Perceived outcomes of an integrated menstrual hygiene intervention on empowerment among secondary school girls in Nasarawa State Nigeria

Inadequate menstrual hygiene management (MHM) remains a major barrier to girls’ education, health, and dignity in low-resource settings. This qualitative study explored adolescent girls’ self-reported knowledge, experiences, and perceptions of empowerment following a school-based menstrual hygiene intervention in Nasarawa State, Nigeria. We used a qualitative descriptive design and conducted six focus group discussions (FGDs) with 55 adolescent girls from intervention schools. The intervention combined menstrual clubs and sanitary pad provision in both LGAs, with additional WASH facility improvements implemented in Nasarawa LGA. Data were analyzed thematically using Braun and Clarke’s framework in NVivo 12. Three major themes emerged: (1) knowledge acquisition and confidence building, (2) improved hygiene practices and supportive school environments, and (3) sustainability and menstrual agency. Within these themes, participants described self-reported improvements in menstrual literacy, self-confidence, and school participation. Menstrual clubs were reported to facilitate open dialogue, reduce stigma, and strengthen peer support. Integrating menstrual hygiene education with improved WASH infrastructure and peer-support structures can enhance girls’ confidence, participation, and sense of menstrual dignity within school settings. Embedding menstrual health education, reusable pad training, and menstrual clubs into Nigeria’s school system may support gender equity and sustainable inclusion. This study adds to the limited qualitative evidence on integrated menstrual health interventions in Nigeria and offers practical insights for gender-responsive school health programming in similar low-resource contexts.