Menstrual Hygiene Management Practices among Adolescent Girls with Disabilities in Selected Primary Schools in Wajir County, Kenya
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Date
2025-10
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Kenyatta University
Abstract
The beginning of menstruation is a significant occurrence to adolescent girls worldwide. Despite global sensitization on the importance of good Menstrual Hygiene Management (MHM), unhygienic practices and absence of an enabling environment persist. This can have adverse negative effects on adolescents, which are more profound for girls with disability due to their co-morbidities. The study aimed to assess MHM practices among adolescent girls with disabilities in selected primary schools in Wajir County. Specifically, it determined and investigated the influence of socio-demographic factors, attitudes, knowledge and institutional resources on MHM practices. A descriptive cross-sectional study design was employed, targeting all adolescent girls with disabilities from three purposively selected schools using census sampling. Data was collected using structured questionnaires and key informant interviews. Quantitative data were analyzed using descriptive statistics and chi-square tests to determine associations between variables. Statistically significant variables were further analyzed using logistic regression to identify predictors of MHM practice. The required logistical and ethical considerations were adhered to. Results revealed that only 11.9% of respondents practiced good MHM. The socio-demographic characteristics significantly associated with MHMP were severity of disability (p*=0.016), caregiver (p*=0.001), Number of family members (p*=0.029) and Occupation of bread winner (p*=0.001). Nature of attitude (p*=0.029) and level of knowledge (p*=0.037) were also significantly associated with MHMP. In terms of institutional resources, provision of menstrual materials (p*=0.004) and availability of water in school (p*=0.005) showed significant associations. Logistic regression results identified severity of disability (AOR=8.000, p=0.001), caregiver (AOR=4.000, p=0.015), and number of family members (AOR=0.429, p=0.025) as key predictors of MHM. Attitudinal predictors included discomfort in class (AOR=2.428, p=0.002), menstruation-related shame and shock (AOR=5.247, p=0.001), and nature of attitude (AOR=0.160, p=0.016). Knowledge-related predictors included understanding menstruation as a normal experience for girls (AOR=7.417, p=0.001), menstruation as an indicator of reproductive maturity (AOR=6.800, p=0.045), and level of knowledge (AOR=4.206, p=0.028). Among institutional factors, only availability of water in school (AOR=0.085, p=0.021) was a significant predictor. The study concludes that MHM practices are very low among girls with disabilities, influenced by personal, social, and institutional factors. It recommends that stakeholders provide free sanitary products and build sufficient school washrooms to ensure privacy. Community education should address menstruation-related myths and stigma to improve attitudes. MHM education should be scaled up among girls with disabilities, while government and NGOs in the WASH sector should prioritize sustainable water access and support services.”
Description
A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Reproductive Health) in the School of Health Sciences of Kenyatta University, October 2025.
Supervisors
1. Redempta Mutisya
2. Christine Wambui Njuguna