Understanding Menstrual Health and Hygiene: Insights from Secondary School Girls in Nigeria

Abstract

Background: Menstrual health remains an under-addressed aspect of adolescent sexual and reproductive health in low- and middle-income countries. Despite increasing awareness, gaps persist in hygienic practices, product affordability, safe disposal, and access to adolescent-friendly services, affecting health, dignity, and school participation. Methods: A school-based cross-sectional study was conducted among menstruating secondary school girls in Ado-Ekiti, southwestern Nigeria. Using stratified random sampling, 253 students were selected from two co-educational schools. Data were collected with a pretested, self-administered questionnaire covering sociodemographics, menstrual knowledge, practices, and perceptions. Internal consistency was acceptable (Cronbach’s α = 0.812). Descriptive statistics summarized findings, while chi-square and independent t-tests assessed associations at a 5% significance level. Results: Most participants were aged 15-18 years. Awareness of menstruation as a biological process was high (>90%), and sanitary pad use was nearly universal (98%). However, only 10.9% practiced correct disposal, revealing a notable knowledge-practice gap. Over half perceived menstrual products as unaffordable or inaccessible, significantly associated with lower monthly allowance (χ² = 23.42, p < 0.001). Receiving menstrual education from a healthcare professional was linked to higher knowledge scores (t = 2.09, p = 0.038) and safer practices, including reduced reuse of menstrual materials (χ² = 15.88, p < 0.001). Conclusion: Despite high menstrual awareness, gaps persist in safe disposal, affordability, and health service engagement. Strengthened school education, improved WASH infrastructure, and policies addressing period poverty could improve menstrual hygiene practices, reduce school absenteeism, and enhance adolescent health and well-being.