Menstrual hygiene management among women of reproductive age in White Nile State, Sudan: a descriptive cross-sectional study

Menstrual Hygiene Management (MHM) remains a major public health challenge in low-resource settings, where cultural taboos, limited access to sanitary products, and inadequate health education can compromise women’s well-being. Evidence from Sudan, particularly rural communities, is limited. This study aimed to assess the Knowledge, Attitude and Practice of Menstrual Hygiene among women of reproductive age in White Nile. A descriptive cross-sectional study was conducted during a three-day medical convoy in three rural villages of the Guli and Alsalam localities, White Nile State, Sudan. Women aged 15–45 years attending the mobile clinic were recruited through convenience sampling. Data were collected using a pretested, interviewer-administered questionnaire covering sociodemographic variables, knowledge of menstruation and hygiene, attitudes toward menstrual and reproductive health, and hygiene practices. Data were analyzed using SPSS version 28 software. A total of 333 women were recruited. The mean age at menarche was 13.9 years, and 95.8% of participants reported undergoing female genital mutilation (FGM). Knowledge levels varied: 53.2% were aware of menstruation before menarche, yet only 36% demonstrated good knowledge of MHM, while 32.1% and 31.8% had moderate and poor knowledge, respectively. Mothers (48.9%) and teachers (42%) were the main sources of information. Attitudes toward reproductive health were mixed; although 78.7% indicated they would seek treatment for Reproductive Tract Infection (RTI)-like symptoms, 21.3% reported barriers such as stigma or financial constraints. Practices were relatively positive:74.8% reported using disposable sanitary pads, most changed absorbents two to three times daily, and 62.2% washed the genital area more than once per day using water and soap. However, affordability (45.5%) and availability (27.6%) limited access to disposable pads. Self-reported RTI-like symptoms were common, with burning urination (55.9%) and abnormal vaginal discharge (49.5%) being the most frequently reported. This KAP study highlights both progress and persistent gaps in MHM among rural Sudanese women. While many practiced safe hygiene and expressed willingness to seek care, knowledge gaps, cultural restrictions, high FGM prevalence, and limited access to sanitary products continue to affect menstrual health. Targeted interventions integrating health education, improved product accessibility, and reproductive health services are urgently needed.