IMPACT OF MENSTRUAL HEALTH EDUCATION ON ADOLESCENT GIRLS’ HEALTH OUTCOMES IN RURAL AREAS

Abstract

Objective: To assess whether a structured menstrual health education program improves knowledge, hygienic practices, school attendance, and self-reported health outcomes among adolescent girls in rural settings.

Methods: We conducted a parallel, community-based intervention with a cluster design (8 schools per arm; ~30 girls per school; total n≈480). The intervention arm received a 12-week package: participatory menstrual health sessions, skills-based hygiene demonstrations, parent–teacher engagement, and referral linkage to primary care. Controls received usual life-skills classes. Outcomes were measured at baseline and 3 months post-intervention: menstrual knowledge (0–20 score), use of hygienic materials, school absenteeism attributable to menstruation, self-reported reproductive tract infection (RTI)-like symptoms, and moderate–severe dysmenorrhea. Analysis used intention-to-treat, comparing change from baseline between arms (difference-in-differences, DID).

Results: Compared with controls, the intervention achieved larger gains in menstrual knowledge (DID +4.8 points on a 0–20 scale) and hygienic material use (DID +20.5 percentage points), and greater reductions in period-related absenteeism (DID −11.0 pp) and RTI-like symptoms (DID −6.9 pp). Dysmenorrhea decreased modestly (DID −3.5 pp). Baseline characteristics were similar across arms.

Conclusion: A pragmatic, school-centered menstrual health education program led to meaningful improvements in knowledge, hygiene, and attendance, and reduced self-reported RTI-like symptoms among rural adolescent girls. Integrating structured menstrual education into routine school health services is likely to be a high-yield, equity-promoting strategy.