Menstrual hygiene management among reproductive-aged women with disabilities in Bangladesh

Abstract Background Women with disabilities in low- and middle-income countries face unique challenges in managing menstruation, affecting their health, dignity, and quality of life. Objective This study explored menstrual hygiene management (MHM) practices among reproductive-aged women with disabilities in Bangladesh and its impact on social participation. Methods We analyzed data from 51,535 women from the 2019 Multiple Indicator Cluster Survey (MICS). The outcome variables were: (i) material used to manage blood flow while menstruating (appropriate, inappropriate), (ii) availability of a private place for washing and changing menstruation rags (yes, no), and (iii) impacted in attendance of social activities, school, or work during menstruation (yes, no). Disability status was considered as major explanatory variable and categorized as no disabilities, moderate disabilities, and severe disabilities. Associations of outcome variables with explanatory variable were determined using a multilevel multinomial logistic regression model adjusted for individual-level factors, household-level factors, and community-level factors. Results Among the sample, 2.7% reported severe disability and 19.2% moderate disabilities, with vision-related disabilities (12.2%) being the most prevalent, followed by cognitive (9.5%) and walking disabilities (8.2%). Overall, 4% reported using inappropriate materials for menstrual flow, rising to 8.0% among those with severe disabilities and 5.8% for moderate disabilities. Women with moderate to severe disabilities had 33-47% lower odds of using appropriate materials and 34-44% lower odds of having a private place to change at home. Additionally, women with severe disabilities were 1.66 times more likely to report that menstruation impacted their social activities. Conclusion Women with disabilities in Bangladesh face significant barriers to effective MHM. Addressing these issues requires targeted interventions, including disability-inclusive menstrual health education, improved access to menstrual products and sanitation facilities, and community initiatives to reduce stigma.