Menstrual health challenges and associated barriers among tribal adolescent girls in India: A systematic review

Introduction: Menstrual health is a critical yet neglected public health issue among tribal adolescent girls in India, influenced by socio-cultural, economic, and infrastructural determinants. This review aimed to explore the key menstrual health challenges, barriers, and associated outcomes among tribal adolescent girls in India. Methods: This systematic review was conducted in accordance with PRISMA 2020 guidelines. A comprehensive literature search was performed across PubMed, Scopus, and Google Scholar for studies published between January 2015 and March 2026. Quantitative, qualitative, and mixed-methods studies focusing on menstrual health among tribal adolescent girls in India were included. Study selection, data extraction, and quality appraisal were conducted independently by multiple reviewers. Methodological quality was assessed using the Joanna Briggs Institute (JBI) tools. Due to heterogeneity, a narrative synthesis approach was adopted. Results: Out of 197 identified records, 28 studies met the inclusion criteria. The findings reveal significant disparities in menstrual health management driven by socioeconomic status, education, cultural taboos, and infrastructural limitations. Key challenges included limited access to sanitary products, inadequate WASH facilities, and poor awareness. Cultural stigma and restrictive practices contributed to psychological distress and unsafe hygiene behaviours. These barriers were associated with adverse outcomes such as reproductive tract infections and increased school absenteeism. The quality appraisal indicated overall moderate to high methodological rigour, with most studies demonstrating acceptable quality despite some limitations related to study design and reporting. Conclusion: Menstrual health among tribal adolescent girls remains a significant public health concern in India. Addressing these challenges requires integrated, culturally sensitive interventions focusing on education, improved infrastructure, and equitable access to menstrual health services to enhance health outcomes and well-being.