with
the usage of water and soap for washing the body. In addition, it also encompasses proper
access to amenities that allow the girls and women to accurately dispose of the used materials

PROPOSAL2
(Sommer et al., 2016). Menstrual health is largely built on the aforementioned notion and
includes the wider influences of the socio-political, psychological, and environmental
features that go along with menstruation on physical, mental, and emotional health.
Menarche, or the onset of menstruation in a female has been identified as a vital marker of
health that characterises the transition of the female from childhood to adolescent stage.
However, often it has been found that pre-adolescent and adolescent girls are not equipped
with adequate support and information prior to, and after this transition, thereby making them
unprepared for the safe, comfortable, and confident management of menstrual health
(Hennegan, Dolan, Wu, Scott & Montgomery, 2016). This lack of awareness and information
creates significant negative influence on the health and reproductive life of the girls.
Additionally, the perception about puberty onset in a girl is rarely a positive experience. All
across the globe, the event of menstruation is met with stereotype and silence, thus causing
infection, constrained mobility, lack of financial participation and even death (Muralidharan,
2019). Menstrual health is generally surrounded by disgrace, anxiety, awkwardness, and pain
and occasionally even augmented by social standards that underpin harmful practices (Sahin,
2015). This calls for the need of addressing menstrual health challenges amid adolescent
girls.
Justification for the topic
The menstrual health of a woman is significant to her wellbeing. However, in several
parts of the developing world, institutional biases, customs, and mindsets prevent females
from obtaining the much needed menstrual care. Menstruation is correlated with the
commencement of puberty amid females and it is concomitant with isolation, restriction, and
altered expectations of the society from the girls (van Eijk et al., 2016). This change in
outlook towards females such as, limitations imposed on their schooling, mobility, self-
expressions and freedom. According to Rastogi, Khanna and Mathur (2019) lack of

PROPOSAL3
awareness and knowledge regarding menstruation and the discrimination and silence
concerning it is a significant risk factor for all females. The researchers found that only 40%
girls were aware of menstruation, before their menarche and an estimated 95.7% were not
aware about the source of menstrual blood. In addition, there were 17% girls who considered
women to be impure during their menstruation cycle. A study by Yagnik (2015) also affirmed
that while attitude, knowledge and cognitive involvement with menstrual practice were high,
females and males demonstrated low behavioural involvement. They confirmed that there
existed a positive correlation between greater knowledge about menstruation with lack of
negative sentiments and annoyance amid males. Moreover, increased knowledge was also
associated with better adoption of correct and safe menstrual practices amid females.
Sivakami et al. (2019) also conducted surveys to explore the challenges associated to
menstruation and found that greater number of girls (14.1 years mean age) were
knowledgeable about menstruation before menarche at particular model schools (56%, n =
492) compared to regular schools (36%, n = 2072, P < 0.001). Not only did menstruation
affect their school attendance (6% vs 11%, P = 0.003) and concentration (40% vs 45%, P =
0.1), but was also correlated with fear of smell and/or stain (11% vs 16%, P = 0.002) and pain
symptoms (31% vs 38%, P = 0.004). This was in accordance to the findings by Kaur, Kaur
and Kaur (2018) who mentioned that incorrect, little, or inadequate information about
menstruation is a pronounced barrier to MHM. Females have little or no information
regarding reproductive tract infections owing to their unfamiliarity with personal hygiene at
the time of menstruation. Moreover, lack of access to sanitary products in remote regions and
poor familiarity with the methods and types of using them, besides their high costs force the
females to depend on reusable cloth pads. The aforementioned findings are affirmed by
reports from the National Family Health Survey (NFHS-4), which stated that there are an
estimated 355 million menstruating females in India, who are subjected to a range of barriers