Enhancing Self-Hygiene Awareness and Practices During Menstruation Among Female Adolescent Students in Saudi Arabia:...

Menstrual hygiene management (MHM), the practice of maintaining personal hygiene during menstruation, is still a sensitive and neglected public health issue, primarily for adolescent girls in conservative communities. This study aimed to assess baseline menstrual hygiene knowledge and practices among female adolescent students, to evaluate the predictors of knowledge and practices, and to evaluate a structured educational intervention in improving MHM awareness and practices. Therefore, we addressed the knowledge gaps and misconceptions about menstruation among Saudi adolescent girls to improve health outcomes.

A quasi-experimental pre-test/post-test design was employed, involving 399 female students (aged 13-18) from three secondary schools. Participants completed validated questionnaires before and after a three-session educational program covering menstruation physiology, hygiene practices, and myth dispelling.  Results: The educational intervention significantly improved menstrual knowledge across all subgroups (p<0.05), from 236 (59.1%) to 358 (89.7%) post-intervention. However, disparities persisted for informal learners (80 (53.7%) adequate post-intervention vs. 278 (98.2%) formal learners; p<0.001), suggesting the need for targeted outreach beyond structured programs. Those with adequate knowledge were more likely to have mothers with a college education (98 (41.5%) vs. 32 (19.6%); p=0.002) and from higher-income households (178 (75.4%) vs. 101 (62%); p=0.018). Structural factors like private school attendance (aOR=1.65; p=0.016) and access to adequate water, sanitation, and hygiene (WASH) facilities (aOR=1.78; p=0.004) predicted better hygiene practices. The intervention also decreased menstrual-related absenteeism (aOR=0.41 for ≥3 days missed; p<0.001) and increased academic confidence (aOR=3.25 for board-writing confidence; p<0.001).

The intervention has successfully improved MHM awareness and practice and demonstrated the potential for change. This success underscores the critical nature of sustained school-based efforts and infrastructures and adds to the evidence that school-based menstrual education has a positive impact on knowledge and behaviors when combined with structural or parental support. Stigmatization, parental involvement, and policy-level interventions should be included in future interventions to achieve equal access to menstrual health management.