Adolescent Menstrual Health Education and Its Impact on Knowledge, Hygiene Practices, and Quality of Life: A Quasi Experimental Community Intervention Study in Rural South India

Abstract

ABSTRACT Menstrual health and hygiene (MHH) remains a significant public health challenge among adolescent girls in low- and middle-income regions, particularly in rural South India. Sociocultural taboos, structural deficits in sanitation facilities, and inadequate access to formal health education contribute to poor menstrual practices, psychological distress, and elevated school absenteeism. This study evaluated the longitudinal impact of a structured, culturally tailored Adolescent Menstrual Health Education Program (AMHEP) on menstrual knowledge, hygienic practices, and health related quality of life (HRQoL) among adolescent schoolgirls in rural districts of Tamil Nadu and Karnataka. A prospective, quasi-experimental non randomized controlled community trial was conducted over a 12-month period involving 640 adolescent girls aged 12 to 17 years, allocated to an intervention group (n = 320) and a control group (n = 320). The intervention group received a multi-component educational package consisting of interactive workshop modules, visual flipcharts, peer-led group discussions, and reusable sanitary pad demonstration kits across 12 weeks. Pre intervention and post-intervention evaluations (at 3 and 6 months follow-up) were performed using validated instruments, including the Menstrual Knowledge and Practice Scale (MKPS) and the Pediatric Quality of Life Inventory (PedsQL 4.0). Results revealed a statistically significant improvement in mean menstrual knowledge scores in the intervention group from baseline to 6-month follow-up (8.42 ± 2.15 to 17.10 ± 1.88 out of 20, p < 0.001), whereas the control group showed negligible change (8.36 ± 2.21 to 8.95 ± 2.05). Safe menstrual hygiene practices—comprising exclusive use of hygienic absorbents, regular changing frequency, and hygienic disposal— increased from 31.25% to 84.68% in the intervention cohort (p < 0.001). Furthermore, school absenteeism due to menstrual discomfort dropped from 42.50% to 11.25% in the intervention group, alongside substantial gains across physical, emotional, and school functioning domains of HRQoL (p < 0.001). Structured school-based MHH education significantly enhances health literacy, dignity, and quality of life among rural adolescent girls.

KEYWORDS: Menstrual Health Education, Adolescent Health, Menstrual Hygiene Management, Quality of Life, PedsQL 4.0, Rural Health, South India, Quasi-Experimental Study, School Absenteeism