A qualitative study on menstrual health and hygiene management among adolescent schoolgirls in peri-urban Lusaka, Zambia

Menstrual health and hygiene (MHH) requires adequate sanitary facilities, clean and safe water, access to products, awareness, privacy and safety, and disposal. MHH can significantly influence girls' health and educational achievements. However, schools in some developing countries lack proper WASH amenities to manage healthy menstruation. Therefore, it is pressing to enhance WASH services to tackle menstrual-related difficulties effectively. Zambian government schools struggle with insufficient WASH infrastructure. Hence, it is imperative to reveal the status of WASH services for policy progress and to promote girls' optimal menstrual health. We conducted observations and a qualitative study to evaluate the school's WASH facilities, investigate the sociocultural factors impacting MHH, and examine the coping mechanisms girls employ to manage their menstruation. Thirty adolescent schoolgirls, aged 14-19, residing in Lusaka peri-urban areas participated in five focus group discussions. Insufficient school security, inadequate sanitary facilities, absence of clean water, and limited access to menstrual materials presented notable challenges. Culturally, there was an expectation for girls to swiftly embrace womanhood despite being unprepared for the natural biological process it entailed. Girls formulated strategies for managing challenges associated with MHH. The fundamental needs of menstruating girls include a sufficient supply of menstrual materials, improved WASH services, increased safety, and enhanced privacy.