Rural-Urban Variation in Exclusion from Social Activities due to Menstruation among Adolescent Girls and Young Women in Ghana

Menstruation among adolescent girls and young women (AGYW) can be marked by several challenges that often result in exclusion from social activities. Information regarding this subject matter is however sparse in Ghana. This study examined the rural-urban differences in prevalence and correlates of exclusion from social activities due to menstruation among AGYW in Ghana. The study used cross-sectional data drawn from the women dataset of 2017/2018 Ghana Multiple Indicator Cluster Survey Six (GMICS 6). Data of adolescents (n = 2927; age 15-19) and young women (n = 2194; age 20-24) was analyzed in Stata version 14. About 21.65% of the respondents indicated that they excluded themselves from activities during menstruation with slightly higher rates for rural AGYW (22.2%) compared to their urban counterparts (21.11%). Multivariable Poisson regression models showed that compared with nonattainment of formal education, urban AGYW who attained a primary level education were more likely to exclude themselves from social activities due to menstruation [APR=2.76, 95% CI:1.11, 6.90]. Also, currently married urban AGYW were less likely to exclude themselves from social activities due to menstruation [APR=0.63, 95% CI:0.44, 0.91]. AGYW residing in the second-lowest wealth household in rural areas had a higher likelihood of exclusion from social activities due to menstruation [APR=1.34, 95% CI:1.03, 1.75]. Region of residence was a significant correlate in both rural and urban samples but with an observed rural-urban variation. Given the prevalence of AGYW who exclude themselves from social activities, the government and non-governmental organizations that seek to improve menstrual hygiene and empower young women to participate in social activities regardless of their monthly menstrual flow should take into consideration the urban-rural differentials in the associated factors identified in this study.