Drivers of menstrual hygienic practice among adolescent girls and young women: Evidence from the 2022 Tanzania nationwide survey

Background and aims: Menstrual hygiene practice is a crucial aspect of reproductive health that affects millions of adolescent girls and young women (AGYW) worldwide. Despite growing recognition, menstrual hygiene problems continue to adversely affect girls' health, schooling, and well-being, leading to school absenteeism and reduced social participation. This study aimed to assess the drivers of menstrual hygienic practice among AGYW in Tanzania. Methods This study employed an analytical cross-sectional design, utilizing secondary data from the 2022 Tanzania Demographic and Health Survey (TDHS). Given the hierarchical nature of the TDHS, we employed a multilevel mixed-effect logistic regression model to determine drivers of menstrual hygiene practices. Results The prevalence of menstrual hygienic practices was 51.3% (95%CI:48.9–53.6). AGYW with secondary/higher education (Adjusted odds ratio [AOR] = 1.76, 95%CI: 1.33–2.33) had higher odds of menstrual hygienic practices than those with no formal education. AGYW in the middle wealth quintile (AOR = 1.57, 95%CI: 1.27–1.94) and the rich quintile (AOR = 2.22, 95%CI: 1.76–2.82) had increase odds of menstrual hygienic practices than their counterparts. Regarding communication channels, AGYW who own a mobile phone (AOR = 1.69, 95% CI: 1.44–1.97), use the internet (AOR = 2.03, 95% CI: 1.63–2.54), and those with media exposure (AOR = 1.49, 95% CI: 1.26–1.76) had increased odds of menstrual hygiene practices compared to their counterparts. AGYW in rural settings had lower odds of practicing menstrual hygiene compared to their counterparts (AOR = 0.60, 95% CI: 0.48–0.76). Conclusion Menstrual hygienic practices among AGYW in Tanzania remain insufficient, with only about half practicing adequate menstrual hygiene. Higher education, wealth status, mobile phone ownership, internet use, and media exposure all increase the likelihood of good menstrual hygiene, whereas rural residence poses significant challenges. These disparities need to be addressed through integrated education, economic, infrastructural, and community-based interventions to improve menstrual health outcomes.