Documentation detailing the relative inaccessibility of education in Ethiopia’s Somali Region continues to grow. Structural barriers—including limited access to school programs, a shortage of qualified teachers, insufficient funding, and scarce learning resources—act as compounding disadvantages for all learners. These realities are further exacerbated for adolescent girls by inadequate access to dedicated gender-responsive washrooms (private latrines and clean water) essential for Menstrual Hygiene Management (MHM). When girls lack access to private, gender-segregated facilities, physical limitations become a catalyst for acute psychological distress. This psychological distress (marked by shame and embarrassment), combined with social pressures (leading to planned absenteeism) and diminished cognitive engagement (distraction caused by the ongoing anxiety of leakage), results in lower overall attendance and academic achievement. These factors define the parameters of social disapproval surrounding female education. The social disapproval associated with menstruation directly impacts girls' intentions to attend school while menstruating, acting as a socially constructed mechanism of exclusion that violates the fundamental right to education enshrined by UNESCO. This study (n=450) compares girls with access to re-useable MHM kits, paired with health education to a control group. This represents a baseline study to then revisit longitudinally to see if having access to reliable MHM changes beliefs and behaviours around school attendance and engagement during menstruation. A theory-driven principal component analysis explored key factors influencing school attendance and engagement for girls in the Somali Region of Ethiopia.