The Stressor in Adolescence of Menstruation: Coping Strategies, Emotional Stress & Impacts on School Absences among Young Women in Nepal
Abstract
:1. Introduction
2. Materials and Methods
2.1. Conceptional Framework
2.2. Empirical Specification
2.3. Hypotheses
2.4. Data & Survey Design
2.5. Key Variables
2.6. Estimation Strategies
2.6.1. Single Equation Estimation
2.6.2. Simultaneous Estimation of Emotional Stress & School Absences
3. Results
3.1. Basic Statistics
3.2. Single Equation Estimation Results
3.3. Simultaneous Estimation Results
3.3.1. Specification A: Binary-Binary Dependent Variables
3.3.2. Specification B: Binary-Ordinal Dependent Variables
3.3.3. Robustness Checks
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Description | Mean (S.D.) | Percentage | Min/Max |
---|---|---|---|---|
OUTCOME VARIABLES | ||||
Emotional Stress | =1 if female self-reports as feeling sad or lonely during menstruation, 0 otherwise | 48% | 0/1 | |
Missed School | =1 if female self-reports missing school due to menstruation, 0 otherwise | 32.7 | 0/1 | |
Day Miss School | =1 if missed 0 days of school last month due to menstruation, 2 if missed 1–2 days, 3 if missed 3+ | 1.331 (0.554) | 1/3 | |
EXPLANATORY VARIABLES | ||||
School Environment | PCA index of (1/0) self-reported yes answers to the existence of sanitation supplies, separate toilet, soap, disposal bin, & hygiene education at school | −1.39–08 (1.45) | −2.16/2.67 | |
Community Cultural Environment | PCA index heavily loaded with (1/0) self-reported yes answers to not being able to enter prayer room, participate in cultural functions, or enter the kitchen | 5.73–09 (1.25) | −4.51/1.90 | |
Family Cultural Environment | PCA index heavily loaded with (1/0) self-reported yes answers to not being able to stay in the same house & not meet family | 5.08–09 (1.04) | −0.789/5.44 | |
Age | Age | 16.6 (1.96) | 12/20 | |
ADDITIONAL CONTROL | ||||
PNMHI | =1 if attending PNMHI School, 0 otherwise | 19.6% | 0/1 | |
Paklihawa | =1 if attending Paklihawa School, 0 otherwise | 31.7% | 0/1 | |
Purkot | =1 if attending school in Purkot, 0 otherwise (Base Category) | 48.8% | 0/1 | |
HYGIENE PRODUCT USE | ||||
Old Clothes | =1 if hygiene product currently using is old clothes, 0 otherwise | 22.8% | 0/1 | |
Reusable | =1 if female currently using reusable hygiene product, 0 otherwise | 10.3% | 0/1 | |
Disposable | =1 if female currently using disposable hygiene product, 0 otherwise | 66.9% | 0/1 | |
CASTE | ||||
Brahman Chhetri | =1 if female belongs to Brahman-Chhetri caste, 0 otherwise (Base) | 47% | 0/1 | |
Dalit | =1 if female belongs to Dalit caste, 0 otherwise | 11.4% | 0/1 | |
Madhesi | =1 if female belongs to Madhesi caste, 0 otherwise | 16.4% | 0/1 | |
Other | =1 if female belongs to other castes, 0 otherwise | 23.1% | 0/1 | |
Wealth Index | Sum of binary (1/0) self-reported yes answers to self/family owning land & cement home | 1.38 (0.568) | 0/2 | |
Married | =1 if the female is married, 0 otherwise | 3.6 | 0/1 |
(1) | (2) | (3) | |
---|---|---|---|
Variables | Emotional Stress 2 (Probit) | Missed School 3 (Probit) | Days Missed 4 (Oprobit) |
Community Environment | 0.116 | ||
(0.070) | |||
Family Environment | 0.128 | ||
(0.075) | |||
School Environment | −0.299 ** | ||
(0.095) | |||
Emotional Stress | 0.580 *** | 0.341 * | |
(0.170) | (0.161) | ||
Age | 1.096 | −0.997 | −0.958 |
(0.614) | (0.619) | (0.557) | |
Age Sq. | −0.035 | 0.031 | 0.028 |
(0.019) | (0.019) | (0.017) | |
Constant/Cut Point 1 | −8.7 | 7.055 | −7.132 |
(5.042) | (5.052) | (4.651) | |
Cut Point 2 | −5.924 | ||
(4.659) | |||
Fixed Effects 5 | Yes | Yes | Yes |
Caste 6 | Yes | Yes | No |
N | 281 | 281 | 281 |
ln(L) | −180 | −159 | −192 |
χ2 | 29 | 32.9 | 25.5 |
AIC | 381 | 336.4 | 398.3 |
BIC | 421 | 369.2 | 423.7 |
Explanatory Variables | MODEL 1 | MODEL 2 | ||
---|---|---|---|---|
Emotional Stress | Missing School | Emotional Stress | Missing School | |
Community Environment | 0.158 ** | 0.146 * | ||
(0.056) | (0.057) | |||
Family Environment | 0.160 ** | 0.148 * | ||
(0.061) | (0.058) | |||
School Environment | −0.221 ** | −0.252 ** | ||
(0.083) | (0.083) | |||
Emotional Stress | 1.737 *** | 1.818 *** | ||
(0.183) | (0.120) | |||
Age | 1.191 * | −1.017 | 1.372 * | −0.957 |
(0.600) | (0.568) | (0.606) | (0.571) | |
Age Sq. | −0.038 * | 0.032 | −0.044 * | 0.03 |
(0.019) | (0.018) | (0.019) | (0.018) | |
Constant | −9.463 | 6.651 | −10.697 * | 6.092 |
(4.868) | (4.559) | (4.892) | (4.582) | |
Rho (ρ) | −0.917 *** | −1 *** | ||
(0.176) | (2.20 × 10−11) | |||
Fixed Effects 1 | Yes | Yes | Yes | Yes |
Caste 2 | No | No | Yes | Yes |
N | 281 | 281 | ||
ln(L) | −341 | −333 | ||
AIC | 713 | 706.6 |
MODEL 1 | MODEL 2 | |||
---|---|---|---|---|
Emotional Stress | Missing School 1 | Emotional Stress | Missing School 1 | |
Community Environment | 0.0586 ** | 0.053 ** | ||
(0.022) | (0.020) | |||
Family Environment | 0.0592 ** | 0.0537 * | ||
(0.022) | (0.020) | |||
School Environment | −0.0819 ** | −0.0916 *** | ||
(0.030) | (0.0287) | |||
Emotional Stress | 0.474 *** | 0.489 *** | ||
(0.026) | (0.013) | |||
Fixed Effects 2 | Yes | Yes | Yes | Yes |
Caste 3 | No | No | Yes | Yes |
Explanatory Variables | MODEL 1 | MODEL 2 | ||
---|---|---|---|---|
Emotional Stress | Days Missed 1 | Emotional Stress | Days Missed 1 | |
Community Environment | 0.085 | 0.08 | ||
(0.069) | (0.070) | |||
Family Environment | 0.153 * | 0.152 * | ||
(0.061) | (0.062) | |||
School Environment | −0.206 ** | −0.226 ** | ||
(0.069) | (0.074) | |||
Emotional Stress | 1.630 *** | 1.671 *** | ||
(0.131) | (0.142) | |||
Age | 1.274 * | −0.938 | 1.325 * | −1.001 |
(0.585) | (0.567) | (0.597) | (0.585) | |
Age Sq. | −0.040 * | 0.028 | −0.042 * | 0.031 |
(0.018) | (0.017) | (0.018) | (0.018) | |
Constant/Cut 1 | −10.157 * | −6.195 | −10.488 * | −6.537 |
(4.818) | (4.681) | (4.898) | (4.802) | |
Cut 2 | −5.32 | −5.636 | ||
(4.670) | (4.789) | |||
Rho (ρ) | −0.905 *** | −0.899 *** | ||
(0.064) | (0.073) | |||
Fixed Effects 2 | Yes | Yes | Yes | Yes |
Caste 3 | No | No | Yes | Yes |
N | 281 | 281 | ||
ln(L) | −369.56 | −364.24 | ||
AIC | 771.12 | 772.49 |
MODEL 1 | MODEL 2 | |||||
---|---|---|---|---|---|---|
Effect on No. Days Miss School 1 | 0 Days | 1–2 Days | 3+ Days | 0 Days | 1–2 Days | 3+ Days |
Emotional Stress | −0.454 *** | 0.142 *** | 0.312 *** | −0.465*** | 0.151 *** | 0.314 *** |
(0.021) | (0.039) | (0.054) | (0.024) | (0.043) | (0.061) | |
Effects on Emotional Stress | ||||||
School Environment | −0.0771 ** | −0.0836 *** | ||||
(0.025) | (0.026) | |||||
Family Environment | 0.0574 * | 0.0563 * | ||||
(0.022) | (0.023) | |||||
Community Environment | 0.0317 | 0.0297 | ||||
(0.026) | (0.026) | |||||
Fixed Effects 2 | Yes | Yes | Yes | Yes | Yes | Yes |
Caste 3 | No | No | No | Yes | Yes | Yes |
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Yilmaz, S.K.; Bohara, A.K.; Thapa, S. The Stressor in Adolescence of Menstruation: Coping Strategies, Emotional Stress & Impacts on School Absences among Young Women in Nepal. Int. J. Environ. Res. Public Health 2021, 18, 8894. https://doi.org/10.3390/ijerph18178894
Yilmaz SK, Bohara AK, Thapa S. The Stressor in Adolescence of Menstruation: Coping Strategies, Emotional Stress & Impacts on School Absences among Young Women in Nepal. International Journal of Environmental Research and Public Health. 2021; 18(17):8894. https://doi.org/10.3390/ijerph18178894
Chicago/Turabian StyleYilmaz, Siobhan K., Alok K. Bohara, and Swati Thapa. 2021. "The Stressor in Adolescence of Menstruation: Coping Strategies, Emotional Stress & Impacts on School Absences among Young Women in Nepal" International Journal of Environmental Research and Public Health 18, no. 17: 8894. https://doi.org/10.3390/ijerph18178894