Silent Struggles: Menstrual Hygiene Challenges Faced by Female University Students in Uganda

Abstract

Menstruating individuals face barriers in managing their periods safely and with dignity, especially in low-and middle–income countries like Uganda. Menstrual health interventions have focused on schoolgirls, assuming university students have fewer challenges. However, female university students in Uganda face significant challenges. Thus, the objective of this study was to explore challenges faced by female university students in Central and Southwestern Uganda through a socio-ecological perspective. A phenomenological design was used. A sample of 88 participants was purposively selected using a two-stage stratified sampling technique. Four focus group discussions and 16 key informant interviews were conducted to collect data. Interviews were transcribed and analysed thematically using NVivo 12 software. These were complemented by structured observations of WASH facilities. The socioecological model (SEM) is a public health framework that describes how health is impacted at multiple levels including individual, interpersonal, community, organizational and policy levels. Key themes were identified, and challenges contributing to menstrual hygiene were categorized as per the SEM. The findings showed that female students experienced physical pains and missed classes hindering their education. Also, linking menstruation to sorcery led to fears related with disposal of menstrual absorbents and inadequate WASH infrastructure, which contributed to poor menstrual hygiene management reflecting systemic failures at universities. Many female students had knowledge gaps about menstrual hygiene management based on biases of cultural taboos and practices. They lacked confidence in managing their menstruation while at university, highlighting the need for universities to establish programs and policies that promote their well-being and academic success.