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Effect of Pelvic Health Education on Pelvic Health Self-Care Practices among Adult Women in Nigeria

Abstract

Pelvic health is an important component of women's overall health and may influence urinary, bowel, sexual, reproductive, musculoskeletal, and quality-of-life outcomes. Adult women in Nigeria may experience pelvic health concerns such as urinary leakage, pelvic-floor weakness, constipation, pelvic pain, and other pelvic-related conditions, but may have limited knowledge of appropriate preventive and self-care practices. Misconceptions, embarrassment, cultural beliefs, limited access to reliable health information, inadequate awareness of pelvic-floor health, and the tendency to normalize pelvic symptoms may discourage women from adopting appropriate self-care practices or seeking professional advice when necessary. Pelvic health education provides an opportunity to improve women's understanding of pelvic health, preventive measures, appropriate self-care, and the importance of professional assessment for persistent or concerning symptoms. Against this background, this study investigates the effect of pelvic health education on pelvic health self-care practices among adult women in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Framework, and Social Cognitive Theory. The Health Belief Model explains how women's perceptions of susceptibility to pelvic health problems, perceived severity, perceived benefits of preventive practices, perceived barriers, self-efficacy, and cues to action may influence pelvic health self-care. The Health Literacy Framework emphasizes women's ability to access, understand, evaluate, and apply reliable information concerning pelvic health and appropriate self-care. Social Cognitive Theory emphasizes observational learning, self-efficacy, reinforcement, social support, and environmental influences in shaping women's health behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how pelvic health education may influence pelvic health self-care practices among adult women in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adult women aged 18 years and above residing in selected urban and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, healthcare facilities, and eligible women. Pelvic health education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, information on pelvic-floor anatomy and function, pelvic-floor muscle exercises, bladder health, bowel health, constipation prevention, healthy physical activity, appropriate body-weight management, safe lifting and physical strain practices, pregnancy and postpartum pelvic health, menstrual and reproductive health, pelvic pain awareness, sexual and reproductive health, recognition of pelvic health symptoms, appropriate healthcare-seeking, and available pelvic health services. Pelvic health self-care practices will be assessed using indicators such as regular pelvic-floor exercises where appropriate, adequate fluid intake, healthy bowel habits, prevention and management of constipation, appropriate physical activity, healthy weight-management practices, safe lifting practices, attention to urinary and bowel symptoms, appropriate management of pelvic discomfort, maintenance of personal hygiene, adherence to professional advice, and timely healthcare-seeking for persistent or concerning symptoms. Data will be collected using structured questionnaires, standardized pelvic health knowledge and self-care assessment tools, scenario-based questions, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic, socioeconomic, reproductive, and health characteristics, sources of health information, exposure to pelvic health education, and self-care practices. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of pelvic health education on pelvic health self-care practices. Where a quasi-experimental design is adopted, self-care practice scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that pelvic health education has a significant positive effect on pelvic health self-care practices among adult women in Nigeria. Women exposed to structured, evidence-based, culturally appropriate, and sustained pelvic health education are expected to demonstrate better pelvic health self-care practices than women without comparable exposure. Education may improve women's understanding of pelvic-floor health, appropriate pelvic-floor exercises, bladder and bowel health, constipation prevention, physical activity, safe lifting, pregnancy and postpartum pelvic health, and recognition of symptoms requiring professional assessment. Practical demonstrations may improve women's confidence in performing appropriate pelvic-floor exercises and adopting healthier daily practices. Education may also reduce embarrassment and misconceptions surrounding urinary, bowel, pelvic pain, and other pelvic health concerns, thereby encouraging women to discuss persistent symptoms with qualified healthcare professionals. However, cultural beliefs, stigma, limited access to pelvic health services, inadequate availability of trained healthcare professionals, financial barriers, misinformation, and limited integration of pelvic health into routine healthcare may reduce the effectiveness of education alone. The study therefore expects accessible, practical, confidential, culturally sensitive, and sustained pelvic health education, supported by appropriate healthcare and referral services, to contribute significantly to improved pelvic health self-care practices among adult women in Nigeria. The study is expected to contribute to the literature on pelvic health, pelvic-floor health education, women's health, self-care practices, urinary and bowel health, reproductive health, maternal health, health promotion, health literacy, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, hospitals, physiotherapy services, women's health professionals, nurses, midwives, physicians, community health workers, women's health organizations, development partners, and policymakers regarding strategies for strengthening pelvic health promotion. The study will also provide evidence-based recommendations for integrating pelvic health education into primary healthcare and women's health programmes, improving access to reliable pelvic health information, strengthening pelvic-floor health education, increasing awareness of urinary and bowel health, improving referral pathways, and developing sustainable interventions that promote appropriate pelvic health self-care practices among adult women across Nigeria.

Keywords: Pelvic health education, pelvic health self-care practices, pelvic-floor health, adult women, women's health, urinary health, bowel health, reproductive health, health promotion, health literacy, Nigeria, public health.