1.1 Background to the Study

Menstrual Health Management (MHM) remains a fundamental component of women's health, yet it is often overlooked or inadequately addressed, especially within academic environments in developing countries. Menstruation is a natural physiological process, but for many young women, especially students in tertiary institutions, managing their menstrual cycle effectively and hygienically can be a significant challenge. These challenges stem not only from biological and physiological aspects but also from social, economic, and cultural limitations. Among students in the Public Health Department of Abia State University, Uturu, menstrual health practices are influenced by a range of factors including knowledge, accessibility of sanitary products, availability of water and sanitation facilities, and prevailing socio-cultural attitudes.

Evidence from recent studies suggests that poor menstrual hygiene practices are still prevalent among female students, even those within health-related academic disciplines who are presumed to have better awareness (Elledge et al., 2022). These practices may lead to adverse health outcomes such as reproductive tract infections, psychological stress, and disruptions in academic performance due to school absenteeism. According to Chinyama et al. (2021), university students often experience anxiety, shame, and discomfort during menstruation, which may affect their classroom engagement and participation in academic activities.

Despite growing advocacy around menstrual equity, many tertiary institutions in Nigeria, including Abia State University, have yet to fully implement comprehensive menstrual hygiene support systems. These systems include access to clean toilets, disposal facilities, affordable sanitary products, and sensitization programs. The lack of adequate menstrual hygiene infrastructure and supportive institutional policies can exacerbate existing health inequities and undermine educational attainment (Sserwanja et al., 2023). The university setting plays a crucial role in shaping students' practices and attitudes towards menstruation. Therefore, understanding the menstrual health management behaviors among students in the Public Health Department is essential, given that these students are future public health professionals expected to champion health promotion and behavior change in society. Their current experiences, knowledge, and practices concerning menstruation could reflect broader systemic gaps in health education and public health advocacy.

Moreover, socio-cultural taboos and stigmatizing beliefs about menstruation still persist in many communities in Nigeria. These beliefs often infiltrate school settings and may deter young women from discussing their menstrual needs openly, thus hindering their ability to seek help or adopt healthier practices (Okeke et al., 2020). Research has shown that menstrual stigma leads to secrecy, low self-esteem, and embarrassment, all of which affect students’ psychological well-being and academic performance (Abegunde et al., 2021).

In light of the increasing emphasis on gender-sensitive health policies and the Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 4 (Quality Education), addressing menstrual health among female students becomes a priority. As noted by Essien and Umo (2024), promoting menstrual health is central to empowering young women and ensuring gender equality in academic settings. This research, therefore, aims to investigate the menstrual health management practices among students in the Public Health Department of Abia State University, Uturu, with the goal of identifying the challenges they face, the resources available to them, and how these influence their academic experiences and health outcomes. Ultimately, the findings of this study are expected to inform policy makers, university management, and health educators about the real-life challenges female students face in managing their menstruation. It will also provide evidence-based recommendations to improve menstrual hygiene support structures within tertiary institutions, especially those training the next generation of public health professionals.

1.2 Statement of Problem

Despite being a natural and essential part of the female reproductive cycle, menstruation is still surrounded by stigma, misinformation, and infrastructural neglect, particularly in low- and middle-income countries. In tertiary institutions such as Abia State University, Uturu, many female students struggle with effective menstrual health management due to limited access to sanitary products, inadequate water and sanitation facilities, and deeply ingrained cultural taboos. These challenges are even more concerning among students of Public Health, who, as future health advocates, are expected to embody and promote optimal health practices. Studies have consistently shown that when menstrual hygiene is poorly managed, it leads to physical discomfort, reproductive tract infections, emotional distress, and social exclusion (Patkar & Ahmed, 2020). Among university students, these consequences often translate to absenteeism from lectures, reduced concentration, and lower academic performance (Nwagu & Eze, 2022). Yet, the institutional response to these issues remains limited or non-existent, with minimal efforts made to integrate menstrual hygiene management into university health services or student welfare programs. Furthermore, many students still rely on ineffective coping strategies due to financial constraints and a lack of menstrual education. Some resort to using old rags, tissue paper, or reusing sanitary pads without adequate hygiene practices, increasing their risk of infections and reducing their dignity and comfort during menstruation (Nwagu et al., 2022). Even in a department like Public Health, where health education should ideally translate into better personal practices, misconceptions and inadequate facilities persist. This disconnection between knowledge and practice is particularly problematic because it reflects a systemic failure to support young women in academic institutions, even those training in health disciplines. The situation is compounded by social stigma, where menstruation is viewed as unclean or embarrassing. This discourages open conversations among peers and with health professionals, making it difficult for students to seek help or advocate for their needs (Chinyama et al., 2021). As noted by Okeke et al. (2020), many young women navigate menstruation in silence, internalizing shame and guilt, which further affects their mental health and sense of well-being. In light of these persistent challenges, there is a critical need to examine the menstrual health management practices among students in the Public Health Department of Abia State University, Uturu. It is important to understand the extent to which they have access to resources, how their knowledge translates into practice, and what institutional or environmental factors influence their menstrual experiences. By identifying these gaps, this study seeks to contribute to improved MHM interventions and policies that are contextually relevant and gender-sensitive.

Aims and Objective

1.3 General Objective

The general objective of this study is to assess the menstrual health management practices among students of the Public Health Department, Abia State University, Uturu.

1.3.1 Specific Objectives

To achieve this goal, the research will focus on the following specific objectives:

1. To determine the level of knowledge of menstrual hygiene among Public Health students in Abia State University Uturu.
2. To identify the types of menstrual materials used by the students of the Department of Public Health, Abia State University Uturu.

1. To examine the challenges faced by students of Public Health, Abia State University Uturu in managing their menstruation.
2. To propose recommendations for improving menstrual health management among the students of Public Health, Abia State University Uturu.

1.4 Research Questions

To guide this study, the following research questions have been formulated:

1. What is the level of knowledge of menstrual hygiene among students of the Public Health Department, Abia State University Uturu?
2. What types of menstrual materials are commonly used by the students of Public Health Department, Abia State University Uturu?
3. What challenges do students of Public Health Department, Abia State University Uturu face in managing their menstruation?
4. What recommendations can be made to improve menstrual health management among the students of Public Health Department, Abia State University Uturu?