Adolescent Reproductive and Sexual Health (ARSH): What do tribal schoolgirls know and do?
Abstract
Adolescents (10-19 years) constitute 21.4% of India’s population. A healthy adolescence is the corridor to a healthy adulthood. However, many aspects of adolescent health, particularly reproductive and sexual health, are not well understood. This is especially true of marginalised populations like tribals. This study intended to assess the knowledge, attitude and practices of tribal schoolgirls regarding menstruation, pregnancy and HIV/AIDS.
A cross-sectional study was conducted among 100 post-pubertal schoolgirls (10-19 years) in a tribal residential school in Kanyakumari district. The nearest school for tribal children was selected. Permission was obtained from concerned authorities. After stratifying the school girls by grade, systematic random sampling was employed to select the study subjects. The purpose of the study was explained and verbal consent was obtained. Data collection was done using a pre-tested, anonymous, self-administered questionnaire. Data entry and analysis was performed using Epi Info version 3.5.6. Chi-square test and Fisher’s exact test were used to test for statistical significance. A p value of ≤ 0.05 was considered statistically significant.
Mean age at menarche was 13 yrs. Only 33% of the school girls were aware of menstruation before they attained menarche. Of these, 17(52%) said that their mother was the source of information. 71% were scared and anxious during their first menstruation. 69% used sanitary napkins. 37% were unaware of symptoms of pregnancy and only 47% knew that pregnancy can be avoided. Only 24% mentioned un-protected sex as a route of HIV transmission. Higher grade students (11th, 12th) were significantly associated with seeking treatment for menstrual problems (p=0.01); and with better awareness about modes of HIV/AIDS transmission (p=0.03). Lower grades (9th, 10th) were significantly associated with awareness of methods to confirm pregnancy (p=0.007).
The study concludes that there is considerable anxiety among tribal school girls surrounding menarche, probably due to a lack of prior knowledge about the event. The overall lack of awareness regarding pregnancy and contraception indicates an increased vulnerability to unintended pregnancies. Awareness regarding HIV/AIDS though present, misconceptions persist about the spread and outcome of the disease.
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