Menstrual hygiene is not obvious among adolescent girls in low-resource settings: promoting it is a priority

Abstract

Background: Menstrual hygiene management (MHM) is a vital component of adolescent reproductive health, yet it remains inadequately practiced among girls in many low-resource settings. Cultural taboos, limited access to affordable sanitary materials, and poor water and sanitation infrastructure continue to undermine safe and dignified menstrual practices. This study assessed the knowledge, attitudes, and practices regarding menstrual hygiene among adolescent girls in Lari Sub-County, Kiambu County, Kenya.

Methods: A descriptive cross-sectional study was conducted between 4th and 31st July 2023 among 365 secondary school girls aged 13–20 years, randomly selected from 10 schools in Lari Sub-County. Data were collected using structured questionnaires and analysed using STATA and SPSS.

Results: The study included 365 girls aged 13–20 years (mean 16 years), with most attaining menarche at 14 years (29.6%). Most respondents (86%) had heard about menstrual hygiene and 72.3% received information before menarche, mainly from parents (47.5%) and teachers (45.5%). Overall, 59% were knowledgeable, with knowledge significantly varying by school (χ² = 18.047, p = 0.035). Attitudes were moderately positive (53%), though 29.6% felt embarrassed and 21.4% viewed menstruation as spiritually unclean. Regarding practices, 55.1% cleaned with water only, disposal was mainly via pit latrines (57.8%) and bins (38.1%), and 65.8% avoided places of worship during menstruation.

Conclusion: Despite relatively high access to menstrual hygiene materials, knowledge levels remain moderate and several barriers persist, including inadequate water access, stigma, and unsafe disposal practices. Strengthening menstrual health education, improving WASH infrastructure, and enhancing community sensitization are essential interventions to promote safe menstrual hygiene management and improve the dignity, wellbeing, and school participation of adolescent girls.