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Impact of Menstrual Product Accessibility on School Attendance among Adolescent Girls in Rural Nigeria

Abstract

Menstrual health is an important component of adolescent girls' physical, psychological, social, and educational wellbeing. In rural Nigeria, adolescent girls may experience difficulties accessing affordable and appropriate menstrual hygiene products because of poverty, limited availability of menstrual products, inadequate distribution systems, geographical barriers, stigma, and insufficient menstrual health education. Limited access to menstrual products may make it difficult for girls to manage menstruation safely and confidently, potentially contributing to absenteeism, reduced classroom participation, difficulty concentrating, and interruptions in educational activities. Menstrual product accessibility, including the availability, affordability, acceptability, and convenience of obtaining appropriate menstrual materials, may therefore play an important role in supporting girls' continued participation in school during menstruation. Against this background, this study investigates the impact of menstrual product accessibility on school attendance among adolescent girls in rural 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, family, school, community, economic, and environmental factors on menstrual health and school attendance. The Health Belief Model explains how girls' perceptions of menstrual health risks, perceived benefits of using appropriate menstrual products, perceived barriers, and cues to action may influence menstrual hygiene management and school attendance. The Theory of Planned Behavior explains how attitudes toward menstruation and school attendance, subjective norms, perceived behavioural control, and behavioural intentions may influence girls' decisions to attend school during menstruation. Collectively, these theoretical perspectives provide a suitable framework for explaining how menstrual product accessibility may influence school attendance among adolescent girls in rural Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise menstruating adolescent girls enrolled in selected public and private secondary schools in rural communities in Nigeria. A multistage sampling technique will be used to select states, local government areas, rural communities, schools, classes, and eligible adolescent girls. Menstrual product accessibility will be assessed using indicators such as availability of menstrual products, affordability, distance to purchasing locations, regularity of supply, availability of different menstrual product options, ability to obtain products when needed, household capacity to provide menstrual materials, access to school-based menstrual product distribution programmes, and product acceptability. School attendance will be assessed using indicators such as attendance during menstrual periods, number of school days missed because of menstruation, frequency of menstrual-related absenteeism, punctuality during menstruation, classroom participation, and attendance records where available. Data will be collected using structured questionnaires, school attendance registers, menstrual health assessment tools, school WASH records, and relevant menstrual health programme documents. Descriptive statistics will be used to summarize participants' demographic characteristics, menstrual product accessibility, menstrual hygiene conditions, and school attendance patterns. 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 school attendance. Where a quasi-experimental design is adopted, school attendance patterns before and after the introduction or expansion of menstrual product access programmes may be compared, while relevant socioeconomic, household, 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 improved menstrual product accessibility has a significant positive impact on school attendance among adolescent girls in rural Nigeria. Girls who have reliable and affordable access to appropriate menstrual products are expected to have fewer menstrual-related absences and higher school attendance than girls who experience difficulties obtaining menstrual materials. Improved access may increase girls' confidence in managing menstruation at school, reduce anxiety and embarrassment, and enable them to participate more consistently in classroom and school activities. However, poverty, cultural stigma, inadequate school sanitation facilities, lack of privacy, limited water supply, long distances to purchasing locations, and inadequate menstrual health education may continue to affect attendance even when menstrual products are available. The study therefore expects affordable, reliable, acceptable, and easily accessible menstrual products, combined with supportive school environments, to contribute significantly to improved school attendance among adolescent girls in rural Nigeria. The study is expected to contribute to the literature on menstrual product accessibility, menstrual hygiene management, school attendance, adolescent girls' health, school WASH, menstrual health, reproductive health, educational participation, 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, women's and girls' health organizations, development partners, and policymakers regarding strategies for improving menstrual health and educational participation. The study will also provide evidence-based recommendations for expanding affordable menstrual product distribution programmes, improving school-based access to menstrual materials, strengthening menstrual health education, addressing menstrual stigma, improving school WASH facilities, supporting locally appropriate menstrual product options, and integrating menstrual health interventions into broader adolescent health and education programmes across rural Nigeria.

Keywords: Menstrual product accessibility, school attendance, adolescent girls, menstrual hygiene management, menstrual health, school absenteeism, school WASH, reproductive health, adolescent health, rural Nigeria, public health.