The Relationship between Household Sanitation and Women's Experience of Menstrual Hygiene: Findings from a Cross-Sectional Survey in Kaduna State, Nigeria

doi:10.3390/ijerph15050905

. 2018 May 3;15(5):905.

doi: 10.3390/ijerph15050905.

The Relationship between Household Sanitation and Women's Experience of Menstrual Hygiene: Findings from a Cross-Sectional Survey in Kaduna State, Nigeria

Julie Hennegan¹, Linnea Zimmerman², Alexandra K Shannon³, Natalie G Exum⁴, Funmilola OlaOlorun⁵, Elizabeth Omoluabi^{6

7}, Kellogg J Schwab⁸

Affiliations

¹ The Water Institute, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. jhenneg1@jhu.edu.
² Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. linnea.zimmerman@jhu.edu.
³ Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. ashannon@jhu.edu.
⁴ The Water Institute, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. nexum1@jhu.edu.
⁵ Department of Community Medicine, College of Medicine, University of Ibadan, Queen Elizabeth Road, University College Hospital, Ibadan 200284, Nigeria. fmolaolorun@gmail.com.
⁶ Center for Research Evaluation Resources and Development, 17 Ajanaku Estate, Ile-Ife 220005, Nigeria. elizomoluabi@gmail.com.
⁷ Department of Statistics, University of the Western Cape, Robert Sobukwe Rd, Bellville, Cape Town 7535, South Africa. elizomoluabi@gmail.com.
⁸ The Water Institute, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. kschwab1@jhu.edu.

PMID: 29751539
PMCID: PMC5981944
DOI: 10.3390/ijerph15050905

The Relationship between Household Sanitation and Women's Experience of Menstrual Hygiene: Findings from a Cross-Sectional Survey in Kaduna State, Nigeria

Julie Hennegan et al. Int J Environ Res Public Health. 2018.

. 2018 May 3;15(5):905.

doi: 10.3390/ijerph15050905.

Authors

Julie Hennegan¹, Linnea Zimmerman², Alexandra K Shannon³, Natalie G Exum⁴, Funmilola OlaOlorun⁵, Elizabeth Omoluabi^{6

7}, Kellogg J Schwab⁸

Affiliations

¹ The Water Institute, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. jhenneg1@jhu.edu.
² Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. linnea.zimmerman@jhu.edu.
³ Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. ashannon@jhu.edu.
⁴ The Water Institute, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. nexum1@jhu.edu.
⁵ Department of Community Medicine, College of Medicine, University of Ibadan, Queen Elizabeth Road, University College Hospital, Ibadan 200284, Nigeria. fmolaolorun@gmail.com.
⁶ Center for Research Evaluation Resources and Development, 17 Ajanaku Estate, Ile-Ife 220005, Nigeria. elizomoluabi@gmail.com.
⁷ Department of Statistics, University of the Western Cape, Robert Sobukwe Rd, Bellville, Cape Town 7535, South Africa. elizomoluabi@gmail.com.
⁸ The Water Institute, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe, Baltimore, MD 21205, USA. kschwab1@jhu.edu.

PMID: 29751539
PMCID: PMC5981944
DOI: 10.3390/ijerph15050905

Abstract

Global efforts to improve sanitation have emphasized the needs of women and girls. Managing menstruation is one such need, yet there is scarce research capturing current practices. This study investigated the relationships between household sanitation and women’s experience of menstrual management. Secondary analyses were undertaken on data from 1994 women and girls collected through the Performance Monitoring and Accountability 2020 survey in Kaduna, Nigeria. In multivariable models, women had higher odds of using the main household sanitation facility for menstrual management when they had access to a basic (OR = 1.76 95%CI 1.26⁻2.46) or limited (OR = 1.63 95%CI 1.08⁻2.48) sanitation facility, compared to an unimproved facility. Women with no household sanitation facility had higher odds of using their sleeping area (OR = 3.56 95%CI 2.50⁻5.06) or having no facility for menstrual management (OR = 9.86 95%CI 5.76⁻16.87) than women with an unimproved sanitation facility. Menstrual management locations were associated with ratings of their characteristics. Safely managed or basic sanitation facilities were not rated more favorably than unimproved facilities in privacy (OR = 1.02 95%CI 0.70⁻1.48), safety (OR = 1.45 95%CI 0.98⁻2.15), access to a lock (OR = 0.93 95%CI 0.62⁻1.37), or soap and water (OR = 1.04 95%CI 0.70⁻1.56). Women using their sleeping area had more favorable perceptions of their environment. Findings suggest household sanitation influences women’s choices for menstrual management, but that existing indicators for improvement are not sensitive to menstrual needs.

Keywords: cross-sectional survey; menstrual health; menstrual hygiene; sanitation; women’s health.

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Conflict of interest statement

All authors declare that there are no conflicts of interest.

Figures

**Figure 1**
Adjusted odds ratios of the relationship between women’s menstrual management location and their reports of the characteristics of that environment, compared to those using an unimproved sanitation facility (OR = 1.00).

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References

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[1] Das P., Baker K.K., Dutta A., Swain T., Sahoo S., Das B.S., Panda B., Nayak A., Bara M., Bilung B. Menstrual hygiene practices, wash access and the risk of urogenital infection in women from Odisha, India. PLoS ONE. 2015;10:e0130777. doi: 10.1371/journal.pone.0130777. - DOI - PMC - PubMed

[2] Das P., Baker K.K., Dutta A., Swain T., Sahoo S., Das B.S., Panda B., Nayak A., Bara M., Bilung B. Menstrual hygiene practices, wash access and the risk of urogenital infection in women from Odisha, India. PLoS ONE. 2015;10:e0130777. doi: 10.1371/journal.pone.0130777. - DOI - PMC - PubMed

[3] Hennegan J., Dolan C., Steinfield L., Montgomery P. A qualitative understanding of the effects of reusable sanitary pads and puberty education: Implications for future research and practice. Reprod. Health. 2017;14:78. doi: 10.1186/s12978-017-0339-9. - DOI - PMC - PubMed

[4] Hennegan J., Dolan C., Steinfield L., Montgomery P. A qualitative understanding of the effects of reusable sanitary pads and puberty education: Implications for future research and practice. Reprod. Health. 2017;14:78. doi: 10.1186/s12978-017-0339-9. - DOI - PMC - PubMed

[5] Mason L., Nyothach E., Alexander K., Odhiambo F.O., Eleveld A., Vulule J., Rheingans R., Laserson K.F., Mohammed A., Phillips-Howard P.A. ‘We keep it secret so no one should know’—A qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural Western Kenya. PLoS ONE. 2013;8:e79132. doi: 10.1371/journal.pone.0079132. - DOI - PMC - PubMed

[6] Mason L., Nyothach E., Alexander K., Odhiambo F.O., Eleveld A., Vulule J., Rheingans R., Laserson K.F., Mohammed A., Phillips-Howard P.A. ‘We keep it secret so no one should know’—A qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural Western Kenya. PLoS ONE. 2013;8:e79132. doi: 10.1371/journal.pone.0079132. - DOI - PMC - PubMed

[7] Sommer M., Hirsch J.S., Nathanson C., Parker R.G. Comfortably, safely, and without shame: Defining menstrual hygiene management as a public health issue. Am. J. Public Health. 2015;105:1302–1311. doi: 10.2105/AJPH.2014.302525. - DOI - PMC - PubMed

[8] Sommer M., Hirsch J.S., Nathanson C., Parker R.G. Comfortably, safely, and without shame: Defining menstrual hygiene management as a public health issue. Am. J. Public Health. 2015;105:1302–1311. doi: 10.2105/AJPH.2014.302525. - DOI - PMC - PubMed

[9] Geertz A., Iyer L., Kasen P., Mazzola F., Peterson K. An Opportunity to Address Menstrual Health and Gender Equity. FSG; Boston, MA, USA: 2016. Online.

[10] Geertz A., Iyer L., Kasen P., Mazzola F., Peterson K. An Opportunity to Address Menstrual Health and Gender Equity. FSG; Boston, MA, USA: 2016. Online.

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The Relationship between Household Sanitation and Women's Experience of Menstrual Hygiene: Findings from a Cross-Sectional Survey in Kaduna State, Nigeria

Affiliations

The Relationship between Household Sanitation and Women's Experience of Menstrual Hygiene: Findings from a Cross-Sectional Survey in Kaduna State, Nigeria

Authors

Affiliations

Abstract

Conflict of interest statement

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