Awareness about Reproductive Health Issues among the Adolescent Girls in a Rural Area of Bangladesh

Original article: Awareness about Reproductive Health Issues among the Adolescent Girls in a Rural Area of Bangladesh Nasreen Akther1, Meherunnessa Begum2, Tamanna Tasmin3, Khondoker Saif Imtiaz4, Ahmed Nawsher Alam5, Asma Begum6, Nadia Begum7 Abstract: Background: In Bangladesh there is a scarcity of data on the degree of knowledge among adolescents about reproductive health. Objective: To assess the awareness about reproductive health issues among adolescent girls in a rural area of Bangladesh. Materials and method: This descriptive type of cross sectional study was conducted among 148 adolescent girls who were selected purposively at Purba Chandara village of Kaliakair thana of Shafipur upazilla of Gazipur district in Bangladesh. A pre-tested semi structured questionnaire was used to collect data by face to face interview. Results: Most of the respondents (76.35%) were within the age group of 15-19 years. The average age of their menarche was 14 years. Majority of the respondents 136 (91.89%) had history of menstruation and 97 (65.54%) mentioned the duration of menstrual cycle > 7 days. Regarding the hygienic practice during menstruation, majority of them (68.24%) were unhygienic. About knowledge on age at marriage, 131 (88.51%) reportedly mentioned correct answer that marriage age is 18 years or more for girls. Regarding the knowledge on family planning and family planning methods, most of them (41.89%) had no knowledge. About the infection of reproductive tract, 87 (58.78%) had no knowledge and about half of the respondents (92; 56.79%) had no knowledge about symptoms of STDs. Conclusion: it is our responsibility to improve the condition of adolescent girls by giving clear and correct knowledge on reproductive health which will help them to maintain a good and sound reproductive health in future.


Introduction:
Adolescent is a cross road in the development of life through which a child gradually walks to reach the maturity of adults. 1 During this period, a child undergoes biological transition, which is characterized by puberty related changes in physical appearance and the attainment of reproductive capability. 2 Reproductive health includes needs for reproductive health care, family planning, HIV/AIDS information, safer sex, and unwanted pregnancy, complication of early pregnancy, sexually transmitted diseases (STDS), safe abortion and safe motherhood. 3 Adolescents face multifarious challenges and risks that produce an impact directly in their physical, emotional and spiritual well-being. 4 Furthermore, lack of access to information and services and societal pressure to perform as adults make the adolescents particularly vulnerable to health risks, especially in the area of reproductive health. 5 Young girls in Bangladesh reach in their adulthood with very little preparation and information about reproductive health, livelihood and life skills, and they are relatively in a disadvantageous position in all respects compared to men. 6 Socio-economic conditions, urban and rural beliefs and traditions become a barrier between proper information about reproductive health, contraceptives and family planning and the adolescents. This leads to a multitude of issues such as poor hygiene practices, discomfort during menstruation, early pregnancies, unsafe sex practices and other reproductive health issues such as sexually transmitted infections .These problems eventually cause emotional distress as well as physical discomfort. 6 Under the current Health and Population Sector Program (HPSP) of the Government of Bangladesh (GOB), adolescents have been identified as an under-served priority target group. 5 In some parts of the developing countries, still a culture of silence surrounds the topic of menstruation and related issues; as a result many young girls lack of appropriate and sufficient information regarding menstrual hygiene. This may result in inaccurate and unhealthy behaviour during their menstrual period. Also, many mothers lack of correct information and skills to communicate about menstrual hygiene which they pass on to their children, leading to false attitudes, beliefs and practices in this regard and resulting certain diseases like pelvic inflammatory diseases, urinary tract infection etc. 7 Early marriage is another important issue regarding adolescent health. There are many reasons for early marriage, but most vital reasons among them are poverty, superstition and lack of awareness about safe motherhood and even family planning. With early marriage comes early pregnancy. Marriage and early child birth are linked to high rates of pregnancy related complication and high risk of new born. After marriage, adolescence undergoes many health problems like early pregnancy, child birth. The risks of early pregnancy and child birth are increase risk of maternal mortality especially among 14-19 years of age, low birth weight, premature labor, and complications during delivery and higher chance of new born death. 8 Availability of relevant disaggregated data & comprehensive analysis of sexual reproductive health situation is necessary for appropriate planning & successful implementation of Age Specific Reproductive Health (ASRH) strategy. Unfortunately, availability of data related to adolescent & young people in Bangladesh is limited, so they reach in adulthood with very little preparation and information about reproductive health. Thus the result of this study could contribute to a girl to be enlightened, a woman to be enriched and a nation to be endowed with prosperity.

Methodology:
It was a descriptive type of cross-sectional study which was conducted at Purba Chandara village of Kaliakair thana of Shafipur upazilla of Gazipur district in Bangladesh on 23 rd November, 2013 with a view to assess the awareness about reproductive health issues among adolescent girls in a rural area of Bangladesh. A sample of 148 adolescent girls was selected purposively. A pre-tested semi structured questionnaire was used for collection of data. Data were collected by face to face interview by using the questionnaire. The data were presented in simple frequency distribution tables and graphs. Ethical Clearance: Ethical clearance was obtained from the local authority before the study and the adolescent girls gave their informed consent before taking part in this study. Participation was purely on voluntary basis. Results: Table I 15 According to our study, the adolescent girls in the rural area of Bangladesh have not sufficient knowledge about reproductive health issues. Today ' s adolescent girls are the mother of tomorrow and adolescent girls have to experience the reproductive health near future. So, clear and correct knowledge of adolescent girls on reproductive health will help them to maintain a good and sound reproductive health in future.

Conclusion:
Adolescents' population has tremendous demographic significance because at the same time they are the present and the future population of a country.
Bangladesh still faces formidable obstacles in the path to the goals of health of reproductive well being due to inadequate knowledge or misconception about reproductive health issues. So, proper knowledge is a pertinent part of life. Girls seemed to be less cognizant about menstruation and its inception, the level of knowledge is not up-to the mark about these matters probably due to the girls' knowledge and information which they received from their text books and different media like TV, radio, newspaper, friends and relatives are incomplete and insufficient.
Thus their understanding for reproductive health reflected a variety of misconceptions or ignorance, incomplete knowledge, unscientific notions and blindfold faith in social customs. The awareness remains dismal among adolescent girls who have very low knowledge on STDs. This may be due to their lack of interest and shyness about this issue. It is our responsibility to improve the condition of reproductive health of adolescent girls by continuous mass campaigning through different medias and also by giving detailed information in our text book about it as well as there is an urgent need to bring out the real capability of the government health facilities.