Table 5.
Factors associated with missing school during menstruation by adolescent girls, 3 states in India, 2015
| Factor |
Univariate analysis |
Multivariate analysis |
|||
|---|---|---|---|---|---|
|
Missing school: n/N (%) |
Prevalence ratio, 95% CI* |
P-value |
Prevalence ratio, 95% CI* |
P-value |
|
|
Age (years): | |||||
| 13 and below |
47/665 (7.1) |
Reference |
NS |
||
| 14 |
97/981 (9.9) |
1.43, 0.97, 2.10 |
0.068 |
||
| 15 and above |
118/832 (14.2) |
2.03, 1.44-2.85 |
<0.001 |
||
|
State: | |||||
| Chhattisgarh |
166/892 (18.6) |
Reference |
Reference |
||
| Maharashtra |
74/823 (9.0) |
0.48, 0.31-0.75 |
0.001 |
0.56, 0.40-0.77 |
<0.001 |
| Tamil Nadu |
25/791 (3.2) |
0.17, 0.10-0.28 |
<0.001 |
0.24, 0.14-0.40 |
<0.001 |
| Model school | |||||
| Yes |
30/480 (6.3) |
0.54, 0.26-1.13 |
0.104 |
0.50, 0.34-0.73 |
<0.001 |
| No |
235/2026 (11.6) |
Reference |
|||
|
Menstrual item used: | |||||
| Nothing or NR |
15/94 (16.0) |
0.84, 0.49-1.44 |
0.523 |
1.19, 0.73-1.95 |
0.490 |
| Cloth |
131/688 (19.0) |
Reference |
Reference |
||
| Reusable pads |
48/525 (9.1) |
0.48, 0.32-0.72 |
<0.001 |
0.98, 0.74-1.31 |
0.893 |
| Disposable pads |
58/1140 (5.1) |
0.27, 0.19-0.39 |
<0.001 |
0.57, 0.42-0.77 |
<0.001 |
| Insertables† |
13/59 (22.0) |
1.16, 0.70-1.91 |
0.569 |
2.51, 1.54-4.07 |
<0.001 |
|
Pain medication in school: | |||||
| Yes |
25/528 (4.7) |
0.39, 0.26-0.59 |
<0.001 |
0.71, 0.51-0.97 |
0.031 |
| No or not reported |
240/1978 (12.1) |
Reference |
Reference |
||
|
Pads given in school: | |||||
| Yes |
50/943 (5.3) |
Reference |
NS |
||
| No |
181/1329 (13.6) |
2.57, 1.74-3.80 |
<0.001 |
||
| Don’t know |
17/153 (11.1) |
2.10, 1.11-3.95 |
0.022 |
||
| Not reported |
17/81 (21.0) |
3.96, 2.40-6.54 |
<0.001 |
||
|
Education MH in school: | |||||
| Yes |
47/824 (5.7) |
Reference |
NS |
||
| No |
197/1432 (13.8) |
2.41, 1.65-3.53 |
<0.001 |
||
| Don’t know |
11/188 (5.9) |
1.03, 0.57-1.86 |
0.935 |
||
| Not reported |
10/62 (16.1) |
2.83, 1.43-5.60 |
0.003 |
||
|
MH program in school: | |||||
| Yes |
522 (20.4) |
Reference |
|||
| No |
1565 (61.0) |
3.01, 1.77-5.12 |
<0.001 |
NS |
|
| Don’t know |
363 (14.2) |
1.51, 0.75-3.02 |
0.246 |
||
| Not reported |
114 (4.5) |
3.30, 1.54-7.06 |
<0.001 |
||
|
Enough toilets in school: | |||||
| Yes |
93/1240 (7.5) |
0.55, 0.39-0.78 |
0.001 |
NS |
|
| No |
156/1153 (13.5) |
Reference |
|||
| Not reported |
16/113 (14.2) |
1.05, 0.52-2.09 |
0.898 |
||
|
When can you use the toilet?: | |||||
| Any time |
100/887 (11.3) |
Reference |
Reference |
||
| Only during breaks |
106/1365 (7.8) |
0.69, 0.49-0.96 |
0.029 |
0.95, 0.71-1.27 |
0.744 |
| Other responses§ |
21/85 (24.7) |
3.18, 1.70-5.95 |
<0.001 |
1.61, 0.98-2.66 |
0.062 |
| No response |
38/169 (22.5) |
2.90, 1.91-4.38 |
<0.001 |
1.42, 1.01-1.99 |
0.045 |
|
Toilets clean: | |||||
| Always clean |
73 (1128 (6.5) |
Reference |
NS |
||
| Sometimes clean |
122/978 (12.5) |
1.93, 1.32-2.80 |
0.001 |
||
| Never clean or NR |
70/396 (17.7) |
2.73, 1.74-4.29 |
<0.001 |
||
|
Toilets for girls: | |||||
| For female staff & girls |
60/582 (10.3) |
1.40, 0.94-2.07 |
0.096 |
NS |
|
| For girls only |
68/921 (7.4) |
Reference |
|||
| For boys and girls |
79/549 (14.4) |
1.95, 1.07-3.55 |
0.029 |
||
| For all staff & students |
38/320 (11.9) |
1.61, 0.96-2.71 |
0.073 |
||
| No response |
20/134 (14.9) |
2.02, 1.10-3.72 |
0.024 |
||
|
Can wash in school: | |||||
| Can always wash |
95/1287 (7.4) |
Reference |
Reference |
||
| Can sometimes wash |
47/437 (10.8) |
1.46, 1.07-1.98 |
0.017 |
1.44, 1.07-1.92 |
0.015 |
| Can never wash or NR |
123/778 (15.8) |
2.14, 1.56-2.94 |
<0.001 |
1.49, 1.13-1.95 |
0.004 |
|
Disposal options at school: | |||||
| In pits |
92/927 (9.9) |
3.07, 0.96-9.85 |
0.059 |
NS |
|
| In buckets |
44/389 (11.3) |
3.47, 1l06-11.36 |
0.040 |
||
| Take home |
65/515 (12.6) |
3.96, 1.23-12.72 |
0.021 |
||
| Throw in toilet |
17/202 (8.4) |
2.60, 0.78-8.60 |
0.119 |
||
| Incinerator |
6/186 (3.2) |
Reference |
|||
| Other or no answer | 38/259 (14.7) | 4.50, 1.29-15.72 | 0.019 | ||
CI – confidence interval, MH – menstrual hygiene, NR – not reported, NS – not significant
*All analyses adjusted for school as cluster. Factors explored but not significant included class, time of transport to school, and means of transport to school. No interactions of interest were noted between significant variables.
†Tampons or menstrual cups.
§Other included responses such as queuing before toilet, toilet unusable, no toilet present, go home for change.