School Absenteeism and its Association with Menstrual Health, Hygiene, and Scholastic Performance among Adolescent Schoolgirls in Uttar Pradesh: A Mixed Methods Study
Neeraj Pawar, Aayushi Goyal, Bhola Nath, Aswani Kumar Seth, Sourabh Paul, Mukesh Shukla
A
BSTRACT
Background:
School absenteeism among adolescent girls is a significant issue exacerbated by challenges related to menstrual health and hygiene. The study aimed to determine the prevalence of school absenteeism, document menstrual hygiene practices, and identify sociodemographic and menstruation-related factors associated with absenteeism.
Methods:
This cross-sectional study included 300 school-going adolescent girls (8 th –12 th grade) from four periurban and rural schools near Raebareli, Uttar Pradesh. Participants were selected using multistage sampling. Data were collected through a semistructured questionnaire. Around 20 Focus Group Discussions were conducted to explore barriers to school attendance. Bivariable and Multivariate logistic regression model was applied to identify the associated factors. Inductive thematic analysis was performed for the qualitative data.
Results:
The school absenteeism was 34.7%. Most used sanitary pads (86%), while others used cloths. Dysmenorrhea affected 56.9%, and 67% reported mood changes. Despite 96% having access to private toilets at school, 53.7% felt uncomfortable changing pads in school. Absenteeism was notably higher among mid-late adolescents (≥15 years), those with dysmenorrhea, mood changes, poor hygiene, and discomfort changing pads at school. There was a significant reduction in sports participation during menstruation compared with nonmenstrual periods. Academic performance was also hampered due to absence during menstruation, although this result was not significant.
Conclusion:
High school absenteeism is prevalent among adolescent girls and is notably influenced by menstrual health and hygiene practices. Addressing dysmenorrhea, promoting better hygiene management, and fostering supportive school environments can help in reducing absenteeism and improving educational outcomes.