More than 60% of the adolescent schoolgirls in Bhutan stated that a woman must not enter a shrine or temple during menstruation, according to a recent study on Menstrual Hygiene Management (MHM) of adolescent schoolgirls and nuns.

The study by the education ministry and UNICEF highlights the knowledge, attitude, and practices of menstrual hygiene management of adolescent schoolgirls aged between 10-19 years and nuns in the country. Schools in the country observed Menstrual Hygiene Management day on May 28.

The study found that although menstruation is a normal biological process, it is considered as something negative, dirty or shameful in various cultures. Although about 42.2% of schoolgirls stated that they were aware of the fungal infection, more than half of the respondents (57.1%) said that they were unaware of the reproductive tract infection related to poor menstrual hygiene.

It was also found that more than 40% of nuns didn’t know at all about infections related to poor menstrual hygiene management. More than half of the nuns were unaware of the Urinary Tract Infection. “About 7.1% of nuns who responded stated that menstruation is a curse while about 5.4% said it was a disease,” the study states.

It found that more than half of the adolescent nuns reported that they missed class or activity during menstruation since there is no place to the dispose-off sanitary pad. “Lack of sanitary pads and dirty toilets were other reasons for missing classes or activities.”

About 90% of respondents said that they attended school despite menstruation, while half of the schoolgirls reported taking rest during menstruation. However, it was found that about 44.7% stated that they missed school from one to four days during every cycle. “Pain and discomfort were the predominant reasons given for school absenteeism,” the study revealed.

The study found that religious taboos were found to be prevalent among nuns. About 33.2% of nuns stated that women in menstruation are susceptible to get possessed by evil spirits. "More than 76.58% of the adolescent nuns stated that it was important to buy pads without being seen,” the report stated.

The report found that adolescent girls often risk their health using unhygienic clothes and even miss out classes during menstruation. “More than half (57%) of the respondents agreed that they got easily upset during pre-menstrual and menstrual periods than other times.”

The study also found that more than 50% of women agreed that women are more tired than usual when they are on menstruation.Nearly 90% of respondents stated that they used sanitary pads with others either using napkins, cloths or towel. “However, about three percent of the adolescent schoolgirls did not use any kind of absorbent material.”

In cases of special children, the study found that teachers suggested parents to keep their child at home during menstruation as the school lacked the capabilities to help them. “All participants of focused group discussion unanimously agreed that they didn’t have enough WASH facilities to combat menstruation in their schools,” the report stated.

The study also revealed that respondents in MHM programme intervention schools had good knowledge of menstruation than non-intervention schools. About 1,526 schoolgirls and 202 nuns were interviewed for the study.

The study also recommended the education ministry to establish disabled-friendly WASH facilities and to support the installation of the incinerator to burn sanitary pads. Other recommendations include the need of the School Health and Nutrition Division (SHND) to spearhead the development of checklist to account for schools and nunneries.