Assessing the effects of menstrual hygiene, water, and sanitation on girls’ academic performances in public schools, Ethiopia

ABSTRACT This study examined relationship between menstrual hygiene management (MHM), water, sanitation, and hygiene (WASH) services, and girls' academic performance in Ethiopia. This study employed cross-sectional mixed study design with 912 public schoolgirls. Also, 22 key informants, and six focus group discussions in 37 randomly selected public schools. The median age of the schoolgirls was 16 years. Two of the five schoolgirls reported missing classes during menstruation. Out of 912 schoolgirls, 82.5% (95% CI; 81%-84%) achieved good academic performance during the academic year. Schoolgirls who attended class regularly during menstruation (AOR=14.82, 95% CI 8.652-25.391), schoolgirls who were informed about menstrual hygiene before menarche (AOR=1.81, 95% CI 1.011-3.229), schoolgirls whose mothers were educated (AOR=1.88, 95% CI 1.063-3.313), schoolgirls who had basic water services (AOR=4.72, 95% CI 2.315-9.618), schoolgirls who had basic sanitation services (AOR=6.32, 95% CI 4.643-33.670) and who had limited sanitation services (AOR=1.56, 95% CI 1.768-6.636) were significantly associated with good academic performance. Educating mothers about menstrual hygiene, increasing access to WASH, and providing safe spaces for girls can have positive ripple effect on their daughters' academic success. The findings of study provide critical evidence to inform decision makers to address MHM challenges in alignment with Sustainable Development Goals (SDGs) 2030.