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Background: Schoolgirls in resource-limited settings encounter significant challenges in maintaining proper menstrual hygiene management practices. Studies on associated factors in menstrual hygiene management practices among schoolgirls in Bahir Dar City are limited. Objectives: The study aimed to evaluate the menstrual hygiene practices of schoolgirls and identify factors that influence these practices in the limited settings of Bahir Dar City. Design: This study was a school-based, analytical, cross-sectional study conducted among schoolgirls between the ages of 11 and 25. Methods: A total of 701 schoolgirls, selected at random based on their consent, participated in this school-based, analytical, cross-sectional study. The data collection process was comprehensive, involving a self-administered questionnaire and 5 rounds of observations at 10 schools using the Joint Monitoring Program for Water, Sanitation, and Hygiene monitoring tool. The study used a binary logistics regression model to determine the strength of the association between predictor and outcome variables, ensuring a rigorous analysis with a p -value < 0.05. Results: In this study, 375 (53.50%) participants were found to have good menstrual hygiene practices. Factors such as the mothers' education (diploma and above vs not read and write (AOR = 26.29, 95% CI: 11.69–59.12), fathers' education (diploma and above vs not read and write (AOR = 19.21, 95% CI: 8.51–43.32), having access to basic water service (AOR = 14.62, 95% CI: 5.12–41.73), having access to basic sanitation services (AOR = 21.02, 95% CI: 7.87–56.15), being older among the schoolgirls (AOR = 19.69, 95% CI: 10.18–38.07), having private work (AOR = 15.58, 95% CI: 6.99–34.73), having open discussions with sisters (AOR = 27.01, 95% CI: 11.45–63.73), having friendly discussions about menstrual hygiene with schoolgirl friends (AOR = 18.67, 95% CI: 8.45–41.24), and residing in urban areas (AOR = 6.43, 95% CI: 3.52–11.73)) were significantly associated with good menstrual hygiene practices. Conclusion: The schoolgirls in the study area had good menstrual hygiene practices. However, uneducated parents, inadequate facilities, limited access to absorbent materials, and lack of support were challenges that affected proper menstrual hygiene management practice. To improve menstrual hygiene practices, it is crucial to address these identified modifiable factors and consider education programs, better facilities, community support, and policy changes that prioritize menstrual hygiene management in schools for schoolgirls to manage menstruation. Plain language summary: Menstrual hygiene management practices among schoolgirls Menstruation poses challenges for schoolgirls in resource-limited settings. Cultural norms, lack of proper infrastructure, limited access to affordable products, and insufficient education hinder the practice of proper menstrual hygiene practices. These challenges can lead to health risks, absenteeism, and decreased academic performance. For instance, in the Oromia region, only 35% of the schoolgirls used sanitary pads, while in the Amhara region, 44.9%–33% used sanitary pads. A school-based analytical cross-sectional study was conducted in Bahir Dar City from March 2022 to August 2023 to evaluate the menstrual hygiene practices of schoolgirls and identify the factors that influence these practices in the schools of Bahir Dar City, located in Northwest Ethiopia. The mean age of schoolgirls was 16.82 years (SD = ±1.60), and the age of 8 years was the first menarche experience in 7 (1%) schoolgirls. The overall practices showed that 375 (53.50%) schoolgirls exercised good MHM, and the remaining 326 (46.50%) exercised poor MHM. The study revealed that schoolgirls whose mothers' and fathers' had a college education and above, older schoolgirls, schoolgirls with parents working in private, those attending schools with basic water and sanitation facilities, and those who openly discussed menstruation with their sisters and friends tended to have better MHM practices. Parental education levels, WASH facilities, and schoolgirls' residence areas have been identified as factors affecting schoolgirls' menstrual hygiene practices. The identified modifiable factors are the areas of intervention to increase proper menstrual hygiene practices. Concerned bodies should create a supportive and safe environment to help schoolgirls manage their monthly menstruation safely and comfortably. [ABSTRACT FROM AUTHOR]

Background: The challenges of safe menstrual hygiene management practices in low-income settings, including the study areas are pressing. However, Studies specifically focusing on barriers that schoolgirls face in managing monthly menstruation in schools of Bahir Dar are inadequate and scarce. Method: To ensure the robustness of the findings, a comprehensive study was conducted among schoolgirls and boy students aged 12–20 in three schools. This study employed focus group discussions and in-depth interviews with students and leaders of the school gender club. A word cloud generator was used to visually represent frequently mentioned keywords, and the data generated from interviews were analyzed using the Open Code 4.03 tool. Results: The findings, derived from focus group discussions and in-depth interviews, revealed several significant barriers that schoolgirls face in practicing safe menstrual hygiene management. These barriers, including sociocultural factors (133), inadequate use of menstrual hygiene management facilities (73), inadequate knowledge before menarche (59), and a general lack of support (35), underscore the multifaceted nature of the issues. Importantly, these findings emphasize the urgent need for targeted interventions to address these barriers and improve menstrual hygiene management among schoolgirls. Conclusion: Schoolgirls in Bahir Dar encounter numerous challenges in maintaining safe menstrual hygiene practices. Addressing the identified modifiable barriers represents crucial areas for intervention, requiring collaborative efforts from school communities and other relevant stakeholders to create an environment conducive to promoting and enhancing safe menstrual hygiene practices. [ABSTRACT FROM AUTHOR]