Menstrual Hygiene Practices Among School Students in a District of the Northern Province, Sri Lanka: A Cross-Sectional Study

Introduction: Menstrual hygiene (MH) is vital for the health, dignity, and academic performance of adolescent girls, particularly in resource-constrained regions. Sociocultural, economic, and infrastructural factors shape MH practices. This study examines MH practices among students aged 16 in District of Northern Province, Sri Lanka, exploring the influence of sociodemographic factors, school facilities, and related challenges. To investigate menstrual hygiene practices and their association with sociodemographic characteristics among students aged 16 in District of Northern Province, Sri Lanka.

Methods: A descriptive cross-sectional study was conducted over 4-5 months in 2024, targeting students aged 16 across 82 schools in district of norther province. Using stratified random sampling, 385 students were selected.  Data were gathered via a structured questionnaire assessing MH practices and an observation checklist evaluating school sanitation facilities. Descriptive statistics and chi-square tests were employed for analysis.

Results: The sample was predominantly Hindu 75.1% (n=289), with mothers often more educated than fathers, positively influencing menstrual hygiene (MH) management. Most families 73.5% (n=283) earned below 25,000 LKR monthly, limiting access to sanitary products. While 92.2% (n=355) had home toilet access, only 76.5% (n=13) of schools had adequate girls’ toilets, and 47.1% (n=8) provided proper sanitary disposal. Comfort discussing menstruation was moderate, with 70.9% (n=273) somewhat comfortable and 24.4% (n=94) very comfortable. Sanitary pads were universally preferred, with 100% using them during school hours, indicating a positive MH shift.

Discussion: Significant deficiencies in school MH infrastructure, including private toilets, disposal systems, and water access, were identified. Educational initiatives to reduce menstrual stigma and promote open dialogue are critical. Comprehensive interventions, including infrastructure upgrades and awareness programs, are essential to improve MH practices and support students’ health and education.