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Inadequate sanitation facilities was a major challenge to menstrual hygiene management at schools. The use of sanitary pads was significantly associated with school attendance (p-value 0.0001). the level of menstrual hygiene among in-school adolescent girls in northern Ghana is described as average. Although most of the schools had toilet facilities, they lacked clean water, soap, privacy and dustbins which are necessary for menstrual hygiene management. Interventions should target improving water, sanitation and hygiene facilitie