Abstract
Background: Inadequate Water, Sanitation, and Hygiene (WASH) facilities in schools compromise the rights and dignity of menstruating girls, limiting gender equality in education. Evidence on this issue in Namibia’s informal settlements is limited.
Aim: This study assessed WASH facilities, menstrual hygiene management (MHM) practices, and their impact on the dignity of adolescent girls attending a secondary school in an informal settlement of Windhoek.
Methods: A cross-sectional survey was conducted with 119 post-menarcheal girls using self-administered questionnaires. Descriptive statistics summarised WASH access, MHM practices, and psychosocial outcomes. Pearson’s Chi-Square test examined associations between categorical variables, including hygiene perceptions, discomfort, anxiety, and dignity.
Results: While 99.2% of participants reported sex-segregated toilets, poor maintenance, overcrowding, and lack of consumables compromised usability. Soap was poorly available for 78.8% of girls, and 87.8% consistently lacked toilet paper. Water shortages and product scarcity caused some girls to avoid toilets or borrow menstrual supplies. Despite these challenges, 61.9% always washed hands after changing products and 52.2% before. Psychosocial outcomes were significant: 70.2% reported loss of dignity, 57.9% anxiety, and 56.4% discomfort. Chi-Square analyses revealed significant associations between hygiene perceptions and discomfort while changing products (p=0.011), highlighting the relational impact of WASH conditions on well-being.
Conclusion: Institutional shortcomings in WASH infrastructure transform menstruation into a barrier to dignity and learning, despite girls’ resilience in MHM. Policy reform, improved school practices, and institutional support are urgently needed. Future research should include qualitative approaches, longitudinal studies, and comparative analyses to inform context-specific solutions.