Menstrual Hygiene Management Education to Improve Knowledge and Attitudes of Elementary and Secondary School Students in Semarang City

Sutopo Patria Jati; Nurhasmadiar Nandini; Erlin Friska; Vanessa Rizky Aditya; Nadiya Ridha Afifah

doi:10.14710/jphtcr.v9i2.30729

DOI: https://doi.org/10.14710/jphtcr.v9i2.30729

Menstrual Hygiene Management Education to Improve Knowledge and Attitudes of Elementary and Secondary School Students in Semarang City

Sutopo Patria Jati¹ , Nurhasmadiar Nandini¹, Erlin Friska²

, Vanessa Rizky Aditya³, Nadiya Ridha Afifah¹

¹Department of Health Administration and Policy, Faculty of Public Health, Universitas Diponegoro, Semarang, Indonesia

²Public Health Department, Faculty of Medicine, Universitas Negeri Semarang, Indonesia

³Center of Health Research, Institute for Research and Community Service, Universitas Diponegoro, Semarang, Indonesia

Received: 27 Dec 2025; Published: 31 Aug 2026.

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{JPHTCR30729,
    author = {Sutopo Jati and Nurhasmadiar Nandini and Erlin Friska and Vanessa Aditya and Nadiya Afifah},
    title = {Menstrual Hygiene Management Education to Improve Knowledge and Attitudes of Elementary and Secondary School Students in Semarang City},
    journal = {Journal of Public Health for Tropical and Coastal Region},
  volume = {9},
    number = {2},
    year = {2026},
    keywords = {Menstrual Hygiene Management, adolescent health, knowledge, attitudes, Semarang},
    abstract = {  Introduction:    Inadequate Menstrual Hygiene Management (MHM) among adolescents, driven by cultural stigma and limited access to accurate information, increases risks of reproductive tract infections and social challenges like school absenteeism in urban settings like Semarang City, Indonesia. This study evaluates the effectiveness of a quiz card game intervention in enhancing MHM knowledge and attitudes among 1,234 adolescents aged 9–15 years from 19 elementary and junior high schools.  Methods:  Using a pre-experimental, one-group pretest-posttest design, structured questionnaires assessed baseline and post-intervention knowledge and attitudes. The 30-minute quiz card game sessions, facilitated by trained educators, incorporated visual aids to address MHM practices and cultural misconceptions.  Results:  The Wilcoxon Signed-Rank Test showed significant improvements in knowledge (Z = -14.874, p < 0.001; mean: 5.08 to 6.67) and attitudes (Z = -12.851, p < 0.001; mean: 29.41 to 31.64), with 63% of respondents (777 individuals) demonstrating increased knowledge scores, including 336 with initially poor knowledge.  Conclusion:  These findings underscore the quiz card game’s efficacy in engaging adolescents and reducing stigma. Integrating such interactive, culturally sensitive tools into school curricula can promote healthy menstrual practices, mitigate health risks, and empower adolescents in Semarang to adopt dignified hygiene behaviors early. },
   issn = {2597-4378},   pages = {144--154}  doi = {10.14710/jphtcr.v9i2.30729},
    url = {https://ejournal2.undip.ac.id/index.php/jphtr/article/view/30729}
}

Citation Format:

Abstract

Introduction: Inadequate Menstrual Hygiene Management (MHM) among adolescents, driven by cultural stigma and limited access to accurate information, increases risks of reproductive tract infections and social challenges like school absenteeism in urban settings like Semarang City, Indonesia. This study evaluates the effectiveness of a quiz card game intervention in enhancing MHM knowledge and attitudes among 1,234 adolescents aged 9–15 years from 19 elementary and junior high schools. Methods: Using a pre-experimental, one-group pretest-posttest design, structured questionnaires assessed baseline and post-intervention knowledge and attitudes. The 30-minute quiz card game sessions, facilitated by trained educators, incorporated visual aids to address MHM practices and cultural misconceptions. Results: The Wilcoxon Signed-Rank Test showed significant improvements in knowledge (Z = -14.874, p < 0.001; mean: 5.08 to 6.67) and attitudes (Z = -12.851, p < 0.001; mean: 29.41 to 31.64), with 63% of respondents (777 individuals) demonstrating increased knowledge scores, including 336 with initially poor knowledge. Conclusion: These findings underscore the quiz card game’s efficacy in engaging adolescents and reducing stigma. Integrating such interactive, culturally sensitive tools into school curricula can promote healthy menstrual practices, mitigate health risks, and empower adolescents in Semarang to adopt dignified hygiene behaviors early.

Note: This article has supplementary file(s).

Fulltext View|Download | common.other

Ethical Clearance

Subject
Type	Other
	Download (293KB) Indexing metadata

Email colleagues

Keywords: Menstrual Hygiene Management, adolescent health, knowledge, attitudes, Semarang

Article Metrics:

Article Info

Section: Articles

Language : EN

In Vol 9, No 2 (2026): Journal of Public Health for Tropical and Coastal Region

Anand, E., Singh, J., & Unisa, S. (2015). Menstrual hygiene practices and its association with reproductive tract infections and abnormal vaginal discharge among women in India. Sexual and Reproductive Healthcare, 6(4), 249–254. https://doi.org/10.1016/j.srhc.2015.06.001
Arora A, Mittal A, Pathania D, & Singh J. (2013). Impact of Health Education on Knowledge and Practices about Menstruation Among Adolescent School Girls of Rural Part of District Ambala, Haryana Article Cycle Citation. Comm Health, 4, 492–497
BKKBN, Badan Pusat Statistik, & Kementerian Kesehatan. (2018). Survai Demografi dan Kesehatan Indonesia. http://www.DHSprogram.com
Haery, A. H. (2017). Pengaruh Penyuluhan Seksualitas dengan Metode Stratagem terhadap Pengetahuan Bahaya Seks Pranikah pada Remaja Awal
Hasnah, H., Istiqomah, N., & Sysnawati, S. (2019). Metode Stratagem Dapat Meningkatkan Pengetahuan Remaja Tentang Vulva Hygiene. Jurnal Smart Keperawatan, 6(1), 31. https://doi.org/10.34310/jskp.v6i1.249
Hennegan, J., Shannon, A. K., Rubli, J., Schwab, K. J., & Melendez-Torres, G. J. (2019). Women’s and girls’ experiences of menstruation in low-and middle-income countries: A systematic review and qualitative metasynthesis. PLoS Medicine, 16(5). https://doi.org/10.1371/journal.pmed.1002803
Ilmiawati, H., & Kuntoro. (2016). Pengetahuan Personal Hygiene Remaja Putri pada Kasus Keputihan. Jurnal Biometrika Dan Kependudukan, 5, 43–51
Kemenkes RI. (2018). Riskesdas
Latifah, L. S., & Linggardini, K. (2023a). Pengaruh permainan edukatif domino card terhadap pengetahuan anak usia sekolah dasar tentang manajemen kebersihan diri saat menstruasi. Journal of Nursing Practice and Education, 4(1). https://doi.org/10.34305/jnpe.v4i1.846
Latifah, L. S., & Linggardini, K. (2023b). Pengaruh permainan edukatif domino card terhadap pengetahuan anak usia sekolah dasar tentang manajemen kebersihan diri saat menstruasi. Journal of Nursing Practice and Education, 4(1). https://doi.org/10.34305/jnpe.v4i1.846
Miller, J., Rosso, D., & Arlianti, R. (2009). Investing in School Health and Nutrition in Indonesia
Ministry of Health. (2013). Indonesia Demographic and Health Survey 2012 Special Report on Adolescent Reproductive Healt. www.measuredhs.com
Muhammadiyah, J. K., Rohimah, C. I., Solehati, T., Windani, C., Sari, M., Keperawatan, F., Padjadjaran, U., & Jatinangor, K. (2019). Pengaruh Pengetahuan, Sikap dan Tindakan Siswi Sekolah Dasar Terkait Genitalia Hygiene. Jurnal Keperawatan Muhammadiyah, 4(1), 2019. http://journal.um-surabaya.ac.id/index.php/JKM
Mukarramah. (2020). Hubungan Pengetahuan dan Sikap Remaja Putri Terhadap Perilaku Personal Hygiene saat Menstruasi. In Jurnal Kesehatan Luwu Raya (Vol. 7, Issue 1)
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
Pragita, R. R., Purwandari, R., Sulistyorini, L., Keperawatan, F., Jember, U., Kalimantan, J., 37 Kampus, N., Boto, T., & Telp, J. (2018). Pengaruh Pendidikan Kesehatan Metode stratagem dengan Media Audiovisual terhadap Pengetahuan Kesehatan Reproduksi Remaja
Puspitaningrum, W., Agushybana, F., Mawarni, A., Nugroho Bagian Biostatistika dan Kependudukan, D., & Kesehatan Masyarakat, F. (2017). Pengaruh Media Booklet Terhadap Pengetahuan dan Sikap Remaja Putri terkait Kebersihan dalam Menstruasi di Pondok Pesantren Al-Ishlah Demak Triwulan II Tahun 2017 (Vol. 5). http://ejournal3.undip.ac.id/index.php/jkm
Putri, N. A., & Setianingsih, A. (2016). Hubungan Pengetahuan dan Sikap Terhadap Perilaku Personal Hygiene Menstruasi. Ilmu Kesehatan Masyarakat, 5(1)
Sommer, M., Chandraratna, S., Cavill, S., Mahon, T., & Phillips-Howard, P. (2016). Managing menstruation in the workplace: An overlooked issue in low- and middle-income countries. In International Journal for Equity in Health (Vol. 15, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s12939-016-0379-8
Sommer, M., Hirsch, J. S., Nathanson, C., & Parker, R. G. (2015). Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue. American Journal of Public Health, 105(7), 1302–1311. https://doi.org/10.2105/AJPH
Steinberg, L. (2005). Cognitive and affective development in adolescence. Trends in Cognitive Sciences, 9(2), 69–74. https://doi.org/10.1016/j.tics.2004.12.005
World Health Organization. (2018). WHO recommendations on adolescent sexual and reproductive health and rights
Wulandari, P., Aini, D. N., & Astuti, S. W. (2015). Faktor-Faktor yang Berhubungan dengan Kejadian Menarche Siswi di SMPN 31 Semarang
Zuhriya, C., Ketut, N., Armini, A., & Wahyuni, E. D. (2018). Pengaruh Edutainment Ular Tangga Terhadap Perilaku Remaja Tentang Personal Hygiene Menstruasi. In Jurnal Keperawatan Muhammadiyah (Vol. 3, Issue 2). http://journal.um-surabaya.ac.id/index.php/JKM

Last update:

No citation recorded.

Last update:

No citation recorded.

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

In order to be accepted and published by Journal of Public Health for Tropical and Coastal Region, the author (s) who submit a manuscript should complete the review process. Journal of Public Health for Tropical and Coastal Region articles are distributed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0). Articles can be read, shared, and adapted even for commercial purposes under the following conditions:

Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

Copyright of accepted articles remains with the author (s). The author (s) have the right to the articles that have been published. The Editorial Team of Journal of Public Health for Tropical and Coastal Region and the Author(s) strive to ensure that no errors occur in the articles that have been published, both data errors and statements in the articles. Authors who publish in this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
The journal allows the authors to hold the copyright and retain publishing rights without restrictions.
Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) before and during submission, as it can lead to productive exchanges and earlier and greater citation of published work.