Woldia is the capital city of North Wollo zone, Amhara region which is situated 521 km from Addis Ababa, the capital city of Ethiopia. Woldia town has a total population of 75,496 with 38,167 male and 37,279 female in 2008. Woldia town has one preparatory school and three high schools (selam, millinium, and woldia general high school). The town has four rural and three urban kebelle. In these high schools, there are about 7,027 (3217 in Woldia high school, 1500 in Wergiesa high school and 2310) in Mekiet high school.
An institution-based cross-sectional study was implemented from October 1- December 10, 2018
All female students in the selected North wollo high schools
Female students who have had menarche in selected high schools during the data collection time were included
Sample size determination and sampling procedure
The sample size was determined by using Epi info 7software Stat Cal with the assumptions of single population proportion formula.
The actual sample size is calculated using single population proportion formula.
Where: - n = minimum sample size required for the study
Z = standard normal distribution (Z = 1.96) with confidence interval of 95%
P = knowledge of girls on menstrual hygiene in Ethiopia (p = 51.36%).
d = is a tolerable margin of error (d = 0.05)
The final sample size was come up by adding a non-response rate of 10% to the sample size from 384. Therefore, the final sample size for this study was 423.
The systematic random sampling technique was applied. The study was carried out among high school students in North Wollo Zone, Amhara Region.
North Wollo zone has a total of fifteen Woredas. We have been selected high schools by using a proportional sample allocation system. Among the fifteen woredas, three of them were selected by using the lottery method. These are Woldia, Mekiet and Habru woredas. Accordingly, we selected high schools in the respective woredas. Therefore, from Woldia town; Woldia high school, Millinium high school and Selam high school were conveniently selected. Filakit and Wurgesa high schools were randomly selected from Mekiet and Habru woreda respectively. Out of these five selected high schools, we have selected our study participants every k (3389/423 = 8) unit by allocating the sample proportionally. The total female students in the selected high schools in North wollo zone were 3436. 423 high school students were selected by systematic random sampling technique with a proportional allocation of the sample in each selected high schools of North wollo zone.
Data Collection tools
The data were collected using structured, pretested questioners from the selected female students, using a questionnaire adapted from relevant literature of similar studies. The questionnaires consists of basic socio-demographic characteristics, knowledge on menstrual hygiene, attitude on menstrual hygiene, and practice of menstrual hygiene
Menstrual hygiene: personal hygiene during menstrual flow includes bathing once a day, changing clothes regularly, and changing pads at least two- four times per day.
Knowledge: To measure the respondent’s knowledge of menstrual hygiene, there are 14 questions with the coding of 1 for correct and 0 for incorrect or don’t know.
Good Knowledge: Study participants who scored below the mean score of the respondents
Poor knowledge: Study participants who scored below the mean score of the respondents
Practice: The measurement of practice of menstrual hygiene focus on the use of material during menstruation there are10 questions regarding menstrual hygiene practice and coding is similar to the knowledge questions.
Good Practice: Study participants who scored the mean score of the respondents
Poor practice: Study participants who scored below the mean score of the respondents
Attitude: The measurement of attitude towards menstruation and its hygiene there are10 questions regarding attitude of menstrual hygiene and coding is similar to the knowledge questions.
Good attitude: Study participants who scored the mean score of the respondents
Poor attitude: Study participants who scored below the mean score of the respondents
Data processing and analysis
Completeness of the questionnaire was rechecked then the data were coded, entered and analyzed using Epi Data3.1 and SPSS Version 23 respectively.Bivariate logistic regression analysis was done after dichotomizing the dependent variables with coding ’1’for good and ’0’ for poor. After checking associations of the variables in the bivariate model, those variables with p<0.2 were a candidate to multivariable logistic regression analysis so as to control confounding factors in the association. Finally, P-value of < 0.05 was used to declare the statistical significance of the variables.