Menstrual Knowledge, Cultural Restrictions, and School Absenteeism among Adolescents in Congolese Slums: An Evidence-Based Study

Abstract

Background: Adolescent girls in Congolese slums face significant Menstrual Hygiene Management (MHM) challenges due to limited infrastructure and cultural taboos. This study investigated menstrual knowledge, socio-cultural restrictions, and their impact on school absenteeism in the Masina and Kimbaseke districts of Kinshasa. Methods: A mixed-methods cross-sectional study was conducted involving 136 adolescent girls (aged 15–19). Quantitative data were collected via surveys, supplemented by qualitative insights from teachers and peers. Participants were selected using multi-stage sampling (convenience sampling for schools and random sampling for individuals). Data were analyzed using descriptive statistics and multivariable logistic regression. Results: Only 46.4% (95% CI: 38.2%–54.8%) of participants demonstrated good menstrual knowledge. Significant predictors of good knowledge included maternal secondary education (AOR=4.55; 95% CI: 1.32–15.65) and media access (AOR=3.01; 95% CI: 1.05–8.62). While 66.2% used disposable pads, 22.8% reported frequent unaffordability. Cultural restrictions were pervasive, with 79.4% barred from religious activities. Crucially, 24.5% (95% CI: 17.8%–32.4%) of students reported menstruation-related school absenteeism. Furthermore, school WASH infrastructure was critically deficient; 0% of schools provided a consistent supply of water or soap. Conclusions: Menstrual health barriers significantly impede the education of girls in Congolese slums. Effective interventions must prioritize comprehensive menstrual education, improve the affordability of hygiene products, and upgrade school WASH facilities. Addressing these systemic issues is vital for achieving gender equity in education and improving the psychosocial well-being of adolescent girls in low-resource urban settings.