Effectiveness Of Pictorial Booklet-Based Health Education On Improving Menarche Knowledge: A Quasi-Experimental Study

Authors

DOI:

https://doi.org/10.23917/bik.v19i2.15257

Keywords:

pictorial booklet, menarche, knowledge, health education

Abstract

Reproductive health literacy is closely related to adolescents’ readiness to face biological and social changes from an early age and remains a global public health concern. Menarche is a crucial component of menstrual health literacy and marks a significant milestone in girls’ reproductive development. However, many elementary school students have limited knowledge about menarche, which may lead to fear, embarrassment, poor menstrual hygiene practices, and school absenteeism. Therefore, effective educational interventions are required to adequately prepare girls for this transition. This study aimed to evaluate the effectiveness of pictorial booklet–based education in improving elementary school students’ knowledge of menarche. A quasi-experimental study with a one-group pretest–posttest design was conducted. The intervention consisted of health education delivered using pictorial booklets. A pretest was given before the intervention, and a posttest after the intervention. The intervention was carried out once by giving a picture booklet to each sample. The research population was all female students in grades III to VI who had not menstruated. The sample consisted of 36 respondents who were selected through stratified random sampling. The research was conducted at SDS YMI Tani Makmur, Rengat Barat. A statistical test using dependent sample T test. The results showed an overall increase in students’ knowledge following the intervention. The mean knowledge score increased from 18.333 to 21.139 following the intervention. Statistical analysis revealed a significant difference in knowledge levels before and after the educational intervention (p < 0.001). These findings indicate that pictorial booklet–based education is effective in improving elementary school students’ knowledge regarding menarche and may serve as a practical educational medium to enhance menstrual health literacy at an early age.

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References

BBehera, D., Sivakami, M., & Behera, M. R. (2016). Menarche and Menstruation in Rural Adolescent Girls in Maharashtra , India : A Qualitative Study. Journal of Health Management, (408). https://doi.org/10.1177/0972063415612581

Chairunisa, N., Sriyanti, C., Widayani, W., Ferina, F., Kebidanan, J., Kesehatan, P., & Bandung, K. (2025). The Effect of Health Education Using Flipbook on Knowledge About Menarche. 17(1), 214–220. http://doi.org/10.34011/juriskesbdg.v17i1.2660

Chandra-mouli, V., & Patel, S. V. (2017). Mapping the knowledge and understanding of menarche , menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries. 1–16. https://doi.org/10.1186/s12978-017-0293-6

Desie, Y., & Tesfaye, K. (2017). Attitude, Preparation, and Physical Self-Concept as Factors Influencing Emotional Expectation of Menarche among Premenarcheal School Girls in Yewketfana Primary school. 17(1).

Dovis, V., & Kurniawati, W. (2017). Comprehensive Child and Adolescent Nursing The Experience of Young Women Living in a Prostitution Area in Maintaining Their Reproductive Health The Experience of Young Women Living in a Prostitution Area in Maintaining Their Reproductive Health. Comprehensive Child and Adolescent Nursing, 40(1), 137–144. https://doi.org/10.1080/24694193.2017.1386981

Eghbal, S. B., Kenari, Z. A., Ashouri, A., Rouhani-Tonekaboni, N., Kasmaei, P., Mehrabian, F., Karimy, M., Rezaei, F., & Fattahi, E. (2023). The effectiveness of educational program based on health belief model on promotion of puberty health concepts among teen girls: a cross-sectional study in north of Iran. BMC Women’s Health, 23(1). https://doi.org/10.1186/s12905-023-02391-3

Ghimire, S., Gahatraj, N. R., Shrestha, N., Manandhar, S., & Dhital, S. R. (2024). Effects of health education intervention on menstrual hygiene knowledge and practices among the adolescent girls of Pokhara Metropolitan, Nepal. PLoS ONE, 19(9 September). https://doi.org/10.1371/journal.pone.0291884

Gohar, S., Fasihat, L., Khalid, H., & Yasmeen, R. (2025). Impact Of Menstrual Health Education On Adolescent Girls’ Health Outcomes In Rural Areas. Frontier In Medical & Health Research, 3(8), 880–891. https://doi.org/10.5281/zenodo.17434022

Hanifah, R., Oktavia, N. S., Nelwatri, H., Kesehatan, P., Padang, K., Kebidanan, J., Kesehatan, P., & Padang, K. (2021). Perbedaan Efektifitas Pendidikan Kesehatan Melalui Media Video Animasi dan Power Point Terhadap Pengetahuan Remaja Putri Dalam Menghadapi Menarche. Jurnal Kesehatan Mercusuar, 4(2), 74–81. https://doi.org/10.36984/jkm.v4i2.232

Ir, S., Salifou, K., Aaa, O., Hounkpatin, B., Af, H., C, T. A., Vodouhe, M., Denakpo, J., & Rx, P. (2016). Knowledge , Attitudes and Practices of High School Students with Menarche in Parakou/ Benin. Clinics in Mother and Child Health, 13(1), 1–3. https://doi.org/10.4172/2090-7214.1000219

Khan, N., & Mahishale, A. (2024). An Educational Intervention on Situational Awareness and Understanding of Menstrual Hygiene, Knowledge, Taboo, and Its Practices among School-going Adolescent Girls in Rural Areas of Belagavi, Karnataka. Archives of Medicine and Health Sciences, 12(2), 214–222. https://doi.org/10.4103/amhs.amhs_13_24

Kismiati, E., R, N. W. D., & Apsari, D. D. (2023). The Influence Of Health Education Using Media Booklets “MANTAP” (Siap Menghadapi Menstruasi Pertama) On Readiness For Menarche. The Southeast Asian Journal Of Midwifery, 9(1), 22–29.

Lahme, A. M., Stern, R., & Cooper, D. (2016). Original Article Factors impacting on menstrual hygiene and their implications for health promotion. 0(May 2015), 1–9. https://doi.org/10.1177/1757975916648301

Lestari, F. D., Azzahroh, P., & Suciawati, A. (2022). Analisa Kesiapan Menghadapi Menarche Pada Siswi Sekolah Dasar di SDN Tambilung Kabupaten Bogor Tahun 2021 Analysis Of Readiness For Menarche Among Elementary School Students At SDN Tambilung Bogor Regency In 2021. 11(2), 171–184. https://doi.org/10.35890/jkdh.v11i2.210

Lubis, M. S., & Kasjono, S. (2022). Pengaruh Penyuluhan Menstruasi Menggunakan Media Booklet Terhadap Pengetahuan dan Sikap Siswi Dalam Menghadapi Menarche Di Sekolah Dasar. 26(1), 270–276. https://doi.org/10.46984/sebatik.v26i1.1544

Lutfiya, I. (2016). Analisis Kesiapan Siswi Sekolah Dasar dalam Menghadapi Menarche. Jurnal Biometrika Dan Kependudukan, 5(2), 135–145.

Markham, C. M., Ramaiya, A., & Swe, Z. Y. (2022). Adolescent girls’ experiences of menstruation and schooling in monastic schools in Magway Region, Myanmar: A mixed-methods exploration. https://doi.org/DOI10.3389/frph.2022.893266

Msovela, J., Shija, A. E., Ntuyeko, H., Imeda, C., Mugula, A., Mgina, E., & Egidio, A. A. (2025). Puberty and Menstruation Knowledge, Information Sources and Needs among Secondary School Adolescent Girls and Boys in Kibaha, Tanzania. PLOS Global Public Health, 5(3 March). https://doi.org/10.1371/journal.pgph.0004176

Murti, N. N., Darussalam, H., & Agustina, F. (2020). The Effect of Health Education with a Pop-Up Book Media about Menarche on the Female Teenagers ’ s. 3(2), 7–11.

Narsih, U., Widayati, A., & Rohmatin, H. (2021). Dukungan Sosial dan Ketersediaan Informasi Mempengaruhi Kesiapan Remaja Putri dalam Menghadapi Menarche The Social Support and Availability of Information Influence The Readiness of Adolescent Girls in Facing Menarche. 359–371. https://doi.org/10.29241/jmk.v7i2.797

Ningrum, F. I., Wijayanti, L., R, D. E., & Indriani, R. (2025). Hubungan Pengetahuan Menstruasi Dengan Kesiapan Menghadapi Menarche Pada Siswi SD Kelas IV, V, VI. Mahesa, 5(11), 5249–5258. https://doi.org/10.33024/mahesa.v5i11.21786

Nnennaya, E. U., Atinge, S., Dogara, S. P., & Ubandoma, R. J. (2021). Menstrual hygiene management among adolescent school girls in Taraba State , Nigeria. 21(2), 842–851. https://dx.doi.org/10.4314/ahs.v21i2.45

Nopia, E., Lina, L. F., Angraini, W., Studi, P., Masyarakat, K., & Bengkulu, U. M. (2020). Pengaruh Pendidikan Kesehatan Terhadap Pengetahuan Dan Kesiapan Menghadapi Menarche Pada Siswi Sd Negeri 06 Ipuh Desa Semundam Kecamatan Ipuh Kabupaten Mukomuko. 1(1), 1–10. https://doi.org/10.57084/jiksi.v1i1.331

Novitasari, S., Wardani, H. E., & Ariwinanti, D. (2018). Hubungan Pengetahuan Tentang Menstruasi Dengan Kesiapan Dalam Menghadapi Menarche Pada Siswi SDN Asrikaton 1.

Panda, N., Desaraju, S., Panigrahy, R. P., Ghosh, U., Saxena, S., Singh, P., & Panda, B. (2024). Menstrual health and hygiene amongst adolescent girls and women of reproductive age: a study of practices and predictors, Odisha, India. BMC Women’s Health, 24(1). https://doi.org/10.1186/s12905-024-02894-7

Parasuraman, G., Vijay, V., Balaji, S., Nisha, B., Dutta, R., Jain, T., & P, A. E. (2022). Impact of health education intervention on menstruation and its hygiene among urban school - going adolescent girls in Thiruvallur , Tamilnadu. https://doi.org/10.4103/jfmpc.jfmpc

Pramesti, H. D., Suherni, S., & Djanah, N. (2019). Effectiveness menstrual hygiene knowledge using booklet and leaflet media for adolescent girl. Jurnal Kesehatan Ibu Dan Anak, 13(1), 61–68. https://doi.org/10.29238/kia.v13i1.392

Readytia, E. P., Umaroh, U., & Amartha, T. A. S. (2025). Effectiveness of Matching Game on Adolescent Girls’ Menarche Knowledge Level. Jurnal Kebidanan, 15(2), 46–51. https://doi.org/10.31983/jkb.v15i2.12497

Retnaningsih, D., Wulandari, P., & Afriana, V. H. (2018). Kesiapan Menghadapi Menarche Dengan Tingkat Kecemasan Pada Anak Usia Sekolah. Jurnal Kesehatan Kusuma Husada, 57–64. https://doi.org/10.34035/jk.v9i1.260

Sari, S. M., & Effendy, H. V. (2019). The Effect Of Health Education About Menarche On Anxiety In Facing Menarche In 5Th And 6TH Grade Students. Nurse and Health: Jurnal Keperawatan, 8(1), 43–49. https://doi.org/10.36720/nhjk.v8i1.58

Setyowati, S., Rizkia, M., & Ungsianik, T. (2015). Improving Female Adolescents ’ Knowledge , Emotional Response , and Attitude toward Menarche following Implementation of Menarcheal Preparation Reproductive Health Education. 84–91. https://doi.org/10.31372/20190402.1041

Solikhafi, H. N., & Aprilina, H. D. (2023). The Influence Of Lectures And Booklet ’ Clean Menstruation , Say No To Disease !’ On Knowledge , Attitudes , And Menstrual Hygiene Behaviors Among Female Students Of SMK N 1 Kalibagor. 14(04), 256–261.

Susilawati, S., Solechah, M., Kamila, A. S., & Nuraini, N. F. (2025). Optimalisasi Kesehatan Reproduksi Remaja dengan Media Goodie Bag Edukasi Sehat Menghadapi Menstruasi Pertama Optimizing Adolescent Reproductive Health with Healthy Education Goodie Bag Media for the First Menstruation. Jurnal Pengabdian Dan Pemberdayaan Masyarakat, 9(3), 187–196. https://doi.org/10.30595/jppm.v9i3.28090

Uzoechi, C. A., Parsa, A. D., Mahmud, I., Alasqah, I., & Kabir, R. (2023). Menstruation among In-School Adolescent Girls and Its Literacy and Practices in Nigeria: A Systematic Review. In Medicina (Lithuania) (Vol. 59, Number 12). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/medicina59122073

Widiastini, L. P., Agung, I. G., & Karuniadi, M. (2019). The Effect of Health Education about Menstruation on Psychological Readiness of Pre-Adolescent Girls in Facing Menarche. 8(2), 69–73. https://doi.org/10.30994/sjik.v8i2.216

Winarti, A., Fatimah, F. S., & Rizky, W. (2017). Winarti, A., Fatimah, F. S., & Rizky, W. (2017). Pengaruh pendidikan kesehatan terhadap Kecemasan tentang menarche pada siswi kelas V sekolah dasar. JNKI (Jurnal Ners dan Kebidanan Indonesia), 5(1), 51-57. http://dx.doi.org/10.21927/jnki.2017.5(1).51-57

Yulita, C., Devitasari, I., & Delika, M. (2022). Gambaran Menarche Pada Remaja Siswi Di Sekolah Menengah Pertama Negeri 14 Palangka Raya. Jurnal Surya Medika, 8(2). https://doi.org/10.33084/jsm.v8i2.3856

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Submitted

2026-01-01

Accepted

2026-07-14

Published

2026-07-31

How to Cite

Dyna, F., Indy Meisyahrani, Desti Puswati, Arlia Purwaningsih, Veni Dayu Putri, & Parichat Arayajaru. (2026). Effectiveness Of Pictorial Booklet-Based Health Education On Improving Menarche Knowledge: A Quasi-Experimental Study. Jurnal Berita Ilmu Keperawatan, 19(2), 273–283. https://doi.org/10.23917/bik.v19i2.15257

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