Knowledge and Practice of Menstrual Hygiene Among Female Secondary School Students in Shao, Moro Local Government Area, Kwara State

Abstract

Introduction: Inadequate menstrual hygiene management (MHM) is associated with reproductive tract infections, school absenteeism, and stigma among young women in resource-limited environments. Information on MHM among rural Nigerian adolescents is scarce.
Objective: To assess the knowledge, attitudes, practices, and determinants of MHM among adolescent female secondary school students in Shao, Moro Local Government Area, Kwara State, Nigeria.
Methods: This descriptive cross-sectional study involved 350 secondary school girls in classes SSS 1-3 from five purposively selected schools in Shao from June to August 2025. The sample size was calculated using Cochran’s formula with a 10% non-response rate. Participants were selected via multistage sampling with proportionate allocation across classes. Data were gathered using a pretested, semi-structured interviewer-administered questionnaire available in English and Yoruba. The instrument was validated by public health and obstetrics experts, with a Cronbach’s alpha of 0.81 for the knowledge section. Data were analyzed using SPSS version 26.0. Knowledge, attitude, and practice were scored, graded, and categorized. Associations were tested using chi-square at p<0.05, and binary logistic regression was conducted to identify independent predictors of good menstrual hygiene practice.
Result: The mean age was 16.97±1.73 years. Overall, 60.6% had adequate knowledge, 40.9% had good practices, and 76.3% had a negative attitude towards MHM. Although 72.9% used absorbent materials, 68.6% used commercially made sanitary pads. In addition, 60% disposed of used pads improperly. Major constraints included lack of toilet privacy (70.9%), inadequate information (64.9%), and cost of sanitary pads (49.4%). Knowledge had a significant correlation with age, religion, birth order, school type, parents’ education level, regularity, and duration of menstruation (p<0.05). Practice had a significant correlation with guardian, religion, parents' education level, regularity, family history of dysmenorrhea, duration, and pain (p<0.05). Binary logistic regression further identified living with parents (AOR = 2.34, 95% CI 1.45–3.78, p = 0.001), tertiary maternal education (AOR = 1.89, 95% CI 1.12–3.19, p = 0.017), regular menstruation (AOR = 2.11, 95% CI 1.23–3.62, p = 0.007), and absence of dysmenorrhea (AOR = 1.76, 95% CI 1.08–2.87, p = 0.024) as independent predictors of good menstrual hygiene practice.
Conclusion: MHM knowledge was moderate, but not consistently translated into safe practice due to infrastructural and financial constraints. It is recommended that the Kwara State Ministry of Education incorporate menstrual health education into the school curriculum and provide access to proper WASH facilities and affordable sanitary products in all public secondary schools.