Exploring menstrual health knowledge, attitude, and experiences among adolescent girls in public schools in Georgia: a qualitative study

Abstract Background Despite being a physiological process for human development, menstruation can be burdened with a complex interplay of interpersonal, social, and structural factors. Evidence on menstrual health remains scarce across Eastern Europe and Central Asia, and published research specifically addressing adolescent girls’ menstrual health experiences in Georgia is lacking, despite cultural and historical factors that suggest unique challenges in this setting. Public schools represent a critical but understudied environment where infrastructural, educational, and social barriers to menstrual health converge for adolescent girls. This study aims to explore menstrual health knowledge, attitudes, and experiences among schoolgirls in Georgia. Methods We conducted a qualitative study using in-depth interviews and focus group discussions in public schools across urban and rural areas of three cities in Georgia in 2020. An inductive-deductive approach was used for data analysis. We used the Social Ecological Model (SEM) to report and interpret the findings. Results Nine teachers and 39 schoolgirls (28 in six focus groups, 11 in interviews) participated. The Social Ecological Model revealed multilevel challenges: knowledge gaps and misconceptions (individual level); hindered family communication and peer stigma (interpersonal level); inadequate school infrastructure and insufficient teacher training (organizational level); cultural taboos shaping attitudes and practices (community level); and curriculum deficiencies preventing comprehensive education (policy level). These interconnected factors negatively affected schoolgirls’ menstrual health knowledge, hygiene management, and participation in school activities. Conclusion The findings demonstrate that formal educational settings in Georgia inadequately address the schoolgirls’ menstrual health needs. Comprehensive menstrual health education, improved school infrastructure, and teacher training are essential to reduce menstrual stigma and provide accurate information and resources. Addressing these multilevel barriers can significantly enhance menstrual health, educational participation, and overall well-being among schoolgirls across Georgia.