Understanding potential determinants of menstruation-related school absenteeism in Zimbabwe: a cross-sectional study

Menstrual health and hygiene (MHH) plays a vital role in protecting the dignity, safety, privacy, and well-being of girls and women. In low- and medium-income countries, students often face challenges to manage their menstruation in schools. In 2019, Zimbabwe conducted the first national formative research to inform MHH programming in schools. This study conducted a secondary analysis of cross-sectional data from the national formative research to explore potential determinants of menstruation-related school absenteeism in Zimbabwe. The analysis included 1,393 students from 50 schools, and the main outcome variable measured if students ever missed school due to menstruation. Multivariate analysis employed nested logistic regression models after controlling for the complex survey design. The results revealed that 20.6% of students had ever been absent from school due to menstruation-related issues. Students' age, challenges with concentration, physical sickness, pain, presence of a reliable school water source, and handwashing stations at sanitation facilities are significantly associated with school absenteeism in this context. The evidence-based MHH programming can be further advocated and scaled up to promote students' good health and well-being, maximize their educational opportunities, and develop their fullest potential in life.