Quality of public school toilets and the frequency of changing sanitary napkins among students in public secondary schools in the City of Manila, Philippines

• Published in: Tropical Medicine and Health
• Main Authors: Chikako Katsuno, Ernesto R. Gregorio, Marian Fe Theresa C. Lomboy, Daisuke Nonaka, Paul Michael R. Hernandez, Crystal Amiel M. Estrada, Jennel Mae T. Pimentel, Rhea Marie Grace C. Bernadas, Jun Kobayashi
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2019
• Subjects: Menstrual hygiene management; School health; Adolescents; Theory of planned behavior; The Philippines; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1186/s41182-018-0131-8; https://doaj.org/article/3c5dda3a5334453d847bc960587733b9

Abstract Background In sub-tropical countries, poor menstrual hygiene management has been reported. One cause of poor menstrual hygiene management can be poor quality toilets. However, associations between poor quality toilets and menstrual-related behaviors have been poorly understood. The present study aimed to assess the association between the quality of school toilets and the frequency of changing sanitary napkins in school toilet among Filipino students. Methods A cross-sectional study was conducted in six secondary schools of the City of Manila, Philippines, in 2017. A self-administered survey questionnaire with female students collected data on the outcome variable, self-reported daily frequency of changing sanitary napkins in school toilet, and other predictor variables. An observational survey collected data on the main predictor variable, surveyor-rated toilet quality variables. A total of 526 students were included in the analyses. Logistic regression with generalized estimating equation model was used to assess the association between the outcome and predictor variables. Results No significant association was found both between toilet quality and the outcome. Although the association was not significant, the odds ratio (OR) of “sanitary bin is available in toilet” was 2.54 compared to “sanitary bin is not available in toilet.” The results of multivariate analysis showed that participants who reported stronger perceived behavioral control or stronger subjective norm were significantly more likely to change sanitary napkins, compared to those with lower perceived control score or lower subjective norm score, respectively (adjusted OR 2.29, 95% confidence interval 1.24 to 4.25; adjusted OR 2.63, 95% confidence interval 1.45 to 4.76). Conclusions The present study showed that the quality of school toilets was not associated with the frequency of changing sanitary napkins among the studied population. However, it does not mean that the cause-effect relationship was rejected. Further studies involving ...