Background
Lack of menstrual hygiene knowledge combined with stigma towards menstruating girls in low- and middle-income countries contribute to dropout among schoolgirls and gender inequity in education. We conducted a study in urban and rural schools of Bangladesh that aimed to develop and pilot an intervention to foster a more supportive environment for schoolgirls through involvement of schoolboys.
Method
We explored boys’ knowledge, attitudes, and perception toward puberty and menstruation and piloted educational modules for students in a total of eight rural and urban schools in Bangladesh. We conducted in-depth interviews, and pre-and post-intervention surveys among 201 randomly selected boys to determine the impact of the education sessions and develop recommendations. We conducted four focus group discussions with a total of 32 boys to determine the impact of the education sessions, and develop recommendations on how to further destigmatize menstruation and improve puberty and menstrual hygiene management knowledge.
Result
Compared to baseline, boys’ knowledge, attitude and perception about puberty and menstruation considerably increased across all domains. At endline, boys’ awareness of menstruation increased [PD: 15%; 95% CI: 2, 29], and had increased knowledge about the duration of bleeding [PD: 17%; 95%CI: -4, 38]. Most boys agreed that they can support girls during menstruation (29% at baseline vs. 47% at endline, p=0.046), and at endline, boys’ disagreement with menstruation being the curse of God decreased (87% at baseline vs. 98% at endline, p=0.028). In focus group discussion, boys from both urban and rural schools made recommendations for how to make sessions more informative and interactive sessions.
Conclusion
Engagement of schoolboys, combined with well-delivered intervention materials and social and behavior change communication interventions can improve boys’ knowledge, attitude, and perception towards their female peers during menstruation and contribute to more supportive and girl-friendly environments in schools.