Abstract:

Background: Adequate knowledge and a positive attitude towards menstruation are essential for effective menstrual hygiene management, yet many adolescent girls in rural Nigeria lack comprehensive understanding and hold negative perceptions due to cultural taboos and limited access to information. This study assessed the level of knowledge and attitude towards menstrual hygiene among adolescent girls in secondary schools in Ogba/Egbema/Ndoni Local Government Area (ONELGA), Rivers State, Nigeria. Methods: A community-based, cross-sectional study was conducted between January and February 2026 among 386 adolescent girls in secondary schools across ONELGA, with 352 completely filled questionnaires retrieved (91.2% response rate). Participants were selected using stratified random sampling from seven schools. Data were collected using a structured, pre-tested questionnaire adapted from validated instruments, comprising sections on socio-demographics, knowledge of menstruation (9 items), and attitude towards menstruation (10 items on a 4-point Likert scale). Knowledge scores were categorized as poor (0–3 correct), fair (4–6 correct), or good (7–9 correct). Attitude scores were categorized as negative (10–20), moderate (21–30), or positive (31–40). Descriptive statistics were performed using SPSS version 26. Results: The mean age of respondents was 14.6 years (SD=2.3), with a mean age at menarche of 12.8 years (SD=1.4). While 90.3% correctly identified menstruation as a normal physiological process, comprehensive knowledge was limited: only 29.0% knew the correct menstrual cycle length (21–35 days) and 57.1% knew the recommended frequency for changing sanitary materials (every 2–6 hours). Overall, 34.7% had good knowledge, 51.7% had fair knowledge, and 13.6% had poor knowledge. Mothers (65.1%) and teachers (42.9%) were the primary information sources. Regarding attitude, 92.7% affirmed maintaining personal hygiene during menstruation, but negative perceptions were prevalent: only 38.0% were willing to discuss menstruation openly in school, and 76.7% preferred to keep it secret. Overall, 27.8% exhibited negative attitude, 46.9% moderate attitude, and 25.3% positive attitude towards menstruation. Conclusion: This study revealed high basic awareness of menstruation but significant gaps in comprehensive knowledge and a predominance of negative attitudes characterized by secrecy among adolescent girls in ONELGA. With only about one-third of respondents having good knowledge in the face of negative attitudes, there is need to intensify effort to ensure Health Education as a standalone course in schools. This will give more attention to specific issues on personal menstrual hygiene as one of the new public health concepts, Family Life and Sex Education. These findings underscore the need for targeted school-based educational interventions that address comprehensive menstrual health and foster open dialogue to dismantle stigma.