The relationship between menstrual hygiene management, practices, and school absenteeism among adolescent girls in Johannesburg, South Africa

Background. Factors associated with menstrual hygiene management (MHM) and practices affect school absenteeism, with up to 7 million girls missing 25% of their given school year each month in South Africa (SA). Objective. To identify the most significant factors associated with MHM and practices affecting school absenteeism among adolescents in Johannesburg, SA. Methods. A secondary data analyses of a cross sectional study among 489 adolescent girls from 30 schools in Johannesburg, SA was conducted. Data was collected using a self-administered questionnaire. Logistical regression analysis was conducted for all variables affecting school absenteeism using STATA version 14. Results. Female adolescents who had pre-menarcheal training were more likely to attend school (odds ratio (OR) 1.96; 95% confidence interval (CI) 1.04 - 3.73; p = 0.038). Those who disposed of their absorbent materials by burning, throwing them by the roadside or on farmland were almost 2x more likely to be absent from school (OR 2.07; 95% CI 1.05 - 4.08; p = 0.038). Dysmenorrhea (painful menstruation) was associated with higher likelihood of being absent from school (OR 2.6; 95% CI 1.29 - 5.29; p = 0.008). Conclusion. This present study reveals that MHM and practices related to school absenteeism extend beyond the availability of sanitary materials. These findings can be used to create dialogue between various stakeholders about best practices for reducing school absenteeism related to MHM.