Knowledge, Information, and WASH Utilization Factors Associated with Menstrual Hygiene Practices Among Adolescent Girls

Introduction: Menstrual hygiene practices are shaped by personal knowledge, information support, and the school water, sanitation, and hygiene (WASH) environment. Evidence from Indonesian junior high schools remains limited on how knowledge, specific information sources, and the distinction between WASH availability and actual use are associated with practice. Methods: This analytic cross-sectional study examined bivariate associations between knowledge, five information sources, WASH availability, WASH utilisation, and menstrual hygiene practices among 246 menstruating eighth-grade girls from two public junior high schools in the Kasemen Community Health Center area in 2023. All eligible students were included. Data were collected using a self-administered questionnaire completed by each student. Associations were tested using Yates-corrected chi-square or Fisher’s exact tests, and unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results: Poor menstrual hygiene practices were reported by 217 students (88.2%), low knowledge by 191 (77.6%), self-reported WASH availability categorised as not available for 207 students (84.1%), and WASH nonuse by 167 (67.9%). Poor practice was associated with low knowledge (OR = 2.856; 95% CI: 1.270–6.426; p = 0.017), never receiving information from health workers (OR = 2.951; 95% CI: 1.309–6.651; p = 0.013), and WASH nonuse (OR = 2.561; 95% CI: 1.169–5.614; p = 0.028). Information from family, teachers, peers, or media and self-reported core WASH availability were not statistically associated with practice. Conclusion: In these unadjusted bivariate analyses, knowledge, information from health workers, and WASH utilisation were associated with menstrual hygiene practices, whereas self-reported core WASH availability was not. The findings support evaluating school-based menstrual health education and interventions that facilitate appropriate WASH use; longitudinal or intervention studies are needed to determine their effects. girls