Knowledge, Attitudes, and Practices of Reproductive Healthcare Schemes and Evaluation of a Menstrual Hygiene Awareness Module among Tribal Women and Adolescent Girls in Jharkhand, India: A mixed-methods pilot study

Abstract

Purpose: This study aimed to evaluate the Knowledge, Attitude, and Practices (KAP) related to the healthcare schemes among reproductive-age tribal women, along with the perspective of various, and to pilot an awareness module on menstrual health among adolescent girls.

Method: In the first phase needs assessment for KAP with a sample of 100 randomly selected participants was done. Thiswascollected through a questionnaire, followed by an in-depth interviews among ten participants. Adescriptive analysis in terms of frequency and percentage, followed by the chi-square test was done. For in depth interviews, analysis was performed manually, and themes were generated. In the second phase, a preliminary awareness module related to the menstrual hygiene was developed. A health awareness session of the developed module was delivered to 30 participants, and their feedback were collected.

Results:  Approximately half of the reproductive-aged tribal women (52%) and adolescent girls (50%) were aware of reproductive healthcare schemes; however, awareness of specific services was largely partial and primarily limited to cash-incentive schemes. Scheme utilization was reported by 52% of reproductive-aged women, while no adolescent girls reported utilization. Qualitative findings highlighted cash benefits, cultural practices, lack of supervision, inadequate infrastructure, and limited awareness as key barriers. The menstrual hygiene awareness module was well received, with 46.7% rating it as good and recommending school-based integration and culturally relevant visuals.

Conclusion: Study shows that awareness and use of reproductive healthcare schemes among tribal women and adolescent girls in Jharkhand are low, mainly influenced by cash incentives, reflecting gaps in health communication and service delivery. The findings highlight the need for culturally appropriate, community-based policy approaches beyond financial incentives. Strengthening awareness activities, training, supervision, and healthcare infrastructure can improve scheme reach and equity. The menstrual health module was well accepted, supporting its integration into school and community programs for wider and sustainable impact.