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Effect of Menstrual Hygiene Facilities on Menstrual Hygiene Practices among Female Secondary School Students in Nigeria

Abstract

Menstrual hygiene is an important component of adolescent girls' health, well-being, dignity, school participation, and educational development. Female secondary school students in Nigeria may experience challenges in managing menstruation safely and comfortably because of inadequate access to clean and private sanitation facilities, water, menstrual hygiene materials, appropriate disposal systems, changing spaces, and accurate menstrual health information. Poor menstrual hygiene conditions may contribute to discomfort, embarrassment, reduced school attendance, difficulty concentrating in class, and increased risk of poor hygiene practices. Menstrual hygiene facilities within schools provide an enabling environment for girls to manage menstruation safely by providing access to water, functional toilets, privacy, handwashing facilities, changing areas, menstrual hygiene materials, and appropriate disposal mechanisms. However, inadequate infrastructure, poor maintenance, overcrowding, lack of water supply, insufficient menstrual waste disposal facilities, and limited access to menstrual products may reduce the effectiveness of school menstrual hygiene facilities. Against this background, this study investigates the effect of menstrual hygiene facilities on menstrual hygiene practices among female secondary school students in Nigeria. The study will be anchored on the Social Ecological Model, Health Belief Model, and Theory of Planned Behavior. The Social Ecological Model emphasizes the influence of individual, interpersonal, school, community, and environmental factors on menstrual hygiene practices. The Health Belief Model explains how students' perceptions of menstrual health risks, perceived benefits of appropriate hygiene practices, perceived barriers, and cues to action may influence their menstrual hygiene behaviours. The Theory of Planned Behavior explains how students' attitudes, subjective norms, perceived behavioural control, and behavioural intentions may influence their adoption of appropriate menstrual hygiene practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how menstrual hygiene facilities may influence menstrual hygiene practices among female secondary school students in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise menstruating female students enrolled in selected public and private secondary schools across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, schools, classes, and eligible students. Menstrual hygiene facilities will be assessed using indicators such as availability of functional toilets, privacy of sanitation facilities, availability of water, handwashing facilities, soap, changing spaces, menstrual hygiene materials, sanitary pad disposal facilities, waste bins, cleanliness of toilets, accessibility of facilities during school hours, and maintenance of menstrual hygiene infrastructure. Menstrual hygiene practices will be assessed using indicators such as frequency of changing menstrual materials, appropriate washing and cleaning practices, handwashing before and after changing menstrual materials, safe disposal of used menstrual materials, use of clean menstrual materials, storage practices, management of menstrual discomfort, and appropriate use of school sanitation facilities during menstruation. Data will be collected using structured questionnaires, school facility assessment checklists, direct observation, school health records, and relevant school WASH programme documents. Descriptive statistics will be used to summarize students' characteristics, availability of menstrual hygiene facilities, and menstrual hygiene practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of menstrual hygiene facilities on menstrual hygiene practices. Where a quasi-experimental design is adopted, menstrual hygiene practice scores before and after improvement or provision of menstrual hygiene facilities may be compared, while relevant demographic, socioeconomic, school, and environmental factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that adequate menstrual hygiene facilities have a significant positive effect on menstrual hygiene practices among female secondary school students in Nigeria. Students attending schools with functional, clean, private, and accessible menstrual hygiene facilities are expected to demonstrate better menstrual hygiene practices than students in schools with inadequate facilities. Reliable water supply, private toilets, handwashing facilities, changing spaces, availability of menstrual hygiene materials, and appropriate disposal systems may enable students to manage menstruation more safely and comfortably. Improved facilities may also reduce embarrassment, support school participation, and create a more supportive environment for menstrual health management. However, inadequate maintenance, water shortages, overcrowding, limited availability of menstrual products, poor waste management, and insufficient menstrual health education may limit the effectiveness of menstrual hygiene facilities. The study therefore expects well-maintained, accessible, gender-responsive, and adequately resourced menstrual hygiene facilities to contribute significantly to improved menstrual hygiene practices among female secondary school students in Nigeria. The study is expected to contribute to the literature on menstrual hygiene management, school WASH facilities, menstrual hygiene practices, adolescent girls' health, reproductive health, school health, 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, school management authorities, local government education authorities, WASH organizations, adolescent health programmes, development partners, teachers, school health personnel, and policymakers regarding strategies for improving menstrual health among schoolgirls. The study will also provide evidence-based recommendations for improving school water, sanitation, and hygiene facilities, ensuring reliable water and handwashing services, providing private changing spaces, strengthening menstrual waste disposal systems, improving access to affordable menstrual hygiene materials, maintaining school sanitation facilities, and integrating menstrual health education into broader school health and WASH programmes across Nigeria.

Keywords: Menstrual hygiene facilities, menstrual hygiene practices, female secondary school students, menstrual hygiene management, school WASH, adolescent girls, reproductive health, school health, sanitation facilities, Nigeria, public health.