Menstrual hygiene practices and WASH practices among women residing in an urban slum in Delhi: a community-based study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20263176Keywords:
Hand hygiene, Menstrual hygiene, Urban slum, WASH, Waste disposalAbstract
Background: Menstrual hygiene management (MHM) is a vital component of women’s health, yet it remains a neglected issue in low-resource settings. Despite improved product availability, women in urban slums continue to face challenges related to sanitation, privacy, and hygiene. This study aimed to assess menstrual hygiene practices among women in an urban slum of Delhi and examine their association with WASH (water, sanitation, and hygiene) behaviours.
Methods: A community-based cross-sectional study was conducted among 307 women of reproductive age residing in an urban slum of Delhi. Data were collected using a pretested, semi-structured questionnaire based on the menstrual practice questionnaire (MPQ) and WASH indicators. Descriptive and inferential statistics were applied to analyse menstrual hygiene practices and their association with hygiene-related outcomes.
Results: Of the 307 participants, 60% were below 30 years and 81.4% were literate. Use of disposable sanitary pads was nearly universal- 93.5% at home and 95.1% outside- while 2.6% used cloth. Only 66.1% reported washing hands before changing menstrual materials compared to 92.8% after. Most women (94.1%) used soap or detergent, and 90.6% practiced daily genital washing. Household garbage was the most common disposal method (69.7%), while 8.1% used unsafe methods. Symptoms suggestive of urinary tract infection (UTI) were significantly associated with inadequate handwashing (p<0.05). Cultural restrictions were reported by 85.3% of women.
Conclusions: Despite high adoption of sanitary pads, gaps remain in hygiene behaviour, disposal practices, and cultural attitudes. Improving WASH facilities, waste management, and menstrual health education is essential for ensuring safe and dignified menstruation in urban slum communities.
References
Sommer M, Sahin M. Overcoming the taboo: advancing the global agenda for menstrual hygiene management for schoolgirls. Am J Public Health. 2013;103(9):1556-9.
van Eijk AM, Sivakami M, Thakkar MB, Bauman A, Laserson KF, Coates S, et al. Menstrual hygiene management among adolescent girls in India: a systematic review and meta-analysis. BMJ Open. 2016;6(3):e010290.
Sommer M, Hirsch JS, Nathanson C, Parker RG. Comfortably, safely, and without shame: defining menstrual hygiene management as a public health issue. Am J Public Health. 2015;105(7):1302-11.
National Family Health Survey (NFHS-5), 2019-21: India. 2022. Available from: https://ruralindiaonline.org/en/library/resource/national-family-health-survey-nfhs-5-2019-21-india/. Accessed on 25 March 2026.
Ray K, Shukla V, Basu M, Manna S, Rashid M, Mondal A. Water, sanitation, and hygiene (WASH) practices among residents of different slum settlements in a ward of Kolkata: a mixed-methods study. J Educ Health Promot. 2024;13(1):113.
WHO/UNICEF Joint Monitoring Program for Water Supply, Sanitation and Hygiene (JMP)- Progress on household drinking water, sanitation and hygiene 2000-2022: Special focus on gender. UN-Water. Available from: https://www.unwater.org/ publications/who/unicef-joint-monitoring-program-update-report-2023. Accessed on 25 March 2026.
Das P, Baker KK, Dutta A, Swain T, Sahoo S, Das BS, et al. Menstrual hygiene practices, WASH access and the risk of urogenital infection in women from Odisha, India. PLoS One. 2015;10(6):e0130777.
Siddique AB, Deb Nath S, Mubarak M, Akter A, Mehrin S, Hkatun MJ, et al. Assessment of knowledge, attitudes, and practices regarding menstruation and menstrual hygiene among early-reproductive aged women in Bangladesh: a cross-sectional survey. Front Public Health. 2023;11:1238290.
Shah SF, Punjani NS, Rizvi SN, Sheikh SS, Jan R. Knowledge, attitudes, and practices regarding menstrual hygiene among girls in Ghizer, Gilgit, Pakistan. Int J Environ Res Public Health. 2023;20(14):6424.
Hennegan J, Zimmerman L, Shannon AK, Exum NG, OlaOlorun F, Omoluabi E, et al. The Relationship between household sanitation and women’s experience of menstrual hygiene: findings from a cross-sectional survey in Kaduna State, Nigeria. Int J Environ Res Public Health. 2018;15(5):905.
Davis J, Macintyre A, Odagiri M, Suriastini W, Cordova A, Huggett C, Agius PA, Budiyani AE, Quillet C, Cronin AA, Diah NM. Menstrual hygiene management and school absenteeism among adolescent students in Indonesia: evidence from a cross‐sectional school‐based survey. Trop Med Int Health. 2018;23(12):1350-63.
Garg S, Bhatnagar N, Singh MM, Basu S, Borle A, Marimuthu Y, et al. Menstrual hygiene management and its determinants among adolescent girls in low-income urban areas of Delhi, India: a community-based study. Osong Public Health Res Perspect. 2022;13(4):273-81.
Paul KK, Chaudhuri S, Maiti A. Menstrual hygiene practices among women aged 15-49 years attending a medical college hospital in Kolkata: a cross-sectional study. J Fam Med Prim Care. 2020;9(9):4699-704.
Das P, Baker KK, Dutta A, Swain T, Sahoo S, Das BS, et al. Menstrual hygiene practices, WASH access and the risk of urogenital infection in women from Odisha, India. PLoS One. 2015;10(6):e0130777.
Gogoi A, Manoranjini M, Ravi T, Kaur M, Gupta M, Rajagopal V. Determinants of respectful maternity care in India: A cross-sectional study. WHO South East Asia J Public Health. 2022;11(1):3-9.
Yaliwal RG, Biradar AM, Kori SS, Mudanur SR, Pujeri SU, Shannawaz M. Menstrual morbidities, menstrual hygiene, cultural practices during menstruation, and WASH practices at schools in adolescent girls of north Karnataka, India: a cross-sectional prospective study. Obstet Gynecol Int. 2020;2020:6238193.
Priya HS, Nandi P, Seetharaman N, Ramya MR, Nishanthini N, Anandaraj L. A study of menstrual hygiene and related personal hygiene practices among adolescent girls in rural Puducherry. Int J Community Med Public Health 2017;4:2348-55.
Downloads
Published
How to Cite
Issue
Section
