Knowledge, Attitude, and Practices among Governmental Secondary School Girls Towards Menstrual Hygiene in Al-Daw Hajouj Secondary School for Girls
DOI:
https://doi.org/10.54536/ajmhc.v1i2.7738Keywords:
Adolescent Girls, Attitudes, Knowledge, Menstrual Hygiene, Menstrual Hygiene Management, Menstruation, PracticesAbstract
Menstruation is a natural part of the reproductive cycle and a physiological process unique to females. However, adolescent girls can face challenges in managing it as a result of limited knowledge, cultural taboos, and inadequate facilities. This study, therefore, assessed the knowledge, attitudes, and practices (KAP) regarding menstrual hygiene among 200 students at Al-Daw Hajouj Secondary School for Girls in Sudan (2022–2025). A descriptive cross-sectional design was used to analyze data collected from a self-administered questionnaire administered to 200 respondents. The results show that 96% of the respondents had good awareness and knowledge of menstruation. Likewise, 76.6% understood menstruation as a normal physiological phenomenon and most students acknowledged that it is caused by hormonal changes. However, misconceptions persisted, particularly regarding the source of menstrual blood. Attitudinal responses showed that students generally recognized the importance of menstrual hygiene for health and supported school attendance during menstruation, though many reported feelings of nervousness and emotional changes. Practices varied, with some gaps in hygienic management. The study concludes that while knowledge and attitudes are relatively positive, persistent misconceptions and emotional challenges highlight the need for strengthened menstrual health education and improved school-based hygiene facilities to promote dignity, safety, and wellbeing among adolescent girls.
Downloads
References
Amoroso, A. P., Fiorini, S., Lopes Neri, L. C., Guglielmetti, M., Tagliabue, A., Nappi, R. E., & Ferraris, C. (2025). Functional hypothalamic amenorrhea and dietary intervention: A systematic review to guide further research in amenorrheic women without overt eating disorder. Nutrition research (New York, N.Y.), 140, 102–115. https://doi.org/10.1016/j.nutres.2025.06.008
Atari, D. O., Tariquzzaman, S. K., & Nancy, A. (2021). Knowledge and perceptions on menstrual hygiene management among school-going adolescent girls in South Sudan. Journal of Adolescent Research. Advance online publication. https://doi.org/10.1177/07435584211043293
Chauhan, P., Shaik, R., Anusha, D., & Sotala, M. (2019). A study to assess knowledge, attitude, and practices related to the menstrual cycle and management of menstrual hygiene among school-going adolescent girls in a rural area of South India. International Journal of Medical Science and Public Health, 8(2), 114–119. https://doi.org/10.5455/ijmsph.2019.1131809112018
Critchley, H. O. D., Babayev, E., Bulun, S. E., Clark, S., Garcia-Grau, I., Gregersen, P. K., Kilcoyne, A., Kim, J. J., Lavender, M., Marsh, E. E., Matteson, K. A., Maybin, J. A., Metz, C. N., Moreno, I., Silk, K., Sommer, M., Simon, C., Tariyal, R., Taylor, H. S., Wagner, G. P., & Griffith, L. G. (2020). Menstruation: Science and society. American Journal of Obstetrics & Gynecology, 223(5), 624–664. https://doi.org/10.1016/j.ajog.2020.06.004
Danial, N. (2023). Menstrual hygiene management: A comprehensive review of current practices, challenges, and interventions. International Journal of Creative Research Thoughts (IJCRT), 11(6), 1–10.
De Sanctis, V., Rigon, F., Bernasconi, S., Bianchin, L., Bona, G., Bozzola, M., Buzi, F., De Sanctis, C., Tonini, G., Radetti, G., & Perissinotto, E. (2019). Age at Menarche and Menstrual Abnormalities in Adolescence: Does it Matter? The Evidence from a Large Survey among Italian Secondary Schoolgirls. Indian journal of pediatrics, 86(Suppl 1), 34–41. https://doi.org/10.1007/s12098-018-2822-x
De Sanctis, V., Soliman, A. T., Elsedfy, H., Soliman, N. A., Soliman, R., & El Kholy, M. (2016). Dysmenorrhea in adolescents and young adults: a review in different country. Acta bio-medica : Atenei Parmensis, 87(3), 233–246.
El Meselhy, H. M., Salama, A. A., & El Mawardy, S. R. (2020). Menstrual hygiene among secondary school students. Menoufia Medical Journal, 33(1), 24–28.
Frankel, R. A., Michels, K. A., Kim, K., Kuhr, D. L., Omosigho, U. R., Wactawski-Wende, J., Levine, L., Perkins, N. J., & Mumford, S. L. (2021). Serum antioxidant vitamin concentrations and oxidative stress markers associated with symptoms and severity of premenstrual syndrome: a prospective cohort study. BMC women’s health, 21(1), 49. https://doi.org/10.1186/s12905-021-01187-7
Gill, D., Del Greco M, F., Rawson, T. M., Sivakumaran, P., Brown, A., Sheehan, N. A., & Minelli, C. (2017). Age at Menarche and Time Spent in Education: A Mendelian Randomization Study. Behavior genetics, 47(5), 480–485. https://doi.org/10.1007/s10519-017-9862-2
Gultie, T., Hailu, D., & Workineh, Y. (2014). Age of menarche and knowledge about menstrual hygiene management among adolescent school girls in Amhara province, Ethiopia: Implications for health care workers and school teachers. PLOS ONE, 9(9), e108644. https://doi.org/10.1371/journal.pone.0108644
Harrington, B. C., Jimerson, M., Haxton, C., & Jimerson, D. C. (2015). Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa. American family physician, 91(1), 46–52.
Hu, Z., Tang, L., Chen, L., Kaminga, A. C., & Xu, H. (2020). Prevalence and risk factors associated with primary dysmenorrhea among Chinese female university students: A cross-sectional study. Journal of Pediatric and Adolescent Gynecology, 33(1), 15–22. https://doi.org/10.1016/j.jpag.2019.09.004
Jazani, A. M., Hamdi, K., Tansaz, M., Nazemiyeh, H., Bazargani, H. S., Fazljou, S. M. B., & Azgomi, R. N. D. (2018). Herbal medicine for oligomenorrhea and amenorrhea: A systematic review of ancient and conventional medicine. BioMed Research International, 2018, Article 3052768, 1–4. https://doi.org/10.1155/2018/3052768
Jha, S. (2019). Effectiveness of planned audio teaching program on menstrual hygiene in terms of knowledge among visually challenged adolescent girls in a selected blind school, West Bengal. International Journal of Scientific Research and Education, 6(10). https://doi.org/10.5958/2454-2660.2016.00058.2
Kaltiala-Heino, R., Marttunen, M., Rantanen, P., & Rimpelä, M. (2003). Early puberty is associated with mental health problems in middle adolescence. Social science & medicine (1982), 57(6), 1055–1064. https://doi.org/10.1016/s0277-9536(02)00480-x
Kavitha, M., Jadhav, J., Ranganath, T. S., & Vishwanatha. (2018). Assessment of knowledge and menstrual hygiene management among adolescent schoolgirls in Nelamangala. International Journal of Community Medicine and Public Health, 5(9), 4135–4139. https://doi.org/10.18203/2394-6040.ijcmph20183608
Kavitha, M., Jadhav, J., Ranganath, T.S., & Vishwanatha (2018). Assessment of knowledge and menstrual hygiene management among adolescent school girls of Nelamangala. International Journal Of Community Medicine And Public Health. https://doi.org/10.18203/2394-6040.ijcmph20183608
Kuo, C. Y., Cheng, Y. T., Ho, S. T., Yu, C. C., & Chen, M. J. (2018). Comparison of anti-inflammatory effect and protein profile between the water extracts from Formosan sambar deer and red deer. Journal of Food and Drug Analysis, 26(4), 1275–1282. https://doi.org/10.1016/j.jfda.2018.02.005
Li, F., Chen, K., Zhang, T., Xu, L., Gu, X., Lin, J., & Jiang, J. (2026). Menstrual and reproductive factors and risk of Alzheimer’s disease in elderly women: a cohort study in Eastern China. Scientific reports, 16(1), 10415. https://doi.org/10.1038/s41598-026-40329-5
Liu, X., Chen, H., Liu, Z. Z., Fan, F., & Jia, C. X. (2017). Early menarche and menstrual problems are associated with sleep disturbance in a large sample of Chinese adolescent girls. Sleep, 40(9). https://doi.org/10.1093/sleep/zsx107
Maleki-Saghooni, N., Karimi, F. Z., Behboodi Moghadam, Z., & Mirzaii Najmabadi, K. (2018). The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review. Avicenna journal of phytomedicine, 8(2), 96–113.
Mitsuhashi, R., Sawai, A., Kiyohara, K., Shiraki, H., & Nakata, Y. (2022). Factors associated with the prevalence and severity of menstrual-related symptoms: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 20(1), 569. https://doi.org/10.3390/ijerph20010569
Moini Jazani, A., Hamdi, K., Tansaz, M., Nazemiyeh, H., Sadeghi Bazargani, H., Fazljou, S. M. B., & Nasimi Doost Azgomi, R. (2018). Herbal Medicine for Oligomenorrhea and Amenorrhea: A Systematic Review of Ancient and Conventional Medicine. BioMed research international, 2018, 3052768. https://doi.org/10.1155/2018/3052768
Mubashra, A., Faridi, T. A., Rana, M. S., Parveen, I., Zahid, M. T., John, A., & Khan, S. (2021). Knowledge, attitude, and practices towards menstrual hygiene among government and private school girls. Pakistan BioMedical Journal, 4(1), 51–59.
Munro, M. G., Critchley, H. O. D., Fraser, I. S., & FIGO Menstrual Disorders Committee. (2018). The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. International Journal of Gynecology & Obstetrics, 143(3), 393–408. https://doi.org/10.1002/ijgo.12666
Nnennaya, E. U., Atinge, S., Dogara, S. P., & Ubandoma, R. J. (2021). Menstrual hygiene management among adolescent school girls in Taraba State, Nigeria. African Health Sciences, 21(2), 843–850. https://doi.org/10.4314/ahs.v21i2.45
Onieva-Zafra, M. D., Fernández-Martínez, E., Abreu-Sánchez, A., Iglesias-López, M. T., García-Padilla, F. M., Pedregal-González, M., & Parra-Fernández, M. L. (2020). Relationship between Diet, Menstrual Pain and other Menstrual Characteristics among Spanish Students. Nutrients, 12(6), 1759. https://doi.org/10.3390/nu12061759
Phillips-Howard, P. A., Caruso, B., Torondel, B., Zulaika, G., Sahin, M., & Sommer, M. (2016). Menstrual hygiene management among adolescent schoolgirls in low- and middle-income countries: research priorities. Global Health Action, 9(1). https://doi.org/10.3402/gha.v9.33032
Rahfiludin, M. Z., Arso, S. P., Joko, T., Anas, A. F., Murwani, R., & Hidayanti, L. (2021). Plant-based diet and iron deficiency anaemia in Sudanese adolescent girls at Islamic boarding schools in Indonesia. Journal of Nutrition and Metabolism, 2021, Article 6698792, 1–7. https://doi.org/10.1155/2021/6469883
Rashed, K., & Butnariu, M. (2021). Antimicrobial and antioxidant effects of Cichorium intybus aerial parts and chemical profile. Egyptian Journal of Chemistry, 64(12), 4689–4696. https://doi.org/10.21608/ejchem.2021.83913.4112
Reid, R. L., & Soares, C. N. (2018). Premenstrual Dysphoric Disorder: Contemporary Diagnosis and Management. Journal of obstetrics and gynaecology Canada : JOGC = Journal d’obstetrique et gynecologie du Canada : JOGC, 40(2), 215–223. https://doi.org/10.1016/j.jogc.2017.05.018
Rheinländer, T., Gyapong, M., Akpakli, D. E., & Konradsen, F. (2019). Secrets, shame and discipline: School girls’ experiences of sanitation and menstrual hygiene management in a peri-urban community in Ghana. Health Care for Women International, 40(1), 13–32. https://doi.org/10.1080/07399332.2018.1444041
Šaffa, G., Kubicka, A. M., Hromada, M., & Kramer, K. L. (2019). Is the timing of menarche correlated with mortality and fertility rates? PLOS ONE, 14(4), e0215462. https://doi.org/10.1371/journal.pone.0215462
Senapathi, P., & Kumar, H. A. (2018). Comparative study of menstrual hygiene management among rural and urban adolescent girls in Mangaluru, Karnataka. International Journal of Community Medicine and Public Health, 5(6), 2548–2556. https://doi.org/10.18203/2394-6040.ijcmph20182193
Shumie, Z. S., & Mengie, Z. A. (2022). Menstrual hygiene management knowledge, practice, and associated factors among school girls in Northeast Ethiopia. PLOS ONE, 17(8), e0271275. https://doi.org/10.1371/journal.pone.0271275
Singh, J., & Anand, E. (2018). Identifying socio-economic barriers to hygienic menstrual absorbent use among unmarried girls in the impoverished states of India. Social Science Spectrum, 4(1), 45–52.
Thakur, H., Aronsson, A., Bansode, S., Stalsby Lundborg, C., Dalvie, S., & Faxelid, E. (2014). Knowledge, practices, and restrictions related to menstruation among young women from a low socioeconomic community in Mumbai, India. Frontiers in Public Health, 2, 72. https://doi.org/10.3389/fpubh.2014.00072
Tijani, A. M., Awowole, I. O., Badejoko, O. O., Badejoko, B. O., Ijarotimi, A. O., & Loto, O. M. (2019). Is menarche really occurring earlier? A study of secondary school girls in Ile-Ife, Nigeria. Tropical Journal of Obstetrics and Gynaecology, 36(1), 114–120. https://doi.org/10.4103/TJOG.TJOG_12_19
United Nations Children’s Fund (2016). Knowledge, attitudes and practices of menstrual hygiene management among schoolgirls and communities in selected woredas of Amhara Region, Ethiopia. UNICEF WASH Baseline Report.
United Nations Children’s Fund (2019). Supporting the rights of girls and women through menstrual hygiene management (MHM) in the East Asia and Pacific Region: Good practice guidance note. UNICEF. https://www.unicef.org/media/91341/file/UNICEF-Guidance-menstrual-health-hygiene-2019.pdf
WebMD Editorial Contributors. (2024, December 10). You know all the signs: Your period is coming. WebMD. Retrieved from https://www.webmd.com/women/signs-your-period-is-coming
Yang, Y., Du, S., Xie, R., Zhang, Y., Yu, T., Ding, Z., & Hong, X. (2022). Association between Age at Menarche and Hyperhomocysteinemia among Women in Hunan, China: A Cross-Sectional Study. Reviews in cardiovascular medicine, 23(7), 221. https://doi.org/10.31083/j.rcm2307221
Zaka, M., & Mahmood, K. T. (2012). Pre-menstrual syndrome: A review. Journal of Pharmaceutical Science and Research, 4(1), 1684–1691.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Samar Sami Muawyih (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
