A comparative study of menstrual poverty among urban and rural female learners in government schools of Zambia

Abstract

Abstract Background Menstrual poverty remains a significant health problem among female learners in Zambia, particularly due to the lack of access to menstrual products, leading to the use of unsafe alternatives and potential health risks such as reproductive tract infections. To address this pressing issue, this study examined the disparities in knowledge, attitudes, and practices concerning menstrual poverty among female learners in both urban and rural government schools within Zambia. Methods The study utilized a mixed-method sequential explanatory design, combining quantitative and qualitative approaches. A cross-sectional survey of 447 female learners was conducted in urban and rural areas using a multistage stratified sampling approach. Quantitative data were analysed using descriptive and bivariate techniques in Stata version 14.2. The qualitative arm consisted of focus group discussions and key informant interviews, with thematic analysis applied. Results The findings revealed that urban female learners possessed a more comprehensive understanding of menstruation than their rural peers, with a significantly higher proportion accurately defining the process (74% vs. 50%). Notably, both urban and rural learners experienced a spectrum of emotional responses to menarche, with fear and discomfort common among learners in both urban and rural settings, while support-seeking behaviours and cultural beliefs varied geographically. Rural learners commonly turned to herbal remedies for menstrual management (30% vs. 21%, p = 0.007). Furthermore, over 50% of urban and rural leaners reported dissatisfaction with the sanitary facilities, citing concerns such as cleanliness, privacy, and inadequate handwashing amenities. Conclusion This study reveals significant disparities in menstrual knowledge, practices, and attitudes between urban and rural female learners. Government funding is imperative to implement comprehensive menstrual health education in all public schools to create a supportive environment for menstruating learners. Collaboration with the Ministry of Health is crucial to ensure access to essential resources, including pain relief and gender-sensitive facilities.

Keywords

• Menstrual poverty
• Female learners
• Rural
• Urban
• Schools
• Zambia