Factors Associated with Menstrual Hygiene Practices Among Secondary School Girls in Nasarawa State, North-Central Nigeria

Abstract

Background Inadequate menstrual hygiene management (MHM) continues to undermine the health, dignity, and educational participation of adolescent girls in sub-Saharan Africa. Although attention to menstrual health has increased, empirical evidence on the determinants of menstrual hygiene practices among school-aged girls in Nigeria remains limited. This study assessed socio-demographic, environmental, and knowledge-related factors associated with menstrual hygiene practices among secondary schoolgirls in Nasarawa State, Nigeria.  Methods A cross-sectional baseline survey was carried out among 1,250 female students aged 10–19 years from 25 secondary schools located in the Nasarawa West Senatorial Zone. Data were obtained using structured questionnaires adapted from validated instruments, alongside observational checklists assessing water, sanitation, and hygiene (WASH) facilities. Menstrual hygiene practices were evaluated using a 10-item composite scale and classified into poor, fair, good, or excellent categories. Bivariate associations were examined using chi-square tests, while binary logistic regression was applied to identify independent predictors of good menstrual hygiene practices.  Results At baseline, only 20.8% of respondents exhibited good or excellent menstrual hygiene practices. Bivariate analysis indicated significant associations between menstrual hygiene practices and school type (χ2 = 17.2, p = 0.002), parental education (p < 0.005), place of residence (χ2 = 7.11, p = 0.008), and age (χ2 = 4.26, p = 0.039). Multivariable analysis identified menstrual hygiene knowledge as the most influential predictor of good practices (OR = 2.27, 95% CI: 1.84–2.80, p < 0.001). Additional significant predictors included having a mother with tertiary education (OR = 1.60, p = 0.012), enrollment in private schools (OR = 1.48, p = 0.021), and residing in urban or semi-urban areas (OR = 1.39, p = 0.029).  Conclusion Menstrual hygiene practices among secondary schoolgirls in Nigeria are largely driven by knowledge levels, with socioeconomic and environmental factors exerting complementary effects. Strengthening school-based menstrual health education, alongside improvements in WASH infrastructure, is essential for promoting effective menstrual hygiene management among adolescent girls.