1.1 Introduction
Vulvar hygiene refers to the practices and behaviors adopted to maintain cleanliness, health, and protection of the external female genitalia (vulva). Proper vulvar hygiene is vital in preventing infections, maintaining the natural balance of microflora, and ensuring overall reproductive health, particularly among women of childbearing age. The vulva, unlike other parts of the body, is a sensitive region that requires careful care, as inappropriate hygiene practices may lead to various reproductive health challenges such as urinary tract infections, bacterial vaginosis, and candidiasis (Akinlusi et al., 2021). Women of childbearing age are especially vulnerable to reproductive tract infections due to hormonal fluctuations, sexual activity, and increased exposure during pregnancy and childbirth (Okunlola & Morhason-Bello, 2020).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of the Study
Globally, the recognition of vulvar hygiene as a public health issue became prominent in the early 20th century when maternal health programs started to integrate hygiene education into antenatal care. Okunlola and Morhason-Bello (2020) reported that the growing awareness of the link between hygiene and maternal outcomes led to policies encouraging women to adopt safe hygienic practices. However, in developing countries, including Nigeria, the translation of such knowledge into practice remained limited due to socio-economic barriers and cultural influences.
Adebayo and Abimbola (2019) stated that studies conducted in Sub-Saharan Africa highlighted the burden of reproductive tract infections among women of reproductive age, many of which were preventable through improved hygiene. Akinlusi et al. (2021) further affirmed that although awareness has increased over time, a significant proportion of women still practice harmful methods such as using harsh chemicals, antiseptics, or traditional concoctions for vulvar care.
Vulvar hygiene is an essential component of women’s reproductive health, particularly for those in their childbearing years. The vulva, being the external genital structure, is highly sensitive and requires careful attention to prevent infections and ensure overall well-being. According to Akinlusi et al. (2021), maintaining vulvar cleanliness with safe and appropriate methods is fundamental to reducing reproductive tract infections and other health complications that often arise from poor hygiene practices. The authors further reported that unhealthy practices such as the use of harsh soaps, and douching significantly disrupt the natural microflora of the vulvovaginal environment.
Women in their reproductive years are at heightened risk of reproductive tract infections due to biological and physiological factors, including hormonal fluctuations, sexual activity, and pregnancy-related changes. Okunlola and Morhason-Bello (2020) asserted that inadequate knowledge of vulvar hygiene contributes to higher susceptibility to urinary tract infections, bacterial vaginosis, and candidiasis, which in turn may affect fertility, safe delivery, and maternal outcomes.
Ezeonu and Ezeonu (2017) reported that many women in Sub-Saharan Africa, including Nigeria, rely on traditional beliefs and practices handed down through generations, some of which are harmful rather than protective. They affirmed that poverty and limited access to sanitary products also reduce the ability of women to adopt safe hygiene practices. On the other hand, Oshiname and Lawal (2018) stated that even when women are knowledgeable, actual practice does not always align with recommended standards due to social stigma, misinformation, and the lack of targeted health education programs.
According to Okunlola & Morhason-Bello (2020), knowledge of vulvar hygiene practices is therefore an important factor that contributes to better maternal and child health outcomes. Poor practices, such as the use of harsh soaps, antiseptics, or unverified herbal substances for cleansing, not only disrupt the natural vaginal pH but also predispose women to recurrent infections (Okunlola & Morhason-Bello, 2020). On the other hand, adequate awareness and safe practices have been shown to significantly reduce the prevalence of preventable reproductive tract diseases (Ezeonu et al., 2017). In many low- and middle-income countries, including Nigeria, cultural norms and socio-economic conditions influence how women perceive and practice vulvar hygiene. For instance, some cultural beliefs encourage excessive washing, insertion of herbal substances, or douching, which compromise reproductive health rather than protect it (Oshiname & Lawal, 2018).
Maternal health policies often focus on areas such as immunization, nutrition, and delivery preparedness, while issues of vulvar hygiene receive minimal attention. Adebayo and Abimbola (2019) asserted that this neglect has led to preventable infections continuing to affect women of childbearing age, undermining the progress of reproductive health goals in Nigeria. The authors contended that strengthening health education programs on vulvar hygiene within antenatal and postnatal care services would significantly reduce maternal morbidity related to poor hygiene practices. This study is set against the backdrop of these health, socio-cultural, and policy gaps that expose childbearing mothers to preventable reproductive health challenges, thereby necessitating an assessment of their knowledge and practices regarding vulvar hygiene.
1.3 Statement of Problems
Investigation revealed that the vulva, being a sensitive anatomical region, is highly susceptible to infections and inflammations when hygienic practices are poor. Lack of adequate knowledge about appropriate hygiene measures is often associated with increased risks of urinary tract infections, bacterial vaginosis, candidiasis, and other reproductive health complications that negatively affect maternal health outcomes (Okunlola & Morhason-Bello, 2020). Unfortunately, many mothers rely on cultural beliefs, myths, or misinformation passed down through generations, which is detrimental to their reproductive health.
In many communities, limited access to accurate health information and healthcare services is a major barrier to adopting safe hygienic practices (Ezeonu & Ezeonu, 2017). On the other hand, even among educated mothers, knowledge does not always translate into proper practice (Oshiname & Lawal, 2018).
Furthermore, misconceptions such as excessive washing with harsh chemicals, the use of unverified herbal preparations, and reliance on unsafe sanitary methods are widespread, leading to irritation, microflora imbalance, and recurrent infections (Akinlusi et al., 2021). It is against this backdrop that this study seeks to assess the knowledge and practice of vulvar hygiene among childbearing mothers.
1.4 Aim and Objectives of the Study
The aim of this study is to evaluate the knowledge and practice of vulvar hygiene among childbearing mothers.
The specific objectives of this study include:
- To identify socio-cultural factors influencing vulvar hygiene practices among childbearing mothers.
- To assess the level of knowledge of vulvar hygiene among childbearing mothers.
- To examine the hygienic practices adopted by childbearing mothers for vulvar care.
- To establish the relationship between knowledge and practice of vulvar hygiene among childbearing mothers.
1.5 Research Questions
Based on the stated objectives, the study will address the following research questions:
- What is the level of knowledge of vulvar hygiene among childbearing mothers?
- What are the hygienic practices adopted by childbearing mothers for vulvar care?
- What socio-cultural factors influence vulvar hygiene practices among childbearing mothers?
- What relationship exists between knowledge and practice of vulvar hygiene among childbearing mothers?
1.6 Significance of the Study
It is believed that at the completion of the study, the findings will serve as a resource for healthcare providers in designing culturally appropriate health education programs. The study will also inform policy makers on the importance of integrating vulvar hygiene into maternal health policies.
Furthermore, the study will benefit childbearing mothers by empowering them with knowledge that promotes safe hygienic practices. In addition, Midwives, nurses, and doctors will be better equipped with data-driven evidence that will inform their approaches in educating women during clinic visits and community outreach programs.
Lastly, the study will serve as a useful reference material for students, researchers, and future scholars in the field of public health, maternal health, and reproductive health. It will add to the growing body of literature on women’s health and stimulate further studies on related issues affecting women in Nigeria and beyond.
1.7 Scope of the Study
The scope of this research is focused on childbearing mothers attending antenatal and postnatal clinics in Anambra State, Nigeria. It will specifically assess their knowledge and practice of vulvar hygiene within the context of maternal healthcare services provided in selected public health facilities.
1.8 Limitations of the Study
A study of this nature is bound to experience certain problems as such the constraints imposed on the research include:
- Time Constraints: A study of this nature needs relatively long time during which information for accurate or at least near accurate inference could be drawn. The period of the study was short, time posed as constraints to the research.
- Financial Constraints: The research would have extended the survey to other area at the empirical level, but limitation as included cost of transportation to the source of material and the cost of time setting of the already completed work.
- Lack of Cooperation: Many of the respondents are usually aggressive on issue that border cooperation among the respondents border.
- Response Bias: The study will involve surveys and interviews with cooperative managers and members. Response bias may occur if respondents provide socially desirable answers or if there is reluctance to disclose negative financial information due to privacy concerns or fear of repercussions.
1.9 Definition of Terms
Vulva: The external female genital organs, including the labia, clitoris, and vaginal opening. According to Akinlusi et al. (2021), the vulva is highly sensitive and requires special hygienic care to prevent infections.
Vulvar Hygiene: Refers to the practices adopted by women to maintain cleanliness and health of the vulva. Okunlola and Morhason-Bello (2020) stated that proper vulvar hygiene is essential for preventing infections and ensuring reproductive well-being.
Childbearing Mothers: Women within reproductive age who are pregnant or have given birth. Adebayo and Abimbola (2019) affirmed that childbearing mothers face unique challenges in maintaining reproductive health due to hormonal and physiological changes.
Reproductive Health: A state of physical, mental, and social well-being in all matters relating to the reproductive system. According to Ezeonu and Ezeonu (2017), reproductive health includes safe practices that protect against infections and complications.
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