MENSTRUAL HYGIENE MANAGEMENT PRACTICES AND SCHOOL ATTENDANCE AMONG GIRLS IN PUBLIC PRIMARY SCHOOLS IN KISUMU WEST SUB-COUNTY, KISUMU COUNTY, KENYA

Abstract

Governments globally prioritize Menstrual Hygiene Management (MHM) for safe school environments, yet girls in Low and Middle-Income Countries (LMICs) face challenges managing menstruation. This study aims to examine MHM Knowledge, Attitudes, and Practices and their impact on school attendance among girls in public primary schools in the Kisumu West sub-county. Additionally, it evaluates the influence of school-based MHM Programs, information dissemination on MHM practices, and the effect of school sanitation systems on attendance. The conceptual framework draws from the Sanitary Hardware theory, the Knowledge-Attitude-Behaviour Theory, and the Multi-stakeholder theory. Using a descriptive survey design, the research targets teachers and girls pupils in Kisumu West's public primary schools. The Yamane (1967) formula determined a representative sample of 356 from a population of 3,233, including girls in grades 6-8, teachers, headteachers, and Ministry of Education officials. Data collection employed structured questionnaires and interview schedules, pilot-tested in Siaya County schools (10% of the sample) for reliability and validity. Collected data underwent filtering, organization, coding, and analysis using SPSS version 22. Analytical techniques included descriptive statistics (means, standard deviations, frequencies, and percentages) and inferential statistics (coefficient of determination and analysis of variance). Quantitative data, presented in tabular format, was accompanied by insightful discussions. Qualitative findings aligned with the study's objectives and were presented thematically. Study findings revealed that MHM Knowledge, Attitudes, and Practices significantly influenced School Attendance (p<0.01), explaining 43.8% of the variance. Information dissemination on MHM significantly impacted School Attendance (p<0.05), explaining 17.2% of the variance. Linear regression analysis confirmed a positive relationship between disseminating MHM information and School Attendance. Additionally, cultural taboos hindered open discussions about menstruation despite some girls receiving information before their first period. Schools needed a dedicated MHM curriculum, relying on sporadic discussions during general health talks led by designated teachers, whose effectiveness remained unassessed. Given MHM practices' critical influence on attendance, recommendations include encouraging open discussions about menstruation among girls, even before their first menstrual cycle. Schools should ensure consistent access to water resources for girls during menstruation. Future research should explore performance as the dependent variable, providing a more comprehensive understanding of MHM practices within the educational context. In conclusion, this study sheds light on the challenges girls in LMICs face in managing menstruation and underscores the pivotal role of MHM Knowledge, Attitudes, and Practices in influencing school attendance. The findings emphasize the need for targeted interventions, including a dedicated MHM curriculum and open discussions, to address cultural barriers and enhance girls' overall well-being in the educational setting.