Menstrual health, food insecurity, and protection vulnerability among adolescent girls in internally displaced persons camps in Benue State, Nigeria: A focused ethnographic study
This focused ethnographic study of 25 adolescent girls in five IDP camps in Benue State, Nigeria, reveals that menstrual health challenges are not isolated hygiene issues but complex outcomes of interacting material, nutritional, sociocultural, and protection vulnerabilities that necessitate integrated humanitarian responses combining menstrual supplies, safe WASH facilities, nutrition support, and safeguarding mechanisms.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
Menstrual health is more than just the biological cycle of bleeding; it is a state of physical, mental, and social well-being that depends on a person having accurate knowledge, access to clean water and private toilets, and the freedom to participate in school and daily life without shame. In stable communities, these needs are often met through family support, local shops, and reliable infrastructure. However, when people are forced to flee their homes due to conflict or disaster, these basic supports can vanish. For adolescent girls in such crises, managing their monthly cycles becomes a daily struggle against a lack of materials, unsafe sanitation, and hunger. This struggle is not isolated; it is deeply connected to whether a girl has enough to eat, whether she feels safe walking to a bathroom at night, and whether her community views her period as a natural event or a source of shame. Understanding how these factors intertwine is crucial for designing humanitarian aid that actually helps girls live with dignity.
A new study conducted in Benue State, Nigeria, explores this complex reality by listening to the voices of adolescent girls living in camps for people who have been internally displaced. The researchers focused on five specific camps where families had gathered after being forced from their homes. Over a period of several months, the team spoke with twenty-five girls between the ages of thirteen and nineteen, asking them about their experiences with menstruation. To get a fuller picture, the researchers also held group discussions with other girls, adult women, men, and camp leaders, and they walked through the camps to observe the actual conditions of the water points, toilets, and food supplies. They conducted these conversations in English and the local Tiv language, ensuring the girls could speak freely about their lives.
The study found that for these girls, managing their periods had transformed from a manageable part of growing up into a source of constant worry and uncertainty. Before displacement, many girls recalled having privacy, access to sanitary pads, and the support of their mothers. In the camps, that stability disappeared. Commercial pads were available only irregularly, often depending on unpredictable aid distributions. When pads ran out, girls were forced to improvise, using folded cloths, tissue, or even rags soaked in hot water. This lack of reliable materials was compounded by unsafe sanitation facilities. The researchers observed that water points were often far away, soap was scarce, and toilets lacked locks or lighting. For many girls, the fear of being seen or the danger of walking to a dark, unlocked toilet at night meant they had to restrict their movement, sometimes staying indoors for days or bathing while fully clothed in the open to avoid detection.
Hunger played a significant role in how these girls experienced their periods. The study revealed that the girls' diets in the camps were often limited to a few starchy foods, with little access to vegetables, meat, or beans. The girls and their families reported that when food was scarce, the physical pain and weakness associated with menstruation felt much worse. One girl explained that when food was not enough, she felt weaker and the pain intensified. The researchers noted that while they did not perform medical tests to confirm anemia or malnutrition, the girls' lived experiences clearly linked their hunger to their ability to function. In a setting where girls often contributed to the household by fetching water or gathering firewood, this weakness meant they could not fulfill their roles, which added to their sense of helplessness.
Cultural beliefs and social norms further complicated the situation. In many households, menstruation was treated as a private, shameful topic that should not be discussed. Some families imposed restrictions, such as prohibiting girls from cooking or sharing sleeping spaces with certain family members during their periods. In some areas, there were fears that menstrual blood could be used for harmful spiritual purposes, leading girls to hide their disposal practices. This silence made it difficult for girls to ask for help or share their needs. However, the study also found that where humanitarian organizations provided consistent education, attitudes began to shift. Mothers and daughters started talking more openly, and girls became more willing to ask questions, showing that community engagement could slowly break down barriers.
Despite these immense challenges, the girls showed remarkable resilience and resourcefulness. They relied heavily on peer support, sharing pads and advice with friends who would not judge them. Yet, this agency sometimes came with new risks. To earn money for pads or basic food, some girls took on informal labor outside the safety of the camp, exposing themselves to potential exploitation or violence. The study highlighted that while aid distributions of pads provided temporary relief, they were often irregular and insufficient. The girls expressed frustration that services were overwhelmed and that their specific needs were not always met with confidentiality or understanding.
The researchers concluded that menstrual health in these displacement camps cannot be solved by simply handing out pads. It is a cross-sector issue that requires a coordinated response. To truly support these girls, humanitarian aid must combine predictable access to a variety of menstrual materials with safe, private, and well-lit sanitation facilities. It must also address food insecurity, provide confidential health services for those with severe symptoms, and ensure that protection mechanisms are in place to keep girls safe as they navigate their daily lives. The study suggests that until these interconnected needs are met, girls will continue to face a system of deprivation that undermines their health, dignity, and ability to participate in their own futures.
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