MENSTRUAL HYGIENE MANAGEMENT PRACTICE AND ITS ASSOCIATION WITH SCHOOL WATER, SANITATION AND HYGIENE FACILITIES AMONG SECONDARY AND PREPARATORY SCHOOL GIRLS IN DIRE DAWA CITY ADMINISTRATION, EASTERN ETHIOPIA

Abstract

Background: Menstrual hygiene management refers to access to menstrual hygiene products to absorb or collect the flow of blood during menstruation, privacy to change the materials, and access to facilities to dispose of used menstrual management materials. Poor water, sanitation, and hygiene facilities in schools, inadequate puberty education and lack of hygienic menstrual hygiene management items (absorbents) cause girls to experience menstruation as shameful and uncomfortable. Menstrual Hygiene Management practices and Water, Hygiene and Sanitation facilities in many developing countries are given less attention. To the knowledge of the investigator, there is no evidence on menstrual hygiene management of female students and its association with water, sanitation, and hygiene facilities in secondary and preparatory schools of Dire Dawa City administration. Objective: To assess the Practices of Menstrual Hygiene management and its association with school WASH facilities among secondary and preparatory schoolgirls at Dire Dawa city administration, Eastern Ethiopia from 30th September 2022 to 30th November 2022. Methods: Institutional-based quantitative cross-sectional study design was conducted among 473 secondary and preparatory schoolgirls selected using stratified sampling technique. Data were collected using a self-administered structured questionnaire, coded and double-entered to Epidata version 3.1 and exported to SPSS version 26 for analysis. Descriptive analysis was computed using frequency, percentage, mean and standard deviations. Multivariable logistic regression was applied to assess the association of the school water, sanitation, hygiene facilities with menustrual hygiene management. Adjusted odd ratio (AOR) with its 95% confidence interval was computed to show the strength of the association. The goodness of fit of the model was tested by Hosmer- Lemeshow goodness of fit test. Results: Overall of 473 study participants, 72.93% (95%CI:68.74, 76.76) reported good menstrual hygiene practices. All schools had source of water and the main water source of water, in 9(90%) of the schools was piped water in the school yard whereas 8 (80%) of the schools had gender-based toilet in their compounds. More than two third, 318 (69.43 %) of study participants were use disposable sanitary pads, 250 (55.8%) use soap and water to wash their genitalia , half 200(50.13%) takes bath more than two times and 447 (94.5%) were change their sanitary material during menstruation .The following factors were found to be significantly associated with menstrual hygiene manegemant practices: Availability of continuoes water supply in the school (AOR = 2.40, 95% CI: [1.42–4.01]), Types of toilet facility in the school (AOR = 2.01, 95% CI: [1.20–3.40]), Availability of Private space (AOR = 3.02, 95% CI: [1.49-4.76]) and having females toilets kept locked inside in the school (AOR = 2.70, 95% CI: [1.20–4.40]) were associated with female students’ good menstrual hygiene management. Conclussion: Overall the study found that seven in ten secondary and preparatory schoolgirls have good practice of menstrual hygiene management. Availability of continous water supply in the school, types of toilet facility in the school, availability of Private space to manage period at school and availability of female’s toilets kept locked inside were school WASH factors significantly associated with menstrual hygiene manegemant practice of students. We recommend Zonal Health and education bereou to jointly work towards improvement of school WASH facilities.