Knowledge and Practices Related to Menstruation among Tribal ...

Text-only Preview

© Kamla-Raj 2009
Ethno-Med, 3(1): 43-48 (2009)
Knowledge and Practices Related to Menstruation among
Tribal (Gujjar) Adolescent Girls
Rajni Dhingra, Anil Kumar* and Manpreet Kour
P.G. Department of Home Science, University of Jammu, Jammu 180 006, Jammu and Kashmir, India
*Himalayan Ayurvedics, Jammu, Jammu and Kashmir, India
KEYWORDS Adolescents. Tribals. Tribal Girls. Menstruation. Cultural Practices
ABSTRACT The present study was undertaken to assess the knowledge and practices related to menstruation
among tribal (Gujjar) adolescent girls. The sample for the study comprised of 200 girls in the age group 13-15
years. Both nomadic and semi-nomadic Gujjars were included. A combination of snowball and random sampling
technique was used for selection of the sample group from various areas of Jammu district of Jammu and Kashmir
State. Interview guide was developed and used to study the knowledge and practices related to menstruation among
adolescent girls. Along with the Interview guide, the menstrual history of the sample group was recorded by the
medical experts in the proforma devised for the purpose. The results revealed that sample girls lacked conceptual
clarity about the process of menstruation before they started menstruating due to which they faced several
gynaecological problems. The most common source of information about menstruation for the majority (83%) of
the sample girls were friends. There were several socio-cultural taboos related to menstruation. The level of
personal hygiene and management of menstruation was found to be quite unsatisfactory. 98% of the girls believed
that there should be no regular bath during menstrual cycle. All the girls reported following these cultural practices
without much questioning. The results hold implications for professionals involved in improvement of adolescent
reproductive health in particular.
Along with cultural constructs which lead to
formation of a certain preconception, the reaction
Adolescence in girls has been recognized as
to menstruation also depends upon awareness
a special period which signifies the transition
and knowledge about the subject. There is a
from girlhood to womanhood. This transitional
substantial lacunae in the knowledge towards
period is marked with the onset of Menarche, an
menstruation among adolescent girls. Several
important milestone. In the existing Indian
research studies have revealed this gap (Ahuja
cultural milieu, the society in interwoven into a
et al. 1995; Chowdary 1998; Khanna 2005 and
set of traditions, myths and misconceptions
Singh 2006) and showed that there is low level of
especially about menstruation and related issues.
awareness about menstruation among girls when
Menstruation is generally considered as unclean
they first experience it. Social prohibitions and
in Indian society. Isolation of the menstruating
negative attitude of parents in discussing the
girls and restrictions imposed on them in the
related issues openly has blocked the access of
family have reinforced negative attitude towards
adolescent girls to right kind of information
this phenomenon in girls. Several studies (Center
for Social Research 1990; Talwar 1997; Singh 2006
especially in rural and tribal communities. Further,
and Paul 2007) have reported restrictions in daily
their strong bondage with the traditional beliefs,
activities such as, not being allowed to take bath,
taboos and misconceptions during menstruation
change clothes, comb hair and enter holy places.
has led to many serious health problems. Poor
Apart from these, dietary restrictions (taboo on
personal hygiene and unsafe sanitary conditions
consumption of food like rice, curd, milk, lassi,
result in the girls facing many gynaecological
potato, onion, sugarcane etc.) during the
problems (Bhatia et al. 1995). Infections due to
menstrual period are also imposed.
lack of hygiene during menstruation have been
reported in many studies (Mehra 1995 and Greene
Address for correspondence:
1997). Repeated use of unclean cloth and
Prof. Rajni Dhingra, Head,
P.G. Department of Home Science, University of
improper drying of used cloth before its reuse
Jammu, Jammu 180 006, Jammu and Kashmir, India
results in harbouring of micro-organisms resulting
Telephone: 0191-2457137, Cell: 094191-04644;
in the spread of vaginal infections among
Fax: 0191-2454137
E-mail: [email protected]
adolescent girls (Paul 2007).

The health problems and complications are
the result of inaccurate and incomplete
information provided to the girls through limited
The sample for the present research com-
sources. Many studies have revealed that
prised of 200 adolescent girls in the age group of
mothers, teachers, friends, relatives, television
13-15 years. Both nomadic and semi-nomadic
and books are the main source of providing
Gujjar adolescent girls were included in the study.
information about menstruation to the adolescent
At the initial stages of sample selection, snowball
girls (Prasad and Sharma 1972; Ghattragi 2005).
technique was employed to select the families
However, it is also seen that information received
and later random sampling technique was used
from these sources is often inaccurate and partial.
for selecting Gujjar girls in the age group of 13-
Data about their level of knowledge and practices
15 years.
followed by them regarding menstruation is
The sample was selected from Gujjar tribe
beneficial for planning programmes for improving
from Jammu and Kashmir located in and around
awareness level regarding their life processes
Jammu District. Since the sample group was
and promoting their quality of life. Keeping above
nomadic, the areas selected (R.S. Pura, Akhnoor,
in view, the present study about the knowledge
Nagrota and Bari-Brahmana) were of their
and practices about menstruation among tribal
temporary settlement at the time of study. Ranbir
(Gujjar) adolescent girls was planned. The study
Singh Pura is famous fort well known for Basmati
was conducted on the sample of adolescent girls
rice, an important military station and a busy trade
of Gujjar Tribe from Jammu and Kashmir region
centre. Various villages (Katyal, Joda farm and
of India, one of the tribes known for being
Maraliya) were selected from this block. Akhnoor
educationally backward and unexposed to
is situated on the bank of river Chenab. The place
modern influences. The Gujjars are one of the
is famous for its variety of mangoes. Burj was
ancient races of India and form the third largest
the village selected from this block about 20 kms
majority in the state. They have been pursuing
rom Jammu city. Nagrota, about 10 kms from
pastoral life since ages. On the basis of their
Jammu on Udhampur road, an important military
occupation and settlement, they form various
station was included. Khanpur a small village
subgroups. Firstly, ‘Basneeks’ are the ones who
about 1.5 kms way from national highway was
have settled beyond the limits of ordinary village
selected from Nagrota Block. The Industrial Hub
land. Secondly, these who practice transhumance
of Jammu, Bari-Brahmana Block was one of the
can be further sub divided into Baniharas (who
other important area selected for drawing of
sell milk / Dodhi Gujjars) and Bakerwal Gujjars
sample group.
(who keep goats). The Gujjars in the Jammu and
Data were collected by using interview guide.
Kashmir state still follow their traditional
Detailed interviews were conducted with the
occupation of rearing cattle, goats and sheeps.
selected sample to obtain information regarding
Their conditions have remained unchanged.
their knowledge and practices related to
Most of the Gujjar girls (especially the nomadic
menstruation. The major components of interview
and semi-nomadic group included in the study)
guide were: the terminology used for men-
are never sent to schools. Their education is
struation, prior information level about men-
limited to religious education mostly at home
struation and its related complications, source
(Kaur et al. 2003). This study aimed to provide
of information about menstruation, practices
an insight into the cultural setup of the tribal
followed during menstruation and the level of
community with regard to most sensitive issue
personal hygiene during the menstrual cycle.
of menstruation which would help in promoting
Both individual and group interviews were con-
improved awareness level and increase in right
ducted. Interviews conducted in groups included
knowledge about menstruation. The specific
two to three girls. Wherever necessary, important
objectives of the study were:
information and feedback was provided to the
(i) Gather baseline data about menstrual history
girls. Clinical observations were also carried by
of adolescent Gujjar Girls.
the medical team regarding their menstrual
(ii) Assess the prior information level of
history and related areas and were recorded in
adolescent girls regarding menstruation.
the proforma devised for the purpose. Medical
(iii) Study the practices followed by the sample
team visited the selected areas once a week. With
girls during menstruation.
each visit, a group of 20 girls (along with family

and community members sometimes) were
medically checked.
The present study is mainly qualitative in
nature and the data obtained by using interview
guide was analyzed through content analysis.
The quantitative data obtained through clinical
assessment was analyzed by calculating
frequencies and computing percentages.
Age and Education Profile of Respondents:
Out of total 200 adolescent girls selected for the
study, the maximum number i.e. 76 (38%) were in
the age group of 13 years, 70 (35%) were in the
age group of 15 years and the rest 54 (27%) were
in the age group of 14 years. Most of the subjects
were illiterate 129 (64.5%), 51 (25.5%) could read
and write, 15 (7.5%) were in primary school
classes and only 5 (2.5%) of the total subjects
were in middle school classes.
Menstrual History: The entire sample under
study was interviewed and observations
regarding their menstrual history were recorded
in the proforma. Out of total 200 subjects 131
(65.5%) were having menstruation while rest 69
Fig. 1. Periodicity of menstrual cycle
(34.5%) subjects had not reported their menarche
at the time of investigation. Out of those 69
Duration of Menstruation and Amount of
subjects who had not reported their menarche, 2
Blood Loss During Menstruation: Out of total
were in the age group of 15 years and 8 were in
131 subjects who were having menstruation, 103
the age group of 14 years and the rest 59 were in
(78.6%) subjects reported their duration of
the age group of 13 years. The data obtained
menstruation between 0 to 6 days while rest of
thus reveals a trend of late menarche among the
them i.e. 28 (21.3%) reported their duration
present group.
between 7 to 12 days. 59 (45.0%) subjects
Age at Menarche: Out of total 131 subjects
reported normal bleeding during their
who were having their menstruation, 71 (54.2%)
menstruation, 37 (28.2%) subjects reported
reported having had their menarche between the
scanty bleeding and 35 (26.7%) reported
age of 10 to 12 years while the rest 60 (45.8%)
subjects reported their menarche between the
age of 13 to 15 years.
Menstrual Cycle: The observations show
that out of 131 subjects, majority of the subjects
i.e. 93 (70.2%) were having their menstrual cycle
between 30 to 45 days, 15 (11.4%) subjects
between 15 to 30 days, 13 (9.9%) subjects
between 45 to 60 days, 9 (6.8%) subjects between
60 to 75 days and 2 (1.5%) subjects were having
cycles between 90 to 105 days. (Fig. 1). The figures
point out that though a large majority of girls
were having normal menstrual cycle, some of
them had their periods with longer than usual
gaps. This could be attributed to some medical
reasons, which need further investigation.
Fig. 2. Amount of blood loss during menstruation

excessive bleeding during their menstruation.
friends, while the source of information for oth-
(Fig. 2). It was hence observed that these girls
ers was T.V. (3%), mothers (5%), magazines (5%),
(26.7%) were having excessive blood loss, which
movies (10%) and relatives (6.5%). The most
could be responsible for anaemic conditions
common source of getting information about
observed in the group.
matters perceived as “secret and personal” such
Management of Menstruation: On the basis
as source of menstrual information was friends.
of reports by the majority of the subjects included
Relatively very few mothers in this group ap-
in the study i.e. 127 (96.9%) it could be concluded
peared to have an open channel of communica-
that their management of menstruation was very
tion with their daughters about these aspects of
poor (Poor management means use of dirty cloth,
improper washing of used cloth and inadequate
On being questioned about the complications
drying mechanisms) and improper, only 4 (3.0%)
faced during the process of menstruation, ma-
of the subjects reported proper (Proper
jority (63.5%) of the girls reported experiencing
management included use of fresh cloth each
stomach ache followed by Nausea (41.5%), pain
day and disposal of used cloth) management of
in legs (12%), loss of appetite (24%) and very
their menstruation.
few (7.5%) stated having headache.
Prior Information about Menstruation/Its
Practices during Menstruation: The com-
Related Complications: The term ‘Menstrua-
munity depicted strong web of social and cultur-
tion’ in local language among adolescents was
al practices during menstruation. It was observed
known as “Kapadaanna or Mahavari”. It was
that through several generations these practic-
found that none of the sample girls had com-
es were believed and followed. There were many
plete information about the process of menstru-
social and religious restrictions on girls during
ation before they started menstruating. They stat-
menstruation. Girls received these instructions
ed that “it was necessary for every girl as it was
for do’s and don’ts from mothers, elder sisters
the removal of dirty blood from the body, other-
and friends. Restrictions particularly related to
wise a female would develop any infection or
prohibitions in going to religious places, offer-
ing prayers and keeping fast (Roza’s) were re-
A large sample (64%) of the girls was only
ported by all the sample girls. Taboos/myths were
partially aware about menstruation before they
also exported by all the girls by avoiding going
experienced it. The respondents were asked to
near water as “it creates problem in the regular
reveal the major sources of information about
cycle because of a belief that reflection of water
menstruation and it was found that 83% of the
creates problems”. All the girls were asked to
respondents had received information from
avoid looking in the mirror by elders of the fam-
ily. (98%) believed that no regular bath should
not be taken during menstrual periods. Few
Table 1: Prior information about menstruation/
(23%) showed prohibition in going to some oth-
its related complications.
er people’s house. All the girls reported follow-
No. of responses
Prior Information Level
n = 200
Partially Aware
Table 2: Practices during menstruation
7 2
*Source of Information About Menstruation
No. of responses
*List of Practices
N = 200
1 0
Prohibition to go to
religious places/read
Literature (Magazines)
1 0
religious text/
2 0
offer prayers/to keep
1 3
fasts (Roza)
*Complications Faced During Menstruation
No regular bath
Not to look in the mirror
2 0 0
8 3
Avoidance in going to some
4 6
1 5
other’s house
Pain in legs
2 4
Stay away from flowing water 182
Loss of Appetite
4 8
(River, Channel etc.)
* Multiple Responses
* Multiple Responses
** Includes those girls who had not started menstruating.

ing these cultural prescriptions and prohibitions
struation. The reason was that they had no prior
without questioning.
information about menstruation due to which
Practices Followed To Maintain Hygiene
they faced several problems. Similar results were
During Menstruation: Poor hygienic conditions
found in many other studies (Centre for Social
were observed during menstruation among
Research 1990; Kudesia 1994 and Gupta et al.
adolescent girls. It is important to maintain
2004). The most common source of information
personal cleanliness as a routine and especially
and discussion about so-called ‘secret’ issues
during the period of menstruation. The responses
were friends (83%) or female relatives like mar-
received from the adolescent girls revealed that
ried sisters or sister-in-laws. Relatively very few
the level of personal hygiene practiced by these
mothers in this group appeared to have an open
girls was not upto the mark. All of them reported
channel of communication with their daughters
that they did not brush their teeth or take bath
about menstruation and its related issues. Ma-
during the days of menstrual period. They were
jority (63.5%) of the girls reported experiencing
also instructed by elders not to wash/comb their
stomach ache, nausea, pain in legs, loss of appe-
hair during these days. “Gujjar women have a
tite and headache.
peculiar hair style where hair are dressed in
The sample was socially and culturally
twelve to fifteen braids called Gundani” (Kumar
bounded with traditional practices during
A and Kumar N 1998). Gujjar women are known
menstruation. Throughout various generations
for keeping these braids formed for day’s
cultural practices were believed and followed
altogether. Similar observations were obtained for
without much questioning. Like previous studies
the present sample group. With regard to the
(Centre for Social research 1990; Talwar 1997 and
question regarding use of material for absorption
Singh 2006) the present research has also
of menstrual blood, they revealed that an old used
documented similar results about several
cloth was recycled for this purpose. Majority
restrictions related to menstruation. The level of
(88.5%) of the adolescent girls washed and buried
personal hygiene practiced by these girls was
the used cloth “It was religious practice that the
unsatisfactory. Reuse of used cloth for
cloth soaked with menstrual blood should not
absorption of menstrual blood was found in
be buried. It should be first washed. After
majority (87.5%) of girls under study. Similar
washing, the cloth can be reused or buried.” The
observations were found in other studies (Mehra
sample girls reported that they washed the used
1995 and Greene 1997) . It is concluded that it is
cloth secretly and dried it in a hidden corner. Sun
important to educate adolescents about issues
drying of the washed cloth was not done.
related to menstruation, so that they can
safeguard themselves against various infections
and diseases. This could further help them to
lead a healthy life. The data of the study can be
The results of the study reveal that there is
used for planning programmes, making new
low level of knowledge about menstruation and
policies for improving the level of information
its related issues among Gujjars adolescent girls.
especially, for tribal adolescent girls.
The age of menarche in most of the subjects
under study show delayed menstruation (Exact
age could not be calculated due to lack of avail-
ability of accurate information and also due to
The authors acknowledge the support pro-
the fact that out of the 200 girls included in the
vided by Indian Council for Social Science and
sample randomly, 69 girls were still not menstru-
Research (ICSSR), New Delhi for providing grant
ating). Other groups studied by Bhattacharyya
(F.No. 5-16/2003 GEN/RP-NEP) for conducting
(1991), Singh et al. (1992), Shukla et al. (1994) and
research project. The present paper is a part of
Vaidya et al. (1998) revealed that the mean me-
data presented in the project.
narcheal age was 13-14 years in various commu-
nities (Urban, rural and tribal) across various parts
of the country. Delayed menstruation in the
present group, may be attributed to poor nutri-
Ahuja A, Tewari S 1995. Awareness of Pubertal Changes
tional status. It was also observed that the sam-
Among Adolescent Girls. Journal of Family Wel-
ple girls lacked conceptual clarity about men-
fare, 41(1): 46-50.

Bhatia JC, Cleland J 1995. Self Reported Symptoms of
Rural Adolescent Girl Ph.D. Thesis. Bangalore,
Gynaecological Morbidity and their Treatment in
Bangalore University, Faculty of Medicine.
South India. Studies in Family Planning, 26(4):
Kumar A, Kumar N 1998. Gujjar Bakerwal – The Eco-
friendly Tribals of Jammu and Kashmir Since Cen-
Bhattacharyya SK, Bhattacharyya S, Das NK 1991.
turies. Bull Ind His Med, XXVIII: 139-145.
Menarche and Menopause among the Mahar of
Mehra S (Ed.) 1995. Adolescent Girl: An Indian Pre-
Maharashtra. Man in India, 71(2 and 3): 491-495.
spective. New Delhi: Mamta Health Institute for
Centre for Social Research, New Delhi 1990. Growing
Mother and Child.
Up in Rural India: Problems and Needs of Rural
Paul D 2007. A Report of an ICMR Funded Research
Adolescent Girls by Ranjana Kumari. New Delhi,
Project: Knowledge and Practices of Adolescent
Girls Regarding Reproductive Health with special
Chaudhary RH 1998, July. Socio-Economic Demographic
Emphasis on Hygiene during Menstruation. New
and Reproductive Health Profiles of Adolescent in
Delhi: National Institute of Public Cooperation and
SAARC Countries. Paper presented at the South
Child Development (NIPCCD).
Asia Conference on Adolescence, New Delhi, India.
Prasad BG, Sharma P 1972. A Study on Menstruation of
Ghattargi CH, Deo DS 2005. Perceptions and Practices
Medical College Girls at Lucknow. Journal of Ob-
regarding Mestruation: A Comparative Study in
stetrics and Gynaecology of India, 22: 690-694.
Urban and Rural Adolescent Girls. Indian Journal
Shukla NB, Sharma NB, Bhushan S 1994. Age of Me-
of Community Medicine, 30(1): 10-14.
narche of Urban and Rural Sports School Girls. Man
Greene E Margaret 1997. Watering the Neighbours Gar-
in India, 74(3): 307-310.
den. New Delhi: Population Council (Working Pa-
Singh AJ 2006. Place of Menstruation in the Reproduc-
per. No. 7).
tive lives of women of Rural North India. Indian
Gupta N, Mathur AK, Singh MP, Saxena NC 2004.
Journal of Community Medicine, 31(1): 10-14.
Reproductive Health Awareness of school-going,
Singh UP, Shukla BRK 1992. Trend of Menarche in
Unmarried, Rural Adolescents. Indian Journal of
Five Endogamous Groups of Tharu Tribal Female
Pediatrics, 71: 797-801
of Uttar Pradesh. Man in India, 72(3): 343-352.
Kaur A, Manhas S, Dhingra R 2003. Play Activities
Talwar R 1997. A Study of the Health Profile of Adoles-
among Gujjar Children. Man in India, 83(3 & 4):
cent Girls in an Urban Slum and Their Knowledge
about Reproductive Health, MD Thesis. New Del-
Khanna A, Goyal RS, Bhawsar R 2005. Menstrual Prac-
hi, Maulana Azad Medical College, Department of
tices and Reproductive Problems: A Study of Ado-
Preventive and Social Medicine. 155.
lescent Girls in Rajasthan. Journal of Health Man-
Vaidya RA, Shringi MS, Bhatt MA, Gujjar M, Joshi JV,
agement, 7(1): 91-107.
Galvankar Priti, Sankari K 1998. Menstrual Pat-
Kudesia P 1994. A Comprehensive study of Health Sta-
tern and Growth of School Girls in Mumbai. The
tus (and Socio-Cultural Factors Influencing it) of
Journal of Family Welfare, 44(1): 66-72