Improving menstrual hygiene management in emergency contexts: literature review of current perspectives

Abstract

Management of menstruation in contexts of humanitarian emergencies can be challenging. A lack of empirical research about effective interventions which improve menstrual hygiene management (MHM) among female populations in humanitarian emergencies and a lack of clarity about which sectors within a humanitarian response should deliver MHM interventions can both be attributable to the lack of clear guidance on design and delivery of culturally appropriate MHM intervention in settings of humanitarian emergencies. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts in order to describe the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations’ menstrual needs. A structured-search strategy was conducted for peer-reviewed and gray literature to identify studies, published reports, guidelines, and policy papers related to menstrual response in emergency humanitarian contexts. Of the 51 articles included in the review, 16 were peer-reviewed papers and 35 were gray literature. Most of the literature agreed that hardware interventions should focus on the supply of adequate material (not only absorbent material but also other supportive material) and adequate sanitation facilities, with access to water and private space for washing, changing, drying, and disposing menstrual materials. Software interventions should focus on education in the usage of materials to manage menstruation hygienically and education about the female body’s biological processes. There was clear agreement that the needs of the target population should be assessed before designing any intervention. Although there is insight about which factors should be included in an effective menstrual hygiene intervention, there is insufficient empirical evidence to establish which interventions are most effective in humanitarian emergencies and which sectors should be responsible for the coordination and implementation of such. Increased monitoring and evaluation studies of interventions should be completed and publicly shared, in order to feed evidence-based guidelines in the humanitarian sector.

Exploring menstrual practices and potential acceptability of reusable menstrual underwear among a Middle Eastern population living in a refugee setting

“…Informed consent forms of women self-declaring illiteracy were cosigned by a witness. Themes emerging through a literature review 14 conducted by the primary researcher were considered when developing qualitative data collection tools. All data collection tools were translated into Arabic and checked by a third party for accuracy.…”

The Extent to Which Menstruation-Related Issues Are Included in Graduate-Level Public Health Curricula

“…A key recommendation is for schools to review their existing curricula for menstruation-related health and hygiene content and application to public health competencies of relevance. This might include, e.g., designing programming or identifying key research questions and how to examine them within the spheres of adolescent health, women's health, reproductive health, health policy, environmental health, health education, and humanitarian response ( 17 , 18 , 31 ). Second, a more in-depth analysis of how menstruation-related topics have been incorporated into existing courses and disciplinary homes would provide more concrete guidance to schools seeking to build menstruation-related issues into their curricula.…”

“…To date, much attention has focused on the menstruation-related challenges facing schoolgirls in low- and middle-income countries ( 11 , 16 ), which has led to the development of menstrual health and hygiene policies in a number of countries. There is also growing programming and evidence being generated on the menstrual management-related challenges experienced by the 30 million girls and women displaced around the world ( 17 , 18 ). However, more evidence is needed on these topics and on the menstruation-related issues impacting numerous other populations, such as women in the workplace or those living in crowded urban slums.…”

Pengaruh Pendidikan Kesehatan Terhadap Pengetahuan dan Sikap Siswa SMP Dharma Pancasila Tentang Manajemen Kesehatan Menstruasi

“…Hal ini diperburuk dengan fakta bahwa anak perempuan sering kesulitan membeli atau mendapatkan pembalut saat diperlukan. Penelitian UNICEF di Indonesia pada 2015 menemukan fakta 1 dari 6 anak perempuan terpaksa tidak masuk sekolah selama satu hari atau lebih, pada saat menstruasi [1].…”