Gender Equity in Menstrual Health: Challenges in Product Access and Disposal Among Adolescent Girls in Lusaka, Zambia

Background Access to reproductive health services is crucial for the empowerment and well-being of women and girls in low-, middle-, or high-income countries, particularly in Menstrual Health and Hygiene Management. Despite global progress in menstrual health advocacy, disparities in menstrual product access, usage and disposal persist, especially in low-resource settings. Adolescent girls in the peri-urban Lusaka, Zambia, face significant sanitary product affordability, access, and disposal infrastructure challenges. Additionally, cultural perceptions and societal stigmas further shape menstrual health experiences, influencing both product access and disposal behaviors. Methods Employing a mixed-methods cross-sectional approach, menstruators from one Government school in Peri-urban Lusaka (n = 266) aged 12–19 were surveyed alongside participants (n = 24) from different grades (5–9), purposively sampled from various peri-urban communities, and in focus group discussions, contributing to an essential discourse on health service access. Data were analysed using JMP Pro and MAXQDA 10 after triangulation with other researchers. Results Quantitative findings revealed a marked preference for disposable menstrual products (85%), with users reporting higher levels of comfort and convenience. Supermarkets and retailers accounted for 94% of the product supply, while others sourced available homemade materials. Menstrual. In contrast, reusable products were utilised primarily by households with lower economic means, where accessibility and cost were significant factors. Statistical analysis indicated a strong correlation between education level and preferred product type, highlighting that increased awareness leads to a stronger inclination towards sustainable options. Qualitative insights from focus groups underscored the influence of cultural beliefs on menstrual management. Participants often transported waste home for discreet disposal, reflecting a cultural understanding of managing waste while identifying inadequate disposal facilities outside the house. Thematic analysis identified key cultural narratives that prioritise discretion and comfort but overlook environmental and health considerations, revealing gaps in knowledge that can hinder adequate reproductive health access. Conclusion Our research reveals significant disparities in the availability and acceptance of menstrual products, highlighting the roles of social stigma, educational opportunities, and environmental considerations. Enhancing access to culturally relevant menstrual health resources can significantly advance gender equity in reproductive health access. Findings suggest critical avenues for culturally sensitive interventions that provide access to appropriate menstrual products and foster educational programs about environmental impacts and health implications. By addressing these cultural dynamics and enhancing the availability of hygiene facilities, we can significantly improve girls’ experiences and promote gender equity in reproductive health. Interventions in reproductive health must include service delivery and more access to quality products for vulnerable populations like adolescent girls.