Challenges and coping strategies adopted for effective menstrual hygiene management among intellectually disabled adolescents and their caregivers: A qualitative study

Ebenezer Kwesi Armah-Ansah, Dorothy Osei, Abdul-Aziz Seidu, Bright Opoku Ahinkorah


Background: Menstruation is important for female life and reproductive health. The concern for parents or caretakers is how girls with intellectual disabilities (GWID) can have the capacity to handle menarche, menses, and sexual abuse. Therefore, this study explored the challenges and coping strategies adopted for effective menstrual hygiene management among intellectually disabled adolescents and their caregivers in Ghana. Methods: This is a cross-sectional qualitative study that involved three school caregivers, seven female intellectually disabled adolescents, and ten home-based caregivers. The study was carried out in the Asokore Mampong Municipality in the Ashanti Region of Ghana. Thematic content analysis was used to analyze the data. Results: The study revealed that both home-based and institution-based caregivers and intellectually disabled adolescents experience challenges in dealing with menstrual hygiene. These challenges include intellectually disabled adolescents destroying unused pads and misusing them. Intellectually disabled adolescents complain of abdominal pain and discomfort during menstruation. Conclusion: Caregivers go through challenges when helping intellectually disabled adolescents manage menstruation, which was revealed by the study to be time-consuming. Addressing this issue can begin with training caregivers on the best measures to practice good menstrual hygiene among intellectually disabled adolescents. Motivation (monetary and any other form) should be given to caregivers especially institution-based caregivers to keep up with their work.

Keywords: Caregivers, intellectually disabled girls, adolescents, menstruation, menstrual hygiene management


Caregivers, Intellectually Disabled Girls, Adolescents, Menstruation, Asokore Mampong Municipality, Menstrual Hygiene Management

Full Text:



AAo, P. (2006). Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics, 118(5), 2245-2250.

Abodey, E., Vanderpuye, I., Mensah, I., & Badu, E. (2020). In search of universal health coverage–highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study. BMC health services research, 20(1), 1-12.

Atkinson, E., Bennett, M. J., Dudley, J., Grover, S., Matthews, K., Moore, P., ... & Walters, T. (2003). Consensus statement: Menstrual and contraceptive management in women with an intellectual disability. The Australian and New Zealand Journal of Obstetrics and Gynaecology, 43(2), 109-110.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3(2), 77-101.

Carlson, G., & Wilson, J. (1994). Menstrual management: The mother's perspective. Mental Handicap Research, 7(1), 51-63..

Chigunwe, G. (2021). Sexual and Reproductive Health Among Adolescent Girls with Disabilities: A Vicious Circle of Womanhood. Sexual and Reproductive Health of Adolescents with Disabilities, 45-60.

Chou, Y. C., & Lu, Z. Y. J. (2012). Caring for a daughter with intellectual disabilities in managing menstruation: a mother's perspective. Journal of Intellectual and Developmental Disability, 37(1), 1-10.

Chou, Y. C., Lu, Z. Y. J., Wang, F. T., Lan, C. F., & Lin, L. C. (2008). Meanings and experiences of menstruation: perceptions of institutionalized women with an intellectual disability. Journal of Applied Research in Intellectual Disabilities, 21(6), 575-584.

Creswell, J. W., & Poth, C. N. (2016). Qualitative inquiry and research design: Choosing among five approaches. Sage publications.

Enoch, A., Nadutey, A., Afful, B. F., & Anokye, R. (2020). Menstrual hygiene management: Challenges and coping strategies for adolescents with disabilities in the Kumasi Metro of Ghana. Disability, CBR & Inclusive Development, 31(2), 77-91.

Fossey, E., Harvey, C., McDermott, F., & Davidson, L. (2002). Understanding and evaluating qualitative research. Australian & New Zealand journal of psychiatry, 36(6), 717-732.

Ghana Statistical Service. (2013). 2010 Population and Housing Census: National Analytical Report. Accra: Author.

Hayden, T. (2012). Menstrual Hygiene Management in Emergencies: Taking stock of support from UNICEF and partners. New York City.

Johnson, R. M., Strayhorn, T. L., & Parler, B. (2020). “I just want to be a regular kid:” A qualitative study of sense of belonging among high school youth in foster care. Children and Youth Services Review, 111, 104832.

Lincoln, Y. S., & Guba, E. G. (1986). But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New directions for program evaluation, 1986(30), 73-84.

Lobo, R. A., & Pinkerton, J. (2010). Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD). The Journal of clinical endocrinology metabolism, 95(4).

Mason, L., & Cunningham, C. (2008). An exploration of issues around menstruation for women with Down syndrome and their carers. Journal of Applied Research in Intellectual Disabilities, 21(3), 257-267.

Nurkhairulnisa, A. I., Chew, K. T., Zainudin, A. A., Lim, P. S., Shafiee, M. N., Kampan, N., ... & Nur Azurah, A. G. (2018). Management of menstrual disorder in adolescent girls with intellectual disabilities: a blessing or a curse?. Obstetrics and Gynecology International, 2018.

Okumoto, E. K. (2016). A multicultural examination of the relationship between coping and well-being in parents of children with disabilities. Washington State University.

Park, H. R. (2013). Menstrual Support for Females with Developmental Disabilities: Survey and Interview of Parents or Caretakers (Doctoral dissertation, University of Kansas).

Quint, E. H., O’Brien, R. F., Braverman, P. K., Adelman, W. P., Alderman, E. M., Breuner, C. C., ... & Marcell, A. V. (2016). Menstrual management for adolescents with disabilities. Pediatrics, 138(1).

Rodgers, J., & Lipscombe, J. (2005). The nature and extent of help given to women with intellectual disabilities to manage menstruation. Journal of Intellectual and Developmental Disability, 30(1), 45-52.

Schmitt, M. L., Clatworthy, D., Ratnayake, R., Klaesener-Metzner, N., Roesch, E., Wheeler, E., & Sommer, M. (2017). Understanding the menstrual hygiene management challenges facing displaced girls and women: findings from qualitative assessments in Myanmar and Lebanon. Conflict and health, 11(1), 1-11.

Sommer, M., Caruso, B. A., Sahin, M., Calderon, T., Cavill, S., Mahon, T., & Phillips-Howard, P. A. (2016). A time for global action: addressing girls’ menstrual hygiene management needs in schools. PLoS medicine, 13(2), e1001962.

Tracy, J., Grover, S., & Macgibbon, S. (2016). Menstrual issues for women with intellectual disability. Australian Prescriber, 39(2), 54.

Wilkinson, J. E., & Cerreto, M. C. (2008). Primary care for women with intellectual disabilities. The Journal of the American Board of Family Medicine, 21(3), 215-222.

Winkler, Inga & Roaf, Virginia. (2014). taking the bloody linen out of the closet: menstrual hygiene as a priority for achieving gender equality. 21. 1-37

Yaacob, N., Nasir, N. M., Jalil, S. N., Ahmad, R., Rahim, N. A. R. A., Yusof, A. N. M., & Ghani, N. A. A. (2012). Parents or caregiver's perception on menstrual care in individuals with down syndrome. Procedia-Social and Behavioral Sciences, 36, 128-136.

Zacharin, M., Savasi, I., & Grover, S. (2010). The impact of menstruation in adolescents with disabilities related to cerebral palsy. Archives of disease in childhood, 95(7), 526-530.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

ISSN: 2454-6623