Effectiveness of a School-Based Intervention to Improve Menstrual Hygiene Awareness and Access Among Adolescent Girls...

Background Menstrual hygiene management (MHM) remains a public health concern among adolescent girls in rural India. Although sanitary pad use has increased, gaps persist in hygienic practices and access. School-based interventions can address both knowledge and accessibility barriers. This study evaluated the effectiveness of a school-based intervention integrating menstrual hygiene education with subsidised sanitary pad distribution. Methods A single-group pre-post quasi-experimental study without a control group was conducted among 172 adolescent girls aged 12-17 years from three rural secondary schools in Howrah district, West Bengal. The intervention included a structured awareness session delivered by trained female teachers and the provision of subsidised sanitary pads to non-users over three months. Data were collected using a pre-tested structured questionnaire. Knowledge was assessed before and after the session, while hygiene practices and pad use were assessed at baseline and follow-up. Paired t-test and McNemar test were used for analysis. Results At baseline, 153 (89.0%) participants used sanitary pads; however, only 52 (30.2%) changed absorbents at recommended intervals, 65 (37.8%) practised adequate hygiene, and 68 (39.5%) followed safe disposal practices. Post-intervention, these improved to 145 (84.3%), 156 (90.7%), and 140 (81.4%), respectively (p<0.001). The mean knowledge score increased from 6.1 ± 2.0 to 11.4 ± 1.8 (p<0.001). Overall, sanitary pad use increased to 169 (98.3%) (p=0.001). Among baseline non-users (19, 11.0%), 16 (84.2%) adopted sanitary pad use following subsidised access. Conclusion This school-based intervention was associated with improvements in MHM, self-reported hygiene practices, and sanitary pad use. These findings suggest that integrated approaches addressing both behavioural and structural barriers may support better MHM in rural school settings.