Effectiveness of a Participatory Educational Intervention on Menstrual Health and Hygiene Knowledge, Attitudes, and Practices Among Nursing Students in Bangladesh

Abstract Background Menstrual Health and Hygiene (MHH) is fundamental to women’s well-being but remains underprioritized in professional health education. In Bangladesh, nursing and midwifery students, future frontline health workers, rarely receive structured menstrual health curricula. This study assessed the effectiveness of a participatory educational intervention in improving menstrual Knowledge, Attitudes, and Practices (KAP) among nursing students. Methods A quasi-experimental pre-test–post-test design was conducted from January to June 2025 among 384 female students at Rajshahi Nursing College, equally divided into intervention and control groups (n = 192 each). The four-week intervention adapted from WaterAid’s Menstrual Hygiene Matters training guide included sessions on menstrual physiology, hygiene practices, stigma reduction, and WASH management. Data were collected using validated questionnaires (KAP tools) and analyzed with paired and independent t -tests, with p < 0.05 considered significant. Results Participants’ mean age was 23.3 ± 5.1 years, and both groups were demographically comparable at baseline. Post-intervention analysis revealed significant improvements across all domains in the intervention group compared with the control. Knowledge indicators such as correct understanding of menstrual-cycle length (from 8% at baseline to 78% post-intervention) and uterine physiology (from 22% to 34%) improved markedly ( p < 0.001; d = 0.68). Attitudinal scores demonstrated positive normalization of menstruation (mean score increased from 4.8 to 5.9; p < 0.001; d = 0.74), while hygienic practices such as regular pad use (from 31% to 88%), frequent material change, and handwashing before and after handling materials increased significantly ( p < 0.01; d = 0.82). The intervention’s success reflects the cognitive–affective–behavioral pathway of learning: factual knowledge fostered understanding, emotional engagement reduced stigma, and experiential learning reinforced hygienic habits. Conclusion A short, participatory menstrual health education program significantly enhanced MHH knowledge, attitudes, and practices among nursing students. Although the intervention did not modify physical WASH infrastructure, it enabled students to better manage their menstrual health using existing resources and facilities. Integrating similar gender-sensitive modules into nursing curricula can empower future health professionals to promote menstrual dignity and advance gender-equitable healthcare. Clinical trial number: not applicable