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Effect of Vaginal Douching Education on Douching Prevention Practices among Female University Students in Nigeria

Abstract

Vaginal douching is a reproductive-health practice involving the introduction of water, cleansing solutions, antiseptics, herbal preparations, or other substances into the vagina. Although some women may perceive douching as a method of maintaining cleanliness, controlling odour, preventing infections, or improving sexual hygiene, routine vaginal douching may disrupt the normal vaginal environment and may be associated with reproductive and sexual-health concerns. Female university students may be exposed to social influences, cultural beliefs, peer advice, commercial advertisements, online information, and misconceptions that encourage douching. Limited knowledge of normal vaginal health and the potential risks associated with unnecessary douching may contribute to continued practice. Vaginal douching education provides an opportunity to improve students' understanding of vaginal health, correct misconceptions, and promote safer practices that discourage unnecessary vaginal douching. Against this background, this study investigates the effect of vaginal douching education on douching prevention practices among female university students in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Theory, and Social Cognitive Theory. The Health Belief Model explains how students' perceptions of susceptibility to vaginal-health problems, perceived severity of potential complications, perceived benefits of avoiding unnecessary douching, perceived barriers, self-efficacy, and cues to action may influence douching prevention practices. Health Literacy Theory emphasizes students' ability to obtain, understand, evaluate, and apply reliable information about vaginal health to make informed decisions. Social Cognitive Theory emphasizes observational learning, peer influence, self-efficacy, behavioural modelling, reinforcement, and environmental influences in shaping health behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how vaginal douching education may influence douching prevention practices among female university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise female undergraduate and postgraduate students aged 18 years and above enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties or departments, academic levels, and eligible students. Vaginal douching education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, knowledge of normal vaginal health, understanding of the vaginal microbiome, awareness of the potential effects of unnecessary douching, misconceptions about vaginal cleanliness, beliefs about douching and infection prevention, awareness of sexually transmitted infections, menstrual hygiene, recognition of symptoms requiring professional assessment, appropriate external genital hygiene, risks associated with inserting substances into the vagina, awareness of reliable reproductive-health information sources, and available reproductive-health services. Douching prevention practices will be assessed using indicators such as avoidance of routine vaginal douching, avoidance of inserting cleansing or antiseptic substances into the vagina without appropriate medical indication, avoidance of unverified herbal or homemade vaginal preparations, use of appropriate external cleansing practices, ability to identify safer hygiene alternatives, avoidance of douching for odour control, appropriate management of vaginal symptoms through professional healthcare, avoidance of inappropriate self-medication, and timely healthcare-seeking when abnormal discharge, itching, irritation, pain, or other concerning symptoms occur. Data will be collected using structured questionnaires, vaginal-health knowledge assessment tools, douching-practice scales, scenario-based questions, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and academic characteristics, previous exposure to reproductive-health education, sources of vaginal-health information, douching experiences, and prevention 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 vaginal douching education on douching prevention practices. Where a quasi-experimental design is adopted, douching prevention-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 vaginal douching education has a significant positive effect on douching prevention practices among female university students in Nigeria. Students exposed to structured, evidence-based, confidential, and culturally appropriate vaginal-health education are expected to demonstrate greater knowledge of the potential risks of unnecessary douching and improved douching prevention practices than students without comparable exposure. Education may correct misconceptions that douching is necessary for maintaining vaginal cleanliness, preventing infections, eliminating odour, or improving sexual hygiene. It may also improve students' understanding of normal vaginal health and encourage appropriate external genital hygiene without unnecessary internal cleansing. Practical education may help students identify reliable reproductive-health information, avoid unverified vaginal preparations, and seek professional healthcare when symptoms require assessment rather than attempting to treat them through douching. However, peer influence, cultural beliefs, social expectations, commercial marketing, misinformation, embarrassment about discussing vaginal health, and exposure to online reproductive-health misinformation may reduce the effectiveness of education alone. The study therefore expects accessible, non-judgmental, culturally sensitive, practical, and sustained vaginal douching education, supported by appropriate university reproductive-health services, to contribute significantly to improved douching prevention practices among female university students in Nigeria. The study is expected to contribute to the literature on vaginal douching, women's health, reproductive health, vaginal health, sexual and reproductive health education, adolescent and young adult health, health literacy, health promotion, infection prevention, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, universities, university health centres, healthcare professionals, gynaecologists, nurses, reproductive-health organizations, student health services, community health workers, development partners, and policymakers regarding strategies for improving reproductive-health practices among young women. The study will also provide evidence-based recommendations for integrating vaginal-health education into university health programmes, correcting misconceptions about vaginal cleanliness, promoting appropriate external genital hygiene, strengthening reproductive-health counselling, improving students' ability to identify reliable health information, discouraging harmful or unnecessary vaginal practices, and developing sustainable reproductive-health education programmes that promote healthy vaginal-health behaviours among female university students across Nigeria.

Keywords: Vaginal douching education, douching prevention practices, female university students, vaginal health, reproductive health, women's health, sexual and reproductive health, health education, health literacy, infection prevention, Nigeria, public health.