A mixed method study of menstrual hygiene management practices and menstrual waste disposal challenges at a medical college in Gujarat, India

Abstract Background While use of hygienic menstrual products has improved in India, challenges related to Menstrual Hygiene Management (MHM) and menstrual waste (MW) disposal among female medical students, and challenges faced by sanitary workers while handling MW, remain insufficiently addressed. Therefore, this study aimed to assess MHM practices and related challenges among female medical students and to explore challenges faced by sanitary workers while handling menstrual waste in a medical college. 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 among 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 materials fewer than three times on the heaviest day, and 39.1% did not change materials during college hours. Students revealed challenges in MHM, including inadequate washroom infrastructure, a lack of soap and water, and insufficient disposal facilities. Sanitary workers reported unsafe disposal practices by students, lack of protective equipment, limited supervisory support, and occupational health concerns while handling MW. Conclusion MHM and MW disposal remains a challenge among female medical students and sanitary workers within the medical institution. Improving washroom infrastructure by ensuring availability of soap, water and designated menstrual waste disposal facilities, promoting safe menstrual hygiene and disposal behaviours among students, and providing protective equipment and institutional support for sanitary workers are essential to strengthen menstrual hygiene management in medical institutions. Graphical Abstract