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Effect of Menstrual Disorders Education on Healthcare-Seeking Practices among Adolescent Girls in Nigeria

Abstract

Menstrual disorders are an important adolescent health concern and may include heavy menstrual bleeding, painful menstruation, irregular menstrual cycles, prolonged bleeding, and other abnormalities that can affect girls' physical, emotional, social, and educational well-being. Although some menstrual changes may occur during adolescence as menstrual cycles become established, persistent or severe symptoms may require appropriate assessment and treatment. Menstrual disorders education provides adolescent girls with accurate information about normal and abnormal menstruation, common menstrual disorders, warning signs, possible causes, complications, menstrual hygiene, appropriate self-care, and when and where to seek professional healthcare. Healthcare-seeking practices refer to the actions taken by adolescent girls when they experience menstrual symptoms or abnormalities, including seeking care from qualified healthcare providers, reporting persistent or severe symptoms, utilizing appropriate health facilities, and following professional recommendations. In Nigeria, inadequate menstrual health knowledge, misconceptions, stigma, embarrassment, cultural beliefs, financial limitations, lack of privacy, and limited access to adolescent-friendly health services may discourage girls from seeking appropriate healthcare for menstrual problems. Effective menstrual disorders education may improve knowledge, reduce misconceptions, increase recognition of concerning symptoms, and encourage timely utilization of appropriate healthcare services. Against this background, this study investigates the effect of menstrual disorders education on healthcare-seeking practices among adolescent girls in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains health-seeking behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding adolescent girls' decisions to seek healthcare for menstrual problems. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from menstrual disorders education may influence healthcare-seeking practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how menstrual disorders education may influence healthcare-seeking practices among adolescent girls in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adolescent girls aged approximately 10 to 19 years in selected secondary schools and communities in Nigeria using a structured anonymous self-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, schools or communities, classes or households, and eligible participants. Where feasible, selected schools or participant groups will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured menstrual disorders education covering normal menstruation, common menstrual disorders, menstrual symptoms requiring professional attention, possible causes and complications, menstrual hygiene, appropriate self-care, misconceptions and stigma, available healthcare services, and the importance of timely healthcare seeking. Healthcare-seeking practices will be assessed using indicators such as recognition of concerning menstrual symptoms, timely consultation with qualified healthcare providers, utilization of appropriate health facilities, reporting of persistent or severe menstrual problems, and adherence to professional recommendations. Descriptive statistics will be used to summarize participants' sociodemographic and menstrual characteristics, menstrual health knowledge, exposure to education, and healthcare-seeking practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the effect of menstrual disorders education on healthcare-seeking practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that menstrual disorders education has a significant positive effect on healthcare-seeking practices among adolescent girls in Nigeria. Girls exposed to structured menstrual disorders education are expected to demonstrate improved knowledge of menstruation, greater ability to distinguish normal menstrual changes from potentially concerning symptoms, and increased willingness to seek professional healthcare when necessary. Education may reduce misconceptions and embarrassment surrounding menstruation, encourage timely reporting of persistent or severe symptoms, and increase utilization of appropriate adolescent-friendly healthcare services. However, education alone may not guarantee appropriate healthcare seeking because adolescent girls may continue to experience barriers such as stigma, cultural beliefs, parental restrictions, financial limitations, lack of confidentiality, inadequate access to adolescent-friendly services, and fear of examination or treatment. Consequently, menstrual disorders education is expected to be most effective when supported by confidential and adolescent-friendly healthcare services, trained healthcare providers, school health programmes, supportive parents and caregivers, and accessible referral systems. The study is expected to contribute to the literature on adolescent health, menstrual health, menstrual disorders, health education, healthcare-seeking behaviour, school health, and public health in Nigeria by providing empirical evidence on the effect of menstrual disorders education on healthcare-seeking practices among adolescent girls. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency (NPHCDA), state ministries of health and education, schools, healthcare providers, school health coordinators, community health workers, development partners, and policymakers regarding strategies for improving adolescent menstrual health. The study will also provide evidence-based recommendations for strengthening menstrual health education, improving adolescent-friendly healthcare services, reducing stigma and misinformation, strengthening school-based health programmes, promoting early recognition of menstrual disorders, and encouraging appropriate healthcare seeking among adolescent girls across Nigeria.

Keywords: Menstrual disorders education, healthcare-seeking practices, adolescent girls, menstrual health, menstrual disorders, menstrual hygiene, adolescent health, school health, health education, health promotion, public health, Nigeria.