The Relationship Between Menstrual Poverty and Depressive Symptoms in Women Aged 15-49 in Balçova District of İzmir

Abstract

The Relationship Between Menstrual Poverty and Depressive Symptoms in Women Aged 15-49 in Balçova District of İzmir

Abstract

Purpose: The aim of this study is to examine the relationship between menstrual poverty and depressive symptoms in women aged 15-49 living in the Fevzi Çakmak and Çetin Emeç neighborhoods of Balçova, İzmir. Material and Methods: This cross-sectional study was conducted among women aged 15-49 living in Balçova between December 2022 and August 2023. A total of 304 women were recruited using a cluster sampling method. Data were collected through face-to-face interviews. The dependent variable was the presence of depressive symptoms, and the independent variable was menstrual poverty. Additional variables included socio-demographic characteristics, economic status, household features, and health perception. Data analysis was performed using Chi-square tests, t-tests, and logistic regression. Results: According to the Patient Health Questionnaire-9 (PHQ-9) scale, 41.1% of women reported moderate depressive symptoms, and 20.1% experienced moderately severe depressive symptoms. Over the past year, 70.4% of the participants experienced menstrual poverty. Women who experienced menstrual poverty were 2.1 times more likely to report depressive symptoms compared to those who did not (OR=2.1, p=0.012, 95% CI=1.1-3.8). Age and household income were also found to be significant risk factors for depressive symptoms. Conclusion: The study indicates that menstrual poverty negatively impacts the mental health of women in Balçova. Policymakers are urged to address this issue and develop supportive interventions for women.

Keywords

• depressive symptoms
• menstrual poverty
• poverty
• hygiene products

References

1. Yaşar S. Kavramsal Olarak Yoksulluk ve Türkiye’de Yoksullukla Mücadele Politikalarının Etkileri. Sosyal Ekonomik Araştırmalar Dergisi 2019; 19(38):118-144.
2. Boudet A, Buitrago P. Gender Differences in Poverty and Household Composition through the Life-cycle[İnternet]. 2018 [Accessed date: 11 Ekim 2023]. Available from: http://hdl.handle.net/10986/29426
3. Michel J, Mettler A, Schönenberger S, Gunz D. Period poverty: why it should be everybody’s business. Journal of Global Health Reports 2022;6: e2022009.
4. Cardoso LF, Scolese AM, Hamidaddin A, Gupta J. Period poverty and mental health implications among college-aged women in the United States. BMC Womens Health 2021;21(1):14.
5. Unwomen. Infographic: End the stigma. Period [İnternet]. 2019[Accessed date: 27 Ekim 2023]. Available from: https://www.unwomen.org/en/digital-library/multimedia/2019/10/infographic-periods
6. Crichton J, Okal J, Kabiru CW, Zulu EM. Emotional and psychosocial aspects of menstrual poverty in resource-poor settings: a qualitative study of the experiences of adolescent girls in an informal settlement in Nairobi. Health Care Women Int 2013;34(10):891-916.
7. Soeiro RE, Rocha L, Surita FG, Bahamondes L, Costa ML. Period poverty: menstrual health hygiene issues among adolescent and young Venezuelan migrant women at the northwestern border of Brazil. Reproductive Health. 2021; 18: 238.
8. Yıldırım P. Toplumsal Eşitsizliklerin Göz Ardı Edilen Yönü: Türkiye'de Regl Yoksulluğunun Sosyal Politika Perspektifinden İncelenmesi, Manisa Celal Bayar University Journal of Social Sciences 2024;22 (1); 167-183.

9. Mari-Klose M, Julia A, Escapa S, Gallo P. Period poverty and mental health in a representative sample of young women in Barcelona, Spain. BMC Womens Health 2023;23(1):201.
10. Kuranoğlu E. Türkiye’de Az Tehlikeli ve Tehlikeli İşyerlerinde Aşırı İş Yükü Algısı. İstanbul Aydın Üniversitesi Dergisi 2019;11(3):255-274.
11. Bilge U. Turkish reliability of the patient health questionnaire-9, Biomedical Research 2016;Special Issue:S460-S462.
12. Arrieta J, Aguerrebere M, Raviola G, Flores H, Elliott P, Espinosa A ve ark. Validity and Utility of the Patient Health Questionnaire (PHQ)-2 and PHQ-9 for Screening and Diagnosis of Depression in Rural Chiapas, Mexico: A Cross-Sectional Study. J. Clin Psychol 2017;73:1076-1090.
13. Pulgar CA, Trejo G, Suerken C, Ip EH, Arcury TA, Quandt SA. Economic Hardship and Depression Among Women in Latino Farmworker Families. J Immigr Minor Health 2016;18(3):497-504.
14. Kuhlmann AS, Bergquist EP, Danjoint D, Wall LL. Unmet Menstrual Hygiene Needs Among Low-Income Women. Obstet Gynecol. 2019; 133(2): 238-244.
15. Gouvernet B, Sebbe F, Chapillon P, Rezrazi A, Brisson J. Period poverty and mental health in times of covid-19 in France. Health Care Women Int 2022;12:1–13.
16. Lovik A. Mental health indicators in Sweden over a 12-month period during the COVID-19 pandemic – Baseline data of the Omtanke 2020 Study. Journal of Affective Disorders 2023; 322:108-117.
17. Jorm AF. Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychol Med 2000; 30(1):11-22.
18. Aksunger N, Vernot C, Littman R, Voors M, Meriggi NF, Abajobir A ve ark. COVID-19 and mental health in 8 low- and middle-income countries: A prospective cohort study. PLoS Med 2023;20(4): e1004081.
19. Lorant V, Deliège D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003;157(2):98-112.
20. Patria B. The longitudinal eects of education on depression: Finding from the Indonesian national survey. Public Health 2022;10:1017995.
21. Ferrie JE, Shipley MJ, Stansfeld SA, Marmot MG. Effects of chronic job insecurity and change in job security on self reported health, minor psychiatric morbidity, physiological measures, and health related behaviours in British civil servants: the Whitehall II study. J Epidemiol Community Health 2002;56(6): 450-4.
22. Boyers M, Garikipati S, Biggane A, Douglas E, Hawkes N, Kiely C ve ark. Period poverty: The perceptions and experiences of impoverished women living in an inner-city area of Northwest England. PLoS ONE 2022;17(7):e0269341.
23. Muhaidat N, Karmi JA, Karam AM, Abushaikha F, Alshrouf MA. Period poverty, reuse needs, and depressive symptoms among refugee menstruators in Jordan's camps: a cross-sectional study. BMC Womens Health 2024;24(1):384.
24. Mohammed S, Larsen-Reindorf RE. Menstrual knowledge, sociocultural restrictions and barriers to menstrual hygiene management in Ghana: Evidence from a multi-method survey among adolescent schoolgirls and schoolboys. PLoS One. 2020; 15(10): e024110615.
25. Plan International UK. Menstrual health day: global period poverty and stigma getting worse under lockdown: girls are struggling with product shortages and price hikes [İnternet]. 2020 [Accessed date: 2 Kasım 2023]. Available from: https://plan-uk.org/media-centre/menstrual-health-day-global-period-poverty and-stigma-getting-worse-under-lockdow
26. Rossouw L, Ross H. Understanding Period Poverty: Socio-Economic Inequalities in Menstrual Hygiene Management in Eight Low- and Middle Income Countries. Int J Environ Res Public Health 2021;18(5):2571.
27. Lambert JE, Denckla C. Posttraumatic stress and depression among women in Kenya's informal settlements: risk and protective factors. Eur J Psychotraumatol 2021;12(1):1865671.
28. Türkiye İstatistik Kurumu (TÜİK) (2019) Türkiye Sağlık Araştırması Mikro Veri Seti https://www.tuik.gov.tr/media/microdata/pdf/turkiye-saglikarastirmasi.pdf), (Güler M. Süleyman Demirel Üniversitesi Tıp Fakültesi Öğrencilerinde Umutsuzluk Depresyon Sıklığı ve Sosyodemografik Özellikler Arasındaki İlişkinin Belirlenmesi, Int J Basic Clin Med 2014;2(1):32-37.
29. Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of Major Depressive Disorder: Results From the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry 2005; 62(10):1097–1106.
30. Freeman A, Tyrovolas S, Koyanagi A, Chatterji S, Leonardi M, Ayuso-Mateos JL ve ark. The role of socio-economic status in depression: results from the COURAGE (aging survey in Europe). BMC Public Health 2016;16(1):1098.
31. Aldanmaz B, Eskitascioglu İ. Türkiye’de Regl Yoksulluğu. Konuşmamız Gerek Derneği [İnternet]. 2022 [Accessed date 4 Ekim 2023]. Available from: www.konusmamizgerek.org
32. TÜRMOB. Katma Değer Vergisi Oranları [İnternet]. 2023 [Accessed date: 5 Kasım 2023]. Available from: https://www.turmob.org.tr/arsiv/mbs/pratikBilgiler/KDV-Oranlar%C4%B1- 7.7.2023.pdf
33. UNESCO. Teaching and learning: achieving quality for all [İnternet]. 2014 [Accessed date: 5 Ekim 2023]. Available from: https://www.heartresources.org/doc_lib/teaching-and-learning-achieving-qualit
34. Jaafar H, Ismail SY, Azzeri A. Period Poverty: A Neglected Public Health Issue. Korean J Fam Med. 2023; 44(4): 183-188.
35. Eskin M, Ertekin K, Harlak H, Dereboy Ç. Lise Öğrencisi Ergenlerde Depresyonun Yaygınlığı ve İlişkili Olduğu Etmenler. Türk Psikiyatri Dergisi 2008; 19(4):382–389.
36. Medina-Perucha L, Lopez-Jimenez T, Jacques-Avino C, Holst AS, Valls-Llobet C, Munros-Feliu J ve ark. Menstruation and social inequities in Spain: a cross-sectional online survey-based study. Int J Equity Health 2023;22(1):92.