Factors affecting menstrual hygiene among women living in slum areas of Budanilakantha Municipality, Kathmandu.
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Menstrual hygiene among women living in slum communities in Kathmandu is shaped not only by knowledge and access to resources but also by deeply entrenched cultural norms, stigma, and restrictions. Nearly all women experienced menstrual restrictions, and perceptions of menstruating women as impure remained common. The authors emphasize that menstrual health interventions must therefore move beyond individual knowledge and hygiene behaviors to challenge harmful social norms and stigma while addressing socioeconomic and infrastructure barriers.
Objectives To identify the socio-demographic, behavioral, environmental, and sociocultural factors influencing menstrual hygiene practices among women aged 18–49 living in slum areas of Budanilakantha Municipality, Kathmandu, Nepal.
Methods This community-based analytical cross-sectional study surveyed 247 women from four wards between July and November 2022. Households were systematically randomly sampled, and trained interviewers administered a pretested questionnaire covering socio-demographic characteristics, menstrual knowledge and practices, access to water, sanitation and hygiene facilities, and sociocultural restrictions. Social norms-related measures included culturally practiced menstrual restrictions and beliefs, such as restrictions on household work, religious and social participation, perceptions of impurity, discrimination, untouchability, and whether menstruation-related family norms were strictly followed. Descriptive statistics and chi-square tests assessed associations between participant characteristics and menstrual hygiene outcomes.
Results Overall, 53.8% of women used sanitary pads and 42.9% used reusable cloth; 66.8% used soap and water for handwashing, while only 38.9% bathed daily during menstruation. Social and cultural restrictions were widespread: 95.1% experienced at least one menstrual restriction and 57.1% reported being perceived as impure. Higher education and income were associated with greater menstrual awareness, while ethnicity, occupation, and income were associated with handwashing practices. The discussion highlights that socioeconomic disadvantage, inadequate sanitation infrastructure, and entrenched cultural norms compound one another in shaping women’s menstrual experiences and practices.
Conclusions Menstrual hygiene practices reflect a complex interaction of socioeconomic conditions, access to resources, and cultural restrictions. Improving menstrual health and dignity requires comprehensive strategies combining education, improved water, sanitation and hygiene infrastructure, stigma reduction, community support, and explicit efforts to address restrictive social norms and taboos.
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