Determinants of Menstrual Hygiene Among Adolescent School Girls in Indonesia

Purpose: The aim of this study was to determine the prevalence of menstrual hygiene management (MHM) and its associated factors among adolescent girls in Tangerang District, Indonesia.Methods: This study was a cross-sectional study of 409 female students aged 12-15 years old from 3 junior high schools selected using multistage sampling. The data were collected through a self-reported questionnaire both online and offline that was administered from April to May 2022. Bivariate and multivariable analysis using binary logistic regression were performed to determine the factors and predictors between sociodemographic characteristics, menstruation variables, knowledge, attitude, enabling environment, and the practice on MHM.Results: Our study revealed a prevalence of good MHM practices among 52.3% of students, as well as moderate knowledge (48.9%) and neutral attitudes (70.4%). With regard to water, sanitation, and hygiene (WASH) facilities at school, most girls reported access to hand washing soap, a hook, a mirror, and a covered bin, but at home, the least available facilities were a mirror and a covered bin. Significant predictors of healthy MHM practices were having reached grade 8 (AOR = 1.80, 95% CI = 1.10-2.95), having ever received information about menstruation at school (AOR = 1.95, 95% CI = 1.19-3.18), having a positive attitude (AOR = 4.21, 95% CI = 1.78-9.96), having access to a private home toilet (AOR = 2.71, 95% CI = 1.36-5.42), and having a home toilet with a covered bin (AOR = 2.15, 95% CI = 1.38-3.37).Conclusion: The girls in this study showed a high prevalence of good MHM practices, but access to WASH facilities at school and at home was still a challenge. Positive attitude was the most significant factor associated with good MHM among female students. Therefore, we suggest establishing menstruation-focused education related to attitudes, particularly sociocultural norms, myths, and misconceptions and WASH facilities provided at home.