Assessment of Menstrual Hygiene Practices and Their Determinants Among Adolescent Girls in Urban Slums of India: A Community-Based Cross-Sectional Study

Abstract

Objectives This study aimed to evaluate the menstrual hygiene practices of adolescent girls in urban slums and examine the socio-demographic and knowledge-related factors associated with good hygiene behavior. Methods A community-based cross-sectional study was conducted among 400 adolescent girls aged 10-19 years in selected urban slums of Datia, Madhya Pradesh, India, using multistage random sampling. Data were collected using a pre-tested, interviewer-administered questionnaire. Descriptive statistics, Chi-squared tests, and multivariate logistic regression were performed for data analysis. A p-value of <0.05 was considered statistically significant. Results Sanitary pads were the preferred absorbent for 328 (82.0%) participants, with 246 (61.5%) changing them three or more times daily. Soap was used for cleaning by 188 (47.0%), and 224 (56.0%) followed safe disposal practices. School absenteeism during menstruation was reported by 150 (37.5%). Awareness before menarche was present in 230 (57.5%), and 172 (43.0%) cited their mothers as the primary source of information. Good hygiene practices were significantly associated with maternal education (χ²=22.18, p<0.001), private toilet access (χ²=14.27, p<0.001), pre-menarcheal awareness (χ²=10.14, p=0.001), and school attendance during menstruation (χ²=4.21, p=0.040). In multivariate analysis, maternal education (aOR=2.63; 95% CI: 1.59-4.34; p<0.001), pre-menarcheal awareness (aOR=1.91; 95% CI: 1.23-2.98; p=0.004), and private toilet access (aOR=2.08; 95% CI: 1.31-3.30; p=0.002) remained significant independent predictors. School-going status (aOR=1.48; 95% CI: 0.96-2.29; p=0.072) was positively associated but did not reach statistical significance. Conclusion Menstrual hygiene practices among adolescent girls in urban slums remain suboptimal and are influenced by socio-educational and infrastructural factors. Promoting maternal and adolescent education, increasing awareness before menarche, and improving access to private sanitation are key to enhancing menstrual health. Targeted interventions addressing these determinants are crucial to ensuring safe, dignified menstruation and advancing adolescent health equity in urban slum settings.