Assessment of menstrual hygiene practices and unmet menstrual needs in rural women using the Menstrual Practice Needs Scale 36 (MPNS36)

Menstrual hygiene management (MHM) remains a significant public health concern influenced by socio-cultural barriers, limited access to menstrual materials, and inadequate sanitation infrastructure. This observational study was conducted from January to December 2025 among women residing in communities surrounding a tertiary care teaching hospital in Rajasthan, India, to evaluate domain-wise MHM practices using the Menstrual Practice Needs Scale (MPNS-36) framework. Individuals aged ≥ 14 years attending the Obstetrics and Gynaecology Outpatient Department, nearby secondary schools, colleges, and community health camps were recruited through convenience sampling, while educational institutions were selected through random sampling. Data were collected by trained female investigators using the MPNS-36 assessment tool during outreach camps conducted across multiple villages. The study followed STROBE reporting guidelines and included a total of 2,759 participants. The findings demonstrated high adequacy in access to menstrual materials, home-based hygiene practices, and infrastructure supporting the reuse of menstrual materials. Most participants reported comfort with menstrual materials, availability of water and soap, and the ability to change materials at home when required. Psychosocial improvements were also observed, including reduced embarrassment and increased confidence in managing menstruation. However, disposal practices showed only moderate adequacy, and material insecurity persisted due to concerns regarding leakage and limited access to additional materials. School-based menstrual hygiene management emerged as the most compromised domain, with limited privacy and inadequate sanitation facilities reported in educational settings.