Barriers to menstrual hygiene management in school environment among adolescent girls of Tatopani Rural Municipality, Jumla: A cross-sectional study

Background: Adolescence, spanning the ages of 10 to 19, is marked by rapid physical, psychological, social, and biological changes. Despite its importance, menstrual hygiene remains a neglected issue. In many developing countries, adolescent girls face numerous of challenges in managing their menstrual hygiene, especially in school environments. These challenges include inadequate access to water and sanitation facilities, a lack of privacy, teasing by boys, insufficient menstrual hygiene education and products, and social stigma along with cultural restrictions on activities. This study aims to explore the barriers to menstrual hygiene management in school environment among adolescent girls in a rural municipality in Jumla, Methods: A cross-sectional study was conducted in public schools located in Tatopani rural municipality, Jumla. Simple random sampling method was used to select the respondents. Data collection was carried out using a semi-structured questionnaire through the self-administered technique. The study population consisted of adolescent girls in grades nine and ten, with a total sample size of 192 participants. Results: The study revealed that the majority of participants were aged between 13 to 15 years old, with 67.7% feeling uncomfortable managing their menstrual cycle at school. While most respondents had access to gender-separated toilets, only 38.0% had soap available for hand washing, and 88.5% faced poor lighting conditions. More than half of the students reported a lack of private spaces to address menstruation needs. Disposal practices varied, with 41.1% using dustbins, 40.1% utilizing rivers, and 16.1% resorting to toilet pans. Merely 15.1% had access to a sick room for resting. A significant number of students mentioned taking medication for menstrual pain, and 32.3% missed school during their cycle, citing reasons such as staining clothes or cultural restrictions. Conclusions: The study identified several barriers to menstrual hygiene management among adolescent girls in a rural school setting, including discomfort, lack of essential facilities, unsanitary disposal methods, and missed school days. Raising awareness, improving infrastructure, educating on proper disposal, implementing policies, and community campaigns to enhance menstrual hygiene management and create a supportive school environment