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Background  The issue of menstrual hygiene is inadequately acknowledged and has not received proper attention. Use of sanitary pads and washing the genital area are essential practices to keep the menstrual hygiene. Unhygienic menstrual practices can affect the health of the girls and there is an increased vulnerability to reproductive tract infections and pelvic inflammatory diseases and other complications. Therefore, the objective of this study was to assess the knowledge and practice of menstrual hygiene among high school girls at Nekemte town, Oromia region, Western Ethiopia.    Method  A school based cross-sectional study design was employed in Nekemte Town, Western Ethiopia. A multi stage sampling technique was used to select 828 female high school students. Data collection was carried out from May 04 to May 30, 2014 using a pre- tested structured questionnaire. The data were entered into a computer using Epi-info version 3.5.1 and then exported to SPSS for Windows version 20.0 for analysis. Bivariate and multivariate logistic regression analysis was done at 95 % confidence interval.    Results  In this study, 504 (60.9 %) and 330 (39.9 %) respondents had good knowledge and practice of menstrual hygiene respectively. The findings of the study showed a significant positive association between good knowledge of menstruation and educational status of mothers (AOR = 1.51, 95 % CI = 1.02 – 2.22), having radio/TV (AOR = 2.42, 95 % CI: 1.64 – 3.56). Educational status of the mother (AOR = 2.03, 95 % CI = 1.38 – 2.97) and earning permanent pocket money from parents (AOR = 2.73, 95 % CI = 1.76 – 4.26) revealed significant positive association with good practice of menstrual hygiene.    Conclusions  The findings showed that the knowledge and practice of menstrual hygiene is low. Awareness regarding the need for information about good menstrual practices is very important. So, health education program should be setup to create awareness and practice of good menstrual hygiene.    Electronic supplementary material  The online version of this article (doi:10.1186/s12905-015-0245-7) contains supplementary material, which is available to authorized users.

Assessment of knowledge and practice of menstrual hygiene among high school girls in Western Ethiopia