Publication:

Evaluation of the impact of the Bwiza initiative on period poverty among high school girls in Burera District, Rwanda

Background Period poverty remains a significant public health problem and a barrier for adolescent girls in low-income settings. Bwiza initiative was launched in 2022 to address this issue by providing menstrual health education and reusable menstrual products to high school girls in Burera, Rwanda. This study evaluated its impact on menstrual health knowledge, attitudes, practices, and school absenteeism.

Methods A quasi-experimental cluster study design was employed, including two interventions and one non-intervention school. The same survey used in baseline assessment was administered, with slight modifications to capture additional variables related to Bwiza participation.

Results A total of 273 female students aged 12-23 years participated. There was no statistical difference in good menstrual health knowledge between 2022 and 2025 (p=0.204), or between those who received Bwiza training and those who did not (p=0.853). Students in the non-intervention school were more likely to have good knowledge (22.1% versus 12.9%, p=0.048). Attitudes improved, with fewer girls considering themselves “unclean” or avoiding religious spaces during menstruation in 2025 than in 2022. Trained participants were less likely to feel insecure during menstruation (p=0.019). However, emotional discomfort, such as fear of odor (56.4%) remained prevalent. Use of unhygienic materials declined from 19% to 9.7%. Among those who received Bwiza products, over 70% found them comfortable, but only 55.6% reported sufficient supply. Absenteeism increased from 18.3% to 43.2%.

Conclusions Despite improvements in attitudes and practices, persistent gaps highlight the need for comprehensive education, consistent product access, and strengthened school-based menstrual health support systems.