Menstrual hygiene management practice and associated factors among disabled women of reproductive age in Nepal: a cross-sectional study

Objectives To assess menstrual hygiene management (MHM) practices and associated factors among disabled women of reproductive age in Nepal. Design A community-based cross-sectional study design. Setting Household settings across seven local levels of Nawalparasi West district, Nepal, from May to December 2025. Participants A total of 218 women with disabilities of reproductive age (15–49 years) participated in the study. Primary and secondary outcome measures MHM practice was the primary outcome, while menstrual knowledge and factors associated with good MHM practice were also assessed. MHM practice and menstrual knowledge were measured using items from the Menstrual Practice Questionnaire and the Multiple Indicator Cluster Survey 2019. Results Among the 218 participants, more than half (52.3%) had poor knowledge of menstruation, with a mean knowledge score of 3.4±2.06. However, 61.5% demonstrated good MHM practices, with a mean practice score of 7±1.6. Multiple logistic regression analysis, including variables with p<0.05 in bivariate analysis and type of disability, showed that participants aged 15–24 years (AOR=5.63, 95% CI 2.12 to 14.93, p=0.001), having mothers with informal education (AOR=2.22, 95% CI 1.02 to 4.82, p=0.044), a family monthly income greater than 30 000 NPR (AOR=2.38, 95% CI 1.15 to 4.96, p=0.020), and good knowledge of menstruation (AOR=2.37, 95% CI 1.05 to 5.32, p=0.037) were significantly more likely to practise good MHM. Conclusions Despite limited knowledge of menstruation among women with disabilities aged 15–49 years, most practised good menstrual hygiene. Interventions targeting menstrual health education, particularly for older and lower-income women with disabilities, are recommended to further improve hygiene practices and menstrual health outcomes.