Socio‑economic Determinants of Menstrual Hygiene Practices among Adolescent Girls: A Rural‑Urban Comparative Study in Bangladesh

Background Menstrual hygiene management (MHM) remains a critical challenge for adolescent girls in low- and middle-income countries like Bangladesh, particularly in rural areas where socio-economic and cultural barriers limit access to hygienic products, knowledge, and facilities, adversely affecting health, education, and well-being. This study examines the socio-economic determinants of MHM practices among adolescent girls in rural and urban settings of Narsingdi District, Bangladesh. Methods A cross-sectional quantitative design was used, involving 250 adolescent girls aged 12–19 years (120 rural, 130 urban) selected via simple random sampling. Data were collected through structured face-to-face interviews assessing socio-demographic characteristics, menstrual hygiene practices, knowledge levels, and socio-cultural beliefs. Descriptive statistics and Pearson’s Chi-Square tests (p < 0.05) were applied using SPSS version 27 to identify associations between socio-economic factors and MHM behaviors. Results Urban girls exhibited significantly better MHM practices than rural counterparts (p < 0.001 for key variables). Sanitary pad usage was higher in urban areas (84.6% vs. 53.3% rural), with urban girls also demonstrating more frequent pad changes (e.g., twice daily: 53.1% vs. 50.8%), safer disposal methods (household waste: 80.0% vs. 55.8%), and fewer cultural restrictions (e.g., avoiding outdoors: 15.4% vs. 42.5%). Maternal literacy and higher socio-economic status were positively associated with improved practices, while rural areas showed greater knowledge gaps and stigma-driven behaviors. Conclusions Socio-economic factors, including maternal literacy and household wealth, significantly influence MHM practices, with urban-rural disparities underscoring structural inequities. Targeted interventions emphasizing education, affordable product access, infrastructure improvements, and stigma reduction are essential to enhance MHM, particularly in rural Bangladesh, supporting Sustainable Development Goal 5 for gender equality.