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Girls’ education remains a significant challenge in sub-Saharan Africa; one promising solution to this dilemma lies in addressing aspects of Menstrual Hygiene Managment. This study focuses on identifying and measuring the impact of a range of factors that impact rural Tanzanian girls’ school attendance during menstruation. Survey data collected from 610 post-menarche adolescent girls in the Mara region were analyzed. Using inferential statistics, our results indicate that the use of factory-made sanitary pads over homemade absorbents and the availability of safe WASH facilities have a direct relationship with school attendance. Physical discomfort, menarche preparedness, and girls’ mental health also play important roles. The findings from this study have implications for educational policy and school leadership focused on improving gender equality.