Factors influencing menstrual hygiene management among adolescent schoolgirls in the pastoralist communities of southern Ethiopia

Background Menstrual hygiene management (MHM) is essential for achieving multiple Sustainable Development Goals. Most previous Ethiopian studies have focused on non-pastoralist schools; however, the pastoralist setting is more complex and requires the identification of specific gaps. This study addresses a critical gap in research on menstrual hygiene management among secondary school girls in Ethiopia’s rural pastoralist communities, where water scarcity, displacement, and harsh climatic conditions create unique challenges beyond those seen in agrarian areas. Objective This study aimed to identify factors influencing MHM among adolescent schoolgirls in pastoralist communities of Southern Ethiopia. Design A school-based cross-sectional study was conducted among 617 schoolgirls in the Borena Zone from March 1 through April 30, 2023. Methods Data were collected using a pre-tested, self-administered structured questionnaire. Simple random sampling was employed. Descriptive statistics, bivariate analysis, and multivariable analysis were performed. Odds ratios with 95% confidence intervals were calculated, and p-values < 0.05 were considered statistically significant. Results A total of 617 secondary school adolescent girls participated. The magnitude of good MHM practice was 72.4%. Most participants (70.8%) had high knowledge, while 24.1% had poor attitudes. Access to water (AOR = 0.48, 95% CI: 0.27–0.84), bathing during menstruation (AOR = 2.25, 95% CI: 1.28–3.97), receiving information before menarche (AOR = 2.64, 95% CI: 1.27–5.47), and age at menarche (AOR = 0.52, 95% CI: 0.29–0.93) were significantly associated with MHM practice. Conclusions Most adolescent schoolgirls demonstrated good MHM practice and used commercial sanitary pads. Significant associated factors included age at menarche, bathing during menstruation, prior information, and access to school water facilities. Program designers, stakeholders, and facility managers should implement MHM health education at all levels, including in elementary schools.