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Impact of Menstrual Product Accessibility on Menstrual Hygiene Practices among Female Students in Nigeria

Abstract

Menstrual health and hygiene are important components of adolescent and young women's health, education, dignity, and wellbeing. Female students in Nigeria may experience difficulties maintaining appropriate menstrual hygiene when they have limited access to affordable, safe, and suitable menstrual products. Financial constraints, inadequate availability of menstrual products, poor water and sanitation facilities, lack of privacy, stigma, and limited access to menstrual health information may affect students' ability to manage menstruation safely and comfortably. Limited access to appropriate menstrual products may contribute to the use of unsuitable materials, delayed changing of menstrual products, restricted movement, absenteeism, discomfort, and other challenges that may affect educational participation and wellbeing. Improving accessibility of menstrual products may therefore support healthier menstrual hygiene practices among female students. Against this background, this study investigates the impact of menstrual product accessibility on menstrual hygiene practices among female students in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Theory of Planned Behavior. The Health Belief Model explains how students' perceptions of menstrual health risks, perceived benefits of appropriate menstrual hygiene, perceived barriers, self-efficacy, and cues to action may influence their hygiene practices. The Social Ecological Model emphasizes the influence of individual, interpersonal, school, community, socioeconomic, and environmental factors on access to menstrual products and menstrual hygiene practices. The Theory of Planned Behavior explains how attitudes toward menstrual hygiene, subjective norms, perceived behavioural control, and behavioural intentions may influence students' adoption of appropriate menstrual hygiene practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how menstrual product accessibility may influence menstrual hygiene practices 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 product accessibility will be assessed using indicators such as availability of menstrual products within or near the school environment, affordability, frequency of product shortages, distance to purchasing points, range of available products, access to emergency menstrual products, ability to obtain products when menstruation begins unexpectedly, household financial capacity, access to reusable menstrual materials where appropriate, and continuity of product availability. Menstrual hygiene practices will be assessed using indicators such as regular changing of menstrual products, appropriate disposal or cleaning of products according to product type, hand hygiene before and after changing menstrual materials, use of clean and suitable menstrual products, management of menstrual discomfort, maintenance of personal cleanliness, access to water and sanitation facilities, ability to change products privately at school, preparedness for menstruation, and avoidance of unsafe menstrual-management practices. Data will be collected using structured questionnaires, standardized menstrual hygiene assessment tools, menstrual-product accessibility checklists, school water, sanitation and hygiene assessments, and relevant school health records where available. Descriptive statistics will be used to summarize students' demographic and socioeconomic characteristics, menstrual experiences, types of menstrual products used, accessibility levels, 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 impact of menstrual product accessibility on menstrual hygiene practices. Where a quasi-experimental design is adopted, menstrual hygiene practices before and after an intervention to improve product accessibility 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 menstrual product accessibility has a significant positive impact on menstrual hygiene practices among female students in Nigeria. Students who have consistent access to affordable, appropriate, and suitable menstrual products are expected to demonstrate better menstrual hygiene practices than students who experience difficulties obtaining menstrual products. Improved accessibility may enable students to change menstrual products regularly, maintain appropriate personal hygiene, manage menstruation more confidently, and participate more comfortably in school activities. Access to emergency menstrual products may also reduce the likelihood of students using unsuitable materials when menstruation begins unexpectedly. However, access to products alone may not be sufficient where students lack clean water, sanitation facilities, privacy, menstrual health information, or supportive school environments. Poverty, product costs, stigma, inadequate WASH infrastructure, cultural restrictions, and limited school-based menstrual support may continue to affect menstrual hygiene practices. The study therefore expects improved availability and affordability of menstrual products, combined with adequate menstrual health education and supportive WASH facilities, to contribute significantly to improved menstrual hygiene practices among female students in Nigeria. The study is expected to contribute to the literature on menstrual health and hygiene, menstrual product accessibility, menstrual poverty, school health, water sanitation and hygiene, adolescent health, reproductive health, health education, gender equity, 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, menstrual-health organizations, development partners, healthcare professionals, community organizations, and policymakers regarding strategies for improving menstrual health among female students. The study will also provide evidence-based recommendations for improving access to affordable menstrual products, establishing school-based menstrual-product support systems, strengthening menstrual health education, improving water and sanitation facilities, providing private menstrual-management spaces, reducing menstrual stigma, and developing sustainable interventions that promote safe and dignified menstrual hygiene practices among female students across Nigeria.

Keywords: Menstrual product accessibility, menstrual hygiene practices, female students, menstrual health, menstrual hygiene, menstrual poverty, school health, WASH, reproductive health, adolescent health, Nigeria, public health.