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Impact of Menstrual-Friendly Facilities on Menstrual Hygiene Management among Female Students in Nigeria

Abstract

Menstrual hygiene management is an important component of the health, dignity, wellbeing, and educational participation of female students in Nigeria. Female students may experience difficulties managing menstruation appropriately when schools lack adequate water, sanitation and hygiene facilities, private changing spaces, functional toilets, disposal systems, water supply, and places for washing or changing menstrual products. Inadequate menstrual-friendly facilities may result in discomfort, use of unsuitable menstrual-management practices, difficulty changing menstrual products during school hours, restricted participation in academic activities, and absenteeism. Improving the availability and quality of menstrual-friendly facilities may therefore support safer and more dignified menstrual hygiene management among female students. Against this background, this study investigates the impact of menstrual-friendly facilities on menstrual hygiene management among female students in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Social Cognitive Theory. The Health Belief Model explains how students' perceptions of menstrual hygiene-related health risks, perceived benefits of appropriate menstrual hygiene management, perceived barriers, self-efficacy, and cues to action may influence their menstrual hygiene practices. The Social Ecological Model emphasizes the influence of individual, interpersonal, school, community, environmental, socioeconomic, and infrastructural factors on menstrual hygiene management. Social Cognitive Theory emphasizes observational learning, self-efficacy, social support, reinforcement, and environmental factors in shaping students' menstrual hygiene behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how menstrual-friendly facilities may influence menstrual hygiene management among female students in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise female students enrolled in selected secondary schools and universities across Nigeria, with the specific educational level determined according to the approved study protocol. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, schools or universities, classes or levels of study, and eligible female students. Menstrual-friendly facilities will be assessed using indicators such as availability of functional toilets, reliable water supply, soap or hand-cleansing materials, private menstrual-changing spaces, adequate lighting, privacy, menstrual-product disposal bins, covered disposal facilities, cleanliness, safety, accessibility during school hours, facilities for washing reusable menstrual products where appropriate, emergency menstrual-product availability, and accessibility for students with disabilities. Menstrual hygiene management will be assessed using indicators such as use of clean and appropriate menstrual products, regular changing of menstrual products, appropriate disposal or cleaning according to product type, handwashing before and after changing menstrual products, ability to change menstrual products during school hours, maintenance of personal cleanliness, management of menstrual discomfort, preparedness for menstruation, and avoidance of unsafe menstrual-management practices. Data will be collected using structured questionnaires, standardized menstrual hygiene assessment tools, school WASH and menstrual-facility observation checklists, facility assessment records, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and socioeconomic characteristics, menstrual experiences, types of menstrual products used, availability of menstrual-friendly facilities, and menstrual hygiene management 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 impact of menstrual-friendly facilities on menstrual hygiene management. Where a quasi-experimental design is adopted, menstrual hygiene-management scores before and after improvement of menstrual-friendly facilities may be compared with those of a comparison school or institution 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 menstrual-friendly facilities have a significant positive impact on menstrual hygiene management among female students in Nigeria. Students who have access to clean, functional, private, safe, and adequately supplied menstrual-friendly facilities are expected to demonstrate better menstrual hygiene management than students without comparable access. Appropriate facilities may enable students to change menstrual products regularly, wash their hands, maintain personal cleanliness, dispose of used products safely, and manage menstruation with greater comfort and privacy during school hours. Reliable water supply, private changing spaces, and appropriate disposal systems may reduce barriers that discourage students from changing menstrual products while at school. Improved facilities may also reduce menstrual-related discomfort, embarrassment, and disruption of educational activities. However, inadequate menstrual-product affordability, cultural stigma, lack of menstrual-health information, poor facility maintenance, overcrowding, unreliable water supply, and insufficient school support may limit the effectiveness of facilities alone. The study therefore expects accessible, clean, private, safe, functional, and well-maintained menstrual-friendly facilities, combined with appropriate menstrual-health education and access to affordable menstrual products, to contribute significantly to improved menstrual hygiene management among female students in Nigeria. The study is expected to contribute to the literature on menstrual hygiene management, menstrual-friendly facilities, school WASH, menstrual health, adolescent health, reproductive health, school health, gender equity, health education, environmental 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, schools and universities, local government authorities, WASH agencies, environmental health officers, menstrual-health organizations, development partners, healthcare professionals, student organizations, and policymakers regarding strategies for improving menstrual health among female students. The study will also provide evidence-based recommendations for improving school water and sanitation facilities, providing private menstrual-changing spaces, strengthening menstrual-product disposal systems, ensuring reliable water and soap availability, establishing emergency menstrual-product support, improving facility maintenance, and developing sustainable school-based interventions that promote safe, dignified, and effective menstrual hygiene management among female students across Nigeria.

Keywords: Menstrual-friendly facilities, menstrual hygiene management, female students, menstrual health, school WASH, menstrual hygiene, sanitation facilities, adolescent health, reproductive health, school health, Nigeria, public health.