Background: MHM is a key dimension of adolescent health, but adolescent girls in rural areas grapple with a lack of awareness, insufficiency in sanitation facilities, and socio-cultural barriers. Lack of menstrual hygiene has been related to the alarming occurrence of RTIs, leading to school and psychosocial distress. The objectives of this study were to evaluate the knowledge, the practices, and the role of nursing interventions in the improvement of menstrual hygiene management.

Methods: A descriptive cross-sectional study was conducted among adolescent girls (13–19 years) in rural communities based on stratified random sampling. Data was gathered using structured questionnaires, observation checklists in-depth interviews. The quantitative method applied descriptive analysis (mean and frequency distribution) and the Pearson correlation test to determine the relationships between menstrual hygiene knowledge and practices. Cultural barriers and influences were identified during qualitative analysis using thematic analysis. Results: Results showed that 65.4% of the participants had moderate knowledge of menstrual hygiene and 72.8% were consistent in using sanitary pads. A total of 81.5% of participants had adequate access to clean water and sanitation. Statistically, there was an association (r = 0.68, p < 0.05) between knowledge of menstrual hygiene and the practice of hygiene. But cultural taboos and ignorance persisted about hygiene. Privacy concerns and financial constraints emerged as the most significant barriers according to the qualitative results.

Discussion: The findings of the study are consistent with the previous literature, which accentuates the importance of menstrual hygiene education programs for knowledge deficiency and cultural stigma. Although there have been continuous awareness programme, there are still socio-economic constraints and traditional beliefs that affect menstrual hygiene management practices. Nursing interventions as school-based interventions, community interventions and policy advocacy, are seen as critical for enhancing menstrual hygiene management.