Menstruation as a Major Stressor in Adolescence & It’s Impacts on School Absences

Much anecdotal evidence exists from surveys and interviews that girls throughout the developing world, and in particular Nepal, face many hardships with menstruation due to a number of constraints, many of which may result in poor emotional wellbeing. Further, there is evidence that many young females miss school days due to menstruation-associated troubles. Chhaupadi, while officially banned by law, is still practiced in rural communities and has caused infection and deaths, often reported in the news. Through collaboration with a research team at the University of New Mexico (UNM)’s Nepal Study Center (NSC) and the non-profit Women2Be, females in Siddharthanagar, Purkot, and Mustang were provided hygiene packets, in the style of those put together by Days for Girls in May 2016 and December 2017. Along with providing these reusable kits, good for up to three years, educational information about female health and hygiene was provided and a survey administered, capturing information on current hygiene practices and knowledge surrounding menstruation, menstruation supporting school infrastructure available, cultural restrictions in the home/community environment, and emotional wellbeing during menstruation.

Research informed by the Transactional Model of Stress and Coping evaluated the roles that cultural and school environments play in appraisals of menstruation as a major life stressor and the impacts of emotional stress on missing school. Using the survey data from schools in both Siddharthanagar and Purkot, empirical results have shown that strong cultural norms during menstruation increase the probability of girls self-reporting as feeling lonely, while presence of hygiene supporting infrastructure at schools reduces this outcome. Further, there is strong support for the hypothesis that the presence of emotional stress during menstruation increases the likelihood of not only missing school, but for a longer period of time. Such evidence improves understandings of potential reasons why past interventions in menstrual health management may have failed, due to a failure to better consider the emotional components. Further, findings provide a greater motivation for increasing government policies to provide stronger hygiene infrastructure in schools to improve the self-efficacy surrounding successful coping skills, and to emphasize more supportive cultural environments/social support.

Research Team Investigators and Collaborative Team: The project team consisted of Dr. Alok K. Bohara – Professor, Department of Economics, UNM, Soumi Roy Chowdhury – Associate Fellow, National Council of Applied Economic Research [NCAER] and Siobhan K. Yilmaz – Ph. D. Candidate, Department of Economics, UNM. We acknowledge the help provided by our collaborator’s at PNMF, Ms. Swati Thapa, and Christine Glidden, founder of Women2Be.

Research Paper