Assessing the knowledge and attitude of menstrual hygiene among high school students, and menstrual practices among high school girls in rural Rwanda


  • Sandra Isano Department of Community Health and Social Medicine, University of Global Health Equity, Rwanda
  • Irakoze Genereuse Iradukunda School of Medicine, University of Global Health Equity, Rwanda
  • Peace Ingabire School of Medicine, University of Global Health Equity, Rwanda
  • Beula Igiraneza School of Medicine, University of Global Health Equity, Rwanda
  • Fred Nkurunziza School of Medicine, University of Global Health Equity, Rwanda
  • Rex Wong Institute of Global Health, University of Global Health Equity, Rwanda



Menstrual hygiene, High school, Reproductive health, Knowledge, Attitude, Practice


Background: This study sought to assess the knowledge, attitude about menstruation among high school teachers, boys and girls in Butaro, a rural area in northern Rwanda. In addition, the menstrual hygiene practices of the high school girls were also assessed; to inform the design of intervention.

Methods: A school-based cross-sectional questionnaire was administered to 339 people in three high schools in a rural region in Rwanda.

Results: Thirty-two teachers and 307 secondary school boys and girls were surveyed. Only 9.8% of students had good knowledge related to menstrual health, with slightly more schoolgirls (13.9%) than schoolboys (5%). Feeling insecure, scared, and worried that others could smell them, were the common menstrual-related concerns cited by girls. About 20% of girls used cloth to manage their menstrual flow and 22.3% reported menstrual-related school absenteeism; lack of sanitary protection products and fear of being teased were among the most prominent reasons.

Conclusions: Providing accessible facilities for girls to change, pain medication, and sufficient sanitary pads are necessary. Reusable sanitary pads and menstrual cups could be cheaper and more sustainable alternatives to commercial menstrual products. Cultivating a psychologically safe school environment is necessary.


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Original Research Articles