Regional variations in the management of reusable menstrual material among women of reproductive age in Bangladesh

Menstruation is a natural biological process, yet menstrual hygiene management (MHM) remains inadequate in many low- and middle-income settings. This study assessed the prevalence, geographic distribution, and determinants of reusable menstrual product use among women in Bangladesh. A secondary analysis was conducted using the Bangladesh Multiple Indicator Cluster Survey (MICS) 2019, including 56,077 women aged 15–49 years. Bivariate associations were examined using chi-square tests, and multivariable relationships were assessed using weighted binomial logistic regression, with adjusted odds ratios (AORs) and 95% confidence intervals. District-wise spatial mapping and wealth-stratified subgroup analyses were also performed. Approximately two-thirds of women reported using reusable menstrual materials. The lowest prevalence was observed in Dhaka (45%), followed by Kushtia (47%) and Jhenaidah (49%), while higher use was seen in northern and southern regions. Higher odds of using reusable products were associated with rural residence, lower education, poorer household wealth, male-headed households, older age, current marriage, and limited mass media exposure. Substantial variation was observed across wealth quintiles, indicating socioeconomic heterogeneity in determinants. The findings highlight the need for targeted educational interventions and menstrual health awareness programs, particularly for socioeconomically disadvantaged groups, to promote safe and hygienic use of reusable menstrual products in Bangladesh.