Dissertation: ADOLESCENTS' REPRODUCTIVE HEALTH IN RURAL BANGLADESH. THE IMPACT OF EARLY CHILDHOOD NUTRITIONAL ANTHROPOMETRY
Author: Alinda Bosch
In her PhD research, Alinda Bosch examined both the influence of contemporary and early childhood nutritional status on the timing of menarche (the first menstruation) and the knowledge and perceptions about reproductive health among adolescent girls and boys in Matlab, a rural area in Bangladesh. In doing so a lifecourse approach was adopted and longitudinal data were obtained from a baseline (secondary) survey among 707 under-five children in 1988-1989 by Dr. Baqui (ICDDR,B) and a follow-up (primary) survey in 2001 among the same children aged 12—16 year. In addition, anthropometric measurements were taken and in-depth interviews were conducted among some of the adolescents, their parents, and key-respondents. The longitudinal data have been analysed with descriptive statistical methods, binary logistic regression models, lifetable techniques, and Cox-regression.
Half of the girls can expect to reach menarche after their 15th birthday. In combination with early marriage and childbirth this late onset of menarche may increase reproductive health risks. The age of menarche seems largely related to a relatively high prevalence of stunting (being short for age) in adolescence, which resonates from a high degree of stunting in early childhood. Moreover, a relatively high proportion of the adolescent girls and boys are not prepared for the main reproductive events in adolescence and lack substantial knowledge about reproductive health. All in all, the reproductive health status of adolescent boys and girls from a mental-emotional perspective seems low.
Monitoring nutritional status from birth to menarche (and preferably thereafter as well) could aid the targeting of nutritional intervention programs for those girls that run the highest risk of reaching their menarche late. In addition, Information Education and Communication (IEC) activities aimed at improving adolescent reproductive health status could benefit from the eagerness that boys and girls displayed in this study towards gathering knowledge on reproductive health matters.
