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Impact of Menstrual Health Services on Menstrual Hygiene Practices among Adolescent Girls in Nigeria

Abstract

Menstrual health is an important component of adolescent girls' health, wellbeing, education, and social participation. Inadequate access to appropriate menstrual health services may make it difficult for adolescent girls to manage menstruation safely, comfortably, and with dignity. Menstrual health services include access to menstrual health education, counselling, affordable and appropriate menstrual materials, water and sanitation facilities, privacy, healthcare support, and reliable information on menstrual management. Menstrual hygiene practices refer to the behaviours adopted by girls to manage menstruation safely and hygienically, including the use of appropriate menstrual absorbents, regular changing of menstrual materials, proper disposal or washing of reusable materials, hand hygiene, body hygiene, and appropriate management of menstrual discomfort. In Nigeria, adolescent girls may experience challenges such as limited access to menstrual materials, inadequate water and sanitation facilities, insufficient menstrual health education, stigma, cultural misconceptions, and financial barriers. These challenges may negatively affect menstrual hygiene practices and potentially contribute to discomfort, reproductive health concerns, school absenteeism, and reduced participation in daily activities. Improving access to comprehensive menstrual health services may provide adolescent girls with the knowledge, resources, facilities, and support required for safe menstrual management. Against this background, this study investigates the impact of menstrual health services on menstrual hygiene practices among adolescent girls in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Theory, and the Health Systems Framework. The Health Belief Model explains health-related behaviours through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. Social Ecological Theory recognizes that menstrual hygiene practices are influenced by individual, interpersonal, school, community, environmental, and broader social factors. The Health Systems Framework emphasizes the importance of service delivery, health workforce, health information, essential supplies, infrastructure, and access to appropriate health services. Collectively, these theoretical perspectives provide a suitable framework for explaining how menstrual health services may influence menstrual hygiene practices among adolescent girls in Nigeria. The study will adopt a quantitative cross-sectional research design. Data will be collected from adolescent girls aged approximately 10–19 years attending selected secondary schools and communities across selected locations in Nigeria. A multistage sampling technique will be used to select states, local government areas, schools, communities, and eligible participants. Menstrual health services will be assessed using indicators such as availability of menstrual health education, access to menstrual health counselling, availability and affordability of menstrual materials, access to clean water, availability of functional sanitation facilities, access to private changing spaces, availability of disposal facilities, access to healthcare support, and exposure to menstrual health information. Menstrual hygiene practices will be assessed using indicators such as type of menstrual materials used, frequency of changing absorbents, handwashing practices, bathing practices, proper disposal or cleaning of menstrual materials, management of reusable materials, access to clean water during menstruation, and appropriate management of menstrual discomfort. Structured questionnaires will be used for data collection, while school or programme records may be reviewed where appropriate to assess the availability of menstrual health services. Descriptive statistics will be used to summarize participants' characteristics, access to menstrual health services, and menstrual hygiene practices. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple regression analysis, will be used to determine the impact of menstrual health services on menstrual hygiene practices. Diagnostic tests will also be conducted to assess the reliability of the research instrument and the robustness of the findings. The study is expected to find that access to adequate menstrual health services has a significant positive impact on menstrual hygiene practices among adolescent girls in Nigeria. Girls who have access to menstrual health education, affordable menstrual materials, clean water, functional sanitation facilities, privacy, and appropriate healthcare support are expected to demonstrate safer and more appropriate menstrual hygiene practices. Menstrual health education may improve knowledge about menstruation, correct misconceptions, encourage regular changing of menstrual materials, and promote proper hand and body hygiene. Adequate water, sanitation, and disposal facilities may also make it easier for girls to manage menstruation safely and with dignity. Conversely, inadequate menstrual health services may contribute to the use of inappropriate or unhygienic menstrual materials, infrequent changing of absorbents, poor disposal practices, inadequate hand hygiene, and difficulty managing menstruation at school or within the community. However, menstrual health services alone may not fully determine hygiene practices because household income, parental support, cultural beliefs, social norms, school policies, availability of water and sanitation infrastructure, and individual knowledge may also influence menstrual management. The study is expected to contribute to the literature on menstrual health, menstrual hygiene, adolescent health, reproductive health, school health, health promotion, gender-related health needs, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, state ministries of health and education, schools, healthcare providers, community health workers, development partners, non-governmental organizations, and policymakers regarding strategies for improving menstrual health among adolescent girls. The study will also provide evidence-based recommendations for strengthening menstrual health education, improving access to affordable menstrual materials, providing clean water and functional sanitation facilities in schools, establishing appropriate menstrual waste-disposal systems, improving privacy for menstrual management, strengthening adolescent-friendly health services, and integrating comprehensive menstrual health programmes into school and community health initiatives across Nigeria.

Keywords: Menstrual health services, menstrual hygiene practices, adolescent girls, Nigeria, menstrual health, menstrual hygiene, adolescent health, reproductive health, school health, water sanitation and hygiene, health promotion, public health.