School absenteeism during menstruation among adolescent girls in Southern Uganda: A multi-level risk factors analysis

Darejan Dvalishvili, Flavia Namuwonge, Rabab F. Ahmed, Fithi Andom, Ozge Sensoy Bahar, Proscovia Nabunya and Fred M. Ssewamala

Children and Youth Services Review, 2025, vol. 179, issue C

Abstract: Menstrual hygiene management (MHM) continues to be a major barrier impacting adolescent girls’ school attendance in low-income countries. In Uganda, only 10 % of adolescent girls practice adequate MHM; and they miss an estimated 11 % of school days due to menstruation. Missing school (school absenteeism) has been associated with negative educational and social outcomes. This paper aimed to explore the individual, family, school and community-level factors associated with school absenteeism among adolescent girls during menstruation. We used crosssectional (baseline) data from 1,237 adolescent girls recruited from 47 secondaryschools in Southern Uganda. The nested logistic model analysis was used to test the significance of blocks of predictor factors on school absenteeism. The results showed that all blocks of factors are statistically significant. Discrete analysis indicated that dysmenorrhea was associated with an 8.1 % increase in school absenteeism. However, family sufficiency and support appeared to be protective factors decreasing absenteeism by 13.8 % and 4.9 %, respectively. Also, both schools’ good water, sanitation, and hygiene (WASH) infrastructure and supportive teachers were associated with decreasing school absenteeism by 28.6 % and 4.6 %, respectively. Inaddition, cultural taboos on menstruation were associated with the strongest (34.3 %) increase in school absenteeism. Our results showed that all blocks of factors matter when discussing MHM and school absenteeism among adolescent girls. Therefore, more multifaceted interventions are needed to address the issue affecting millions of girls regularly.

Keywords: Menstrual hygiene management (MHM); Adolescent girls; School attendance; School absenteeism; Southern Uganda; Low-income countries (LICs); Dysmenorrhea; Family support (search for similar items in EconPapers)
Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:eee:cysrev:v:179:y:2025:i:c:s0190740925004451

DOI: 10.1016/j.childyouth.2025.108562

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