Assessment of Menstrual Hygiene Management Practices among Day Secondary School Girls in Kibera Informal Settlement, Nairobi, Kenya

Abstract

Effective Menstrual Hygiene Management is a holistic approach integrating access to sanitary materials, menstrual health education, stigma-free sociocultural environments, and equitable policies to ensure safety, dignity, and uninterrupted education for adolescent girls in resource-limited settings. Approximately 52% of the female population globally is of reproductive age. Most of these girls and women menstruate each month for between two to seven days. In Sub-Saharan Africa, about 50-70% of girls lack access to adequate sanitary products, 30-40% face school absenteeism due to inadequate facilities, and cultural stigma persists as a barrier to open discussions, disproportionately affecting health, education, and socioeconomic outcomes. Only 46% of women in Kenya report having all they need in ensuring proper menstrual hygiene management this leaves the majority as unable to adequately meet their menstrual hygiene management needs. In Kenya, 1 out of 3 girls miss school at least 5 days a month during menstruation due to lack of access to appropriate sanitary materials and facilities, information and knowledge as well as retrogressive cultures that shuts them out from participating from their daily activities. The study site was Kibera informal settlement, which is characterized by extreme poverty levels and congestion, there are health related challenges when it comes to female hygiene. The high populations have placed pressure on the available utilities such as toilets and water supply as well as increased social issues such as insecurity during late hours to utilize these facilities hence posing a great challenge on how girls manage their menstruation hygienically. The broad objective of this study was to determine the practices and factors that influence menstrual hygiene management among secondary school going girls in mixed day secondary schools in Kibera, Nairobi. This was a cross-sectional study and quantitative data was collected. The target population was girls attending mixed day secondary schools in Kibera. The sample size of 358 girls was randomly selected using simple random sampling methods and the interviewer administered the questionnaires which was the main tool for data collection. This study received ethical approval from University of Nairobi ethical review committee, NACOSTI and the ministry of education. Most of the respondents were aged 16 years. Inferential statistics used in the study included the use of chi-square, correlation analysis and multiple regression analysis. Chi square test revealed that there was a significant relationship between access to water and the students’ age in regard to effective menstrual practices and management among Girls in Kibera Slum. Correlation analysis was performed to determine the strength of linear association between effective menstrual hygiene management and the factors namely menstrual hygiene practices (r = 0.304, P < 0.000) and access to knowledge and information (r = 0.359, P < 0.000) indicated a moderate positive association which was statistically significant at a confidence interval (CI) 95%. Access to sanitary materials and facilities (r = 0.863) indicated a strong positive association which was statistically significant at a confidence interval (CI) 95% respectively while social factors indicated a weak positive association which was statistically significant at a confidence interval (CI) 95%. Using the multi-linear regression model, the R value was 0.872. The R-square value indicates that this model succeeds in predicting up to 76% of the variables in effective menstrual practices and management in secondary schools is accounted for by these factors. The results highlight the complex interplay between social variables, education, and resource accessibility that shape menstrual hygiene habits among girls living in the Kibera Slum. These findings show importance of resources and supportive environments in promoting better MHM. The ministry of education should review the MHM policies and develop implementation strategies to promote better hygiene practices and enhance the level of access to menstrual hygiene information, access to sanitary materials and facilities as well as ensure that retrogressive cultures associated with menstrual hygiene are eradicated.