Menstruation among In-School Adolescent Girls and Its Literacy and Practices in Nigeria: A Systematic Review

Abstract

Background and Objectives: Menstruation is a natural occurrence marked by the periodic release of endometrial cells within the uterine lining from the female genital area. Menstruation knowledge remains highly essential for young adolescents. Inadequate awareness and understanding of menstruation have far-reaching consequences on the overall wellbeing and health outcomes of young adults worldwide. Adolescent girls make up a large percentage of high school students in Nigeria. Girls in countries with low to middle incomes are frequently misled or uneducated regarding menstruation. Menstrual health literacy (MHL) is the level of knowledge concerning matters related to menstrual health. It is observed that a lack of menstrual health literacy is seen among young adults. This systematic review aimed to examine menstruation literacy, attitudes, and adolescent girls’ practices in Nigeria. Materials and Methods: This systematic review included quantitative, cross-sectional, quasi-experimental, and qualitative primary research studies relating to menstruation literacy, attitudes, and practices of adolescents in Nigeria. Articles for this study were searched for on databases such as PubMed and BioMed Central using keywords. These studies were subjected to stringent inclusion and exclusion criteria where the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used, and 13 articles were included after critical appraisal. Data extracted were analysed using narrative synthesis. Results: Findings indicated that knowledge regarding menstruation among adolescents (82.6%) was poor. Menstruation information was obtained from mothers, which was positive as some adolescents reported their closeness to their mothers. Regarding attitudes towards menstruation among adolescents, it was reported that more respondents (70.3%) had negative attitudes towards menstruation. Conclusions: Most of the respondents in Nigeria were not adequately prepared for the onset of their first menstrual period. Knowledge and attitude levels were low regarding periods for adolescents. The only exception was their positive attitude towards using water and soap to wash their hands during menstruation. The review shows a significant gap between adolescents’ menstruation knowledge and actual hygienic methods during menstruation. It is therefore required for educational awareness programmes and campaigns to be put in place to educate adolescents about menstruation.