Are We Still Struggling with Menstrual Hygiene Management? A Mixed Method Study for Menstrual Practices and Menstrual Waste Disposal among Medical Undergraduates

Background Safe and dignified Menstrual hygiene management (MHM) is a fundamental need for women and girls. While use of hygienic menstrual products has improved in India, challenges related to menstrual waste disposal, institutional infrastructure, and occupational safety remain underexplored, particularly within medical institutions. Therefore, this study was conducted to assess menstrual hygiene practices and related challenges from the perspectives of female medical students and sanitary workers. Methods A convergent parallel mixed-method study was conducted from March to May 2023 in a government medical college in Gujarat, India. Quantitative data were collected through a cross-sectional survey among 161 female medical students using a structured questionnaire. Qualitative data included one focus group discussion with 12 female medical students and five in-depth interviews with sanitary workers. Quantitative data were analysed descriptively, while qualitative data were analysed using inductive thematic analysis. Result Disposable sanitary pads were used by 98.1% of participants; however, 38.5% reported changing menstrual material fewer than three times on the heaviest day, and 39.1% did not change material during college hours. Most participants disposed of menstrual waste in common dustbins. Qualitative findings revealed challenges, including inadequate washroom infrastructure, a lack of soap and water, insufficient disposal facilities, and limited acceptance of alternative menstrual products. Sanitary workers reported unsafe disposal practices, systematic and administrative challenges, and occupational health concerns. Conclusion MHM remains a systemic challenge even among female medical students. Addressing MHM requires institutional interventions focusing on infrastructure, behaviour change, menstrual waste management systems, and protection of sanitation workers.