Exploring the association between household sanitation and women’s menstrual hygiene management in rural Odisha, India

<h2>Abstract</h2><h3>Introduction</h3> Access to water, sanitation, and hygiene (WASH) facilities has been globally recognized as a critical need, especially for women and girls to ensure their menstrual hygiene. This study aimed to investigate the association between household sanitation and women's menstrual management experience in Odisha, India. <h3>Methods</h3> A cross-sectional study was conducted in Balasore district of Odisha state in India among 694 rural women and girls aged 15–45 years selected using a multi-stage sampling method. The Performance Monitoring and Accountability (PMA) 2020 questionnaire was used for data collection. Multivariate logistic regression analysis was carried out using SPSS version 25. <h3>Results</h3> More than two-third (68.4 %) of rural families used improved sanitary facilities. Around 30 % of households have been using an unimproved sanitary facility, which means the practice of open defecation is still prevalent in rural areas. About 40.6 % of women and girls reported using clothes as their primary menstrual hygiene material. Further, women and girls with improved sanitation facilities (aOR = 1.56, 95 % CI: 1.09–2.59) were more likely to change menstrual materials at the main household sanitation facility than those with an unimproved sanitation facility. In contrast, households using improved sanitation facility were less likely to use bedroom/sleeping areas to change the menstrual materials (aOR = 0.65, 95 % CI: 0.42–0.99) than those with an unimproved facility. <h3>Conclusion</h3> Availability of improved household sanitation is critical to good menstruation management practices. State-specific policy for menstrual health and hygiene could provide the much-needed impetus to strengthen WASH infrastructure in rural and tribal regions of Odisha.