INFLUENCE OF CULTURE ON MENSTRUAL HYGIENE MANAGEMENT AMONG INSCHOOL ADOLESCENT GIRLS IN MALAWI: WASH PERSPECTIVE

This study explored the influence of cultural beliefs and practices on menstrual hygiene management (MHM) among in-school adolescent girls in Malawi from a Water, Sanitation and Hygiene (WASH) perspective. The research focused on four cultural groups namely the Ngoni, Tumbuka, Mang’anja and Lomwe, to examine how cultural norms and traditions shape menstrual experiences, hygiene practices and the use of WASH facilities in schools and communities. Although global efforts have increasingly recognized the importance of MHM, many adolescent girls in Malawi continue to face challenges associated with menstrual stigma, cultural restrictions and inadequate sanitation infrastructure. The study employed a convergent parallel mixed methods design with a qualitative dominant approach. Data were collected from Chikwawa, Phalombe, Rumphi and Mzimba districts. A sample size of 384 participants was calculated using Cochran’s formula at a 95% confidence level, with a p-value of 0.5 and a margin of error of 0.05. Structured questionnaires, four Focus Group Discussions (FGDs), five Key Informant Interviews (KIIs) and direct observations of WASH facilities were used to collect data. Quantitative data were analyzed using descriptive statistics in Microsoft Excel, while qualitative data were analyzed through thematic analysis. The findings showed that culture influences MHM in both supportive and restrictive ways. Positive cultural practices encouraged regular bathing, proper washing of reusable menstrual materials and responsible disposal of menstrual waste. Careful disposal of menstrual materials was reported by 93% of Tumbuka participants, 73% of Mang’anja participants, 71% of Lomwe participants and 69% of Ngoni participants. However, some beliefs and taboos contributed to shame, secrecy and social restrictions during menstruation. The study further established that 46% of girls relied on cloth materials, 35% used reusable pads and only 19% used disposable sanitary pads due to poverty, limited availability of products and cultural misconceptions surrounding disposable pads. Inadequate WASH facilities, including lack of privacy, soap and functional changing rooms, also negatively affected girls’ ability to manage menstruation safely and comfortably at school. The study recommends the implementation of culturally responsive WASH vi interventions that promote positive cultural practices while addressing harmful myths and stigma surrounding menstruation. It further recommends improving menstrual health education, constructing safe and private sanitation facilities in schools and introducing subsidies or tax reductions on menstrual hygiene products to make sanitary pads more affordable and accessible to schoolgirls.