Attainment of menstrual hygiene by girls in boarding secondary schools in a state in Sub-Saharan Africa

Emmanuel C. Inyang Etoh, Uwemedimbuk S. Ekanem, Aniefiok J. Umoiyoho


Background: Menarche is the most dramatic manifestation of puberty in girls; unlike the biometric developmental changes that occur at puberty, menarche requires the personal adjustment and response of an affected girl in order to attain good menstrual hygiene. This study was designed to evaluate how boarding secondary school girls manage their menstruation in school, away from the guidance of their parents.

Methods: A cross sectional survey was performed in four public boarding secondary schools in the study area with the aid of structured questionnaires to evaluate how such girls manage their menstruation while in school.

Results: The study population was 975 girls whose survey revealed the mean age at menarche of 12.5±1.4 years.  Seven hundred and two (72.0%) respondents had received sexuality education before onset of menarche. Respondents who attained good menstrual hygiene were 775(79.5%). Such respondents were those who had received sexuality education (p<0.001) and those who had access to synthetic sanitary pad (p=0.005). Duration of the menstrual period and the volume of menstrual blood loss did not affect (p=0.219) the ability of respondents to attain good menstrual hygiene. Respondents who received sexuality education had about 605 chances of attaining good menstrual hygiene than those who did not receive such education.

Conclusions: A vast majority of the respondents had received sexuality education before onset of menarche and a larger proportion attained good menstrual hygiene. Major factors that positively influenced the girls’ capacity to attained good menstrual hygiene were prior sexuality education and access to synthetic sanitary pad.


Menarche, Menstrual hygiene, Menstruation, Sanitary pad, Sexuality education

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Nzeako HC, Ezejindu DN, Iwunze AB and Obinwa BN. Pubertal development in Nigerian Igbo girls. J Pharmaceut Sci. 2015;2(4):45-51.

Eyong ME, Ntia HU, Ikobah JM, Eyong EM, Uket H, Enyiuma C, et al. Pattern of pubertal changes in Calabar, South-south Nigeria. PAMJ. 2018;31:20-31.

Fakeye O, Fagbule D. Age and anthropometric status of Nigerian girls at puberty: implication for the introduction of sex education into secondary schools. West Afr J Med. 1990;9(3):226-31.

Tunua KA, Adamu AN, Hassan MA, Ahmed Y, Ekele BA. Age at menarche among schools girls in Sokoto, Nothern Nigeria. Ann Afr Med. 2012;2(11):103-7.

Otobo TM, Onyemauche Osah, Paul NJ. Age at menarche in Nigerian adolescent girls case study: (Igbo, Yoruba, Hausa and Engenni tribes of Nigeria). Eur J Pharm Med Res. 2019;5(1):364-8.

Tijani AM, Awowole IO, Badejoko OO, Badejoko BO, Ijarotini AO, Loto OM. Is menarche really occurring earlier? A study of secondary school girls in Ile Ife, Nigeria. TJOG. 2019;1(36):112-6.

Adefuye PO, Odusoga OL, Adefuye BO, Akindele RA. Age at menarche and menstrual pattern in secondary school girls in Sapamu. NJCP. 2010;1(13):109-13.

Nwankwo M, Damborno B, Oliver HW. Family background and age at menarche among secondary school girls in Nigeria. JECA. 2017;2(16):77-82.

Ofuya ZM. The age at menarche in Nigerian Adolescents from two different socioeconomic classes. Online J Health Allied Scs. 2007;4(6):1-5.

Oduntan SO, Ayeni O, Kale OO. The age of menarche in Nigerian girls. Ann Hum Biol. 2009;3(3):267-74.

Talma H, Schonbeck Y, Dommelen PV. Bakker B, Buuren SV, Hirasing RA. Trends in menarcheal Age between 1955 and 2009 in the Netherlands. PLoS One. 2013;8(4):e60056.

Wyshak G, Frisch RE. Evidence for a secular trend in Age of menarche. N Engl J Med. 1982;306:1033-5.

Weaver H, Smith G, Kippax S. School-based sex education policies and indicators of sexual health among young people: a comparison of the Netherlands, France, Australia and the United States of America. J Sex Educat Sexual Soci Learning. 2007;2(5):171-88.

Crockett LJ, Deardorff J, Johnson M, Irwin C, Petersen AC. Puberty education in a global context: knowledge gaps, opportunities, and implications for policy. J Res Adolesi. 2019;1(29):177-95.

Shortridge JL. Nigeria guidelines for sexuality education introduced at ceremony in Lagos. Siecus Rep. 1997;25(2):4-7.

World Health Organization (WHO). World Health Days: Menstrual Hygiene Day - May 28. Executive Board 144th session provisional agenda item 7.6 of WHO 2019;1-7. A70/12:1-7.

Adika VO, Ayinde MO, Jack-Ide IO. Selfcare practices of menstrual hygiene among adolescent schoolgirls of Amassoma community, Bayelsa State. Int J Nurs Midwifery. 2013;5(5):99-105.

Akinwaare MO, Akindele OM, Oluratosin OA. Menstrual hygiene practices among adolescents in selected secondary schools around the University of Ibadan, Nigeria. JMBR. 2016;1(15):92-101.

Garba I, Rabiu A, Abubakar IS. Menstrual hygiene among adolescent schoolgirls in Kano. TJOG. 2018;2(35):153-7.

Akwa Ibom State Ministry of Education (AKSMOE). Number of Schools and Educational facilities in the state. Updated statistics of the Akwa Ibom State Ministry of Education for the year 2018. Available at: Accessed 5 March 2018.

National Population Commission (NPC) Nigeria. Health Zones in Nigeria. Nigeria National Demographic and Health Survey (NDHS). 2017;10:4-5.

Akanda TM, Akanda AA. Knowledge and perception of sexuality education among students of rural secondary school in kwara state, Nigeria. Niger Med Practr 2007;52(3):55-9.

Orji E, Esimai O. Introduction of sex education into the Nigerian schools: The parents’ teachers’ and students’ perspectives. J Obstet Gynecol. 2003;23(2):185-8.

Woo G, Soon R, Thomas JM, Kaneshiro B. Factors affecting sex education in the school system. J Pediatr Adolesi Gynecol. 2011;24(3):142-6.

Aniebu UU, Aniebu PN, Nwankwo TO. The impact of pre-menarcheal training on menstrual practices and hygiene of Nigerian schoolgirls. The PAMJ. 2009;2:9-19.

Ameade EPK, Majeed SF. Improving girl child education and menstrual hygiene through free sanitary pad provision to secondary school girls- opinion of female University students in Ghana. J Health Edu Res Dev. 2015;3:143-51.

Kovir E, Okwara FN, Okumbe G. Menstrual hygiene management practices among primary school girls from a pastoralist community in Kenya: a cross sectional survey. PAMJ. 2018;31:222-32.

Omidvar S, Begum K. Factors influencing hygiene practices during menses among girls from south India: a cross sectional study. Int J Collabor Res Intl Med Pub Health. 2011;2(2):411-23.

Lahme AM, Stern R. Factors that affect menstrual hygiene among adolescents schoolgirls: A case study from Mongu District, Zambia. Women’s Reprod Health. 2017;3(4):198-211.

Adinma JI, Adinma ED. Ethical considerations in women's sexual and reproductive health care. Nigerian J Clin Pract. 2009;12(1):11-6.