Developing the menstrual justice agenda: insights from a mixed method study in the mid-western region of Nepal

Abstract

This article develops the concept of “menstrual justice”. The legal scholar Margaret E. Johnson has developed an expansive approach to menstrual justice incorporating rights, justice, and a framework for intersectional analysis, with a focus on the US. This framework provides a welcome alternative to the constrictive and medicalised approaches often taken towards menstruation. However, the framework is silent on several issues pertaining to menstruation in Global South contexts. This article therefore develops the concept of menstrual justice in order to extend its relevance beyond the Global North. It presents the findings of mixed-methods research conducted in April 2019 in the mid-western region of Nepal, particularly concerning the practice of chhaupadi , an extreme form of menstrual restriction. We conducted a quantitative survey of 400 adolescent girls and eight focus group discussions, four with adolescent girls and four with adult women. Our findings confirm that dignity in menstruation requires addressing pain management, security issues, and mental health, plus structural issues including economic disadvantage, environmental issues, criminal law, and education.

Spatial heterogeneity of menstrual discriminatory practices against Nepalese women: a population-based study using the 2022 Demographic and Health Survey

“…Our results indicate that Nepal continues to bear a disproportionate burden of menstrual-related discrimination, which manifest as exclusions from participating in social and religious activities. These findings are consistent with recent studies, which showed that Chhaupadi is most prevalent among the Brahmin/Chhetri ethnic community in the mid-western part of Nepal (Amery et al, 2023; Thakuri et al, 2021; UNFPA, 2019; UNICEF, 2020, 2022).…”

“…In conclusion, our study contributes valuable insights into the complexity of menstrual health challenges in Nepal, shedding light on the spatial patterns and determinants of menstrual discriminatory practices. By elucidating the geographical variations, our findings provide a foundation for targeted community based interventions such as the cultural behaviour change education (Amery et al, 2023; Thapa et al, 2019; Thomson et al, 2019). The identification and prioritization of vulnerable populations are crucial steps toward dismantling the deeply rooted beliefs and promoting a more inclusive and equitable society.…”

“…These practices encompass restrictions on accessing places of worship, participation in household chores, physical contact with male household members, and constraints on utilizing water sources (ActionAid, 2024; Mukherjee et al, 2020; Rothchild & Piya, 2020; Thakuri et al, 2021). The western part of Nepal is known for the infamous Chhaupadi —the severest form of menstrual exclusion—that designates women as impure and untouchable during menstruation or postpartum period banishing them to a separate house, cowshed or menstrual hut (ActionAid, 2024; Amatya et al, 2018; Amery et al, 2023; Thakuri et al, 2021). Despite legislative measures against menstrual discriminatory practices, recent studies reveal that this practice is still pervasive in the western part of the country (Adhikari, 2020; Amatya et al, 2018; Baumann, Merante, et al, 2021; UNFPA, 2019; Vaughn, 2019), subjecting women to physical and mental health challenges, sexual abuse, snake bites and even death due to suffocation (Adhikari, 2020; Awasthi et al, 2022; Cardoso et al, 2019, 2019; Joshi & Acharya, 2022; Preiss, 2016; Thakuri et al, 2021).…”