‘We like things tangible:’ A critical analysis of menstrual hygiene and health policy-making in India, Kenya, Senegal and the United States

Alhelou, Nay; Kavattur, Purvaja S.; Rountree, Lillian; Winkler, Inga T.

doi:10.1080/17441692.2021.2011945

Cited by 19 publications

(22 citation statements)

References 28 publications

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“…However, there have been gaps in proper implementation due to challenges in the narrow conceptualization of menstrual health hygiene as just “pad distribution “. 31 Studies in the United States and India also share similar findings on the need to frame Menstrual Health Hygiene as a comprehensive policy that impacts mental health, water and sanitation, education, and financial sectors. 31 As such implementation of menstrual health hygiene in schools not only addresses sustainable development goal (SDG) 3 of improving health and well-being but also SDG 4, in the provision of equitable and quality education especially for adolescent girls.…”

Section: Discussionmentioning

confidence: 72%

“…31 Studies in the United States and India also share similar findings on the need to frame Menstrual Health Hygiene as a comprehensive policy that impacts mental health, water and sanitation, education, and financial sectors. 31 As such implementation of menstrual health hygiene in schools not only addresses sustainable development goal (SDG) 3 of improving health and well-being but also SDG 4, in the provision of equitable and quality education especially for adolescent girls. 13,14 It is important to recognize that even though investments are made to improve sanitation and increase reproductive health supplies and products, adolescent girls may not fully seek care or utilize services if they feel disrespected and undervalued.…”

Section: Discussionmentioning

confidence: 72%

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It’s not just about pads! Adolescent reproductive health in Kenya:A qualitative secondary analysis

Ayieko

Nguku

Kidula

2022

Preprint

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Many adolescents face barriers to accessing reproductive health care even though quality reproductive health care is a fundamental human right. This qualitative analysis describes quality reproductive health requests among adolescent high school girls in Kenya. We conducted a secondary analysis of qualitative data from a sub-sample of adolescent girls in Kenya who participated in the What Women Want global campaign. The campaign utilized one open-ended survey question. We also analyzed interview data from key informants involved in the survey. We used pre-existing codes and current literature to design the coding framework and thematic analysis to describe emerging themes. Atlas. ti 8 was used to organize and analyze codes. Over 4,500 high school girls, ages 12 and 19 years, were included in the analysis, with 61.6% from all-girls boarding schools and 13.8% from mixed-day schools. Data from nine key informants complemented findings from the survey. Emerging themes included: 1) The need for improved menstrual health and hygiene: Sanitary towels and cleaner toilets; 2) Prevention of adolescent pregnancy: Access to contraception; 3) Respect and dignity: Participants want privacy and confidentiality; and 4) The need to address social determinants of health: Economic stability and a safe physical environment. This study indicated that adolescent high school girls have varied requests for reproductive health care and services. While menstrual health and hygiene are key issues, reproductive needs are beyond just sanitary products. The results suggest a need for targeted reproductive health interventions using a multi-sectoral approach.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 72%

It’s not just about pads! Adolescent reproductive health in Kenya:A qualitative secondary analysis

Ayieko

Nguku

Kidula

2022

Preprint

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“…Senegal and the United States (including New York City) adopted the first policies in 2016. The earliest initiatives were concerned with the taxation and provision of menstrual products and relevant infrastructure and were followed by additional policy developments (for more details see the S1 Table) [39]. We conducted our review at the national level and a selected region (state, county, and/or municipality) to gain insights into implementation strategies.…”

Section: Research Design and Methodologymentioning

confidence: 99%

“…Menstrual health and hygiene policies covered a range of issues, from providing menstrual products and building appropriate facilities to ending taxation of menstrual products. The predominant policy focus was on tangible and material solutions, but there was also an acknowledgments that many of the challenges related to menstruation are intangible and rooted in stigma [39]. Of the policies we reviewed, 7 out of 34-all from India and Kenya-explicitly addressed menstrual stigma.…”

Section: Findings: Awareness Raising and Educationmentioning

confidence: 99%

The persistent power of stigma: A critical review of policy initiatives to break the menstrual silence and advance menstrual literacy

Olson

Alhelou²,

Kavattur³

et al. 2022

PLOS Glob Public Health

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Menstruation is shrouded in stigma and shame—that is the common refrain in burgeoning initiatives on menstrual health and hygiene. Public policies alone cannot undo stigma and enact social change, but they do interact with social norms. They can reflect and adopt stigmatizing attitudes and, as a result, institutionalize, formalize, and legitimize stigma; or they can actively challenge and denounce it and mitigate existing discrimination. Against this background, we explored whether and how policies on menstrual health and hygiene address menstrual stigma and advance menstrual literacy based on an analysis of 34 policy documents and 85 in-depth interviews with policy-makers and advocates in four countries: India, Kenya, Senegal, and the United States. We found that policies recognized menstrual stigma and set out to break the silence surrounding menstruation and advance menstrual education, but they did not contribute to dismantling menstrual stigma. Policy-makers seemed constrained by the very stigma they sought to tackle, resulting in hesitancy and missed opportunities. Policies raised awareness of menstruation, often with great noise, but they simultaneously called for hiding and concealing any actual, visible signs of menstruation and its embodied messiness. Educational initiatives mostly promoted bodily management and control, rather than agency and autonomy. As a result, policies might have succeeded in breaking the silence around menstruation, but stigma cannot be broken as easily. We first need to recognize its (invisible) power and its impacts in all spheres of life in order to actively challenge, dismantle, and redefine it.

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“…To what extent is stigma mitigated by menstrual products, and incorporated into the notion of passing as a non-menstrual person? Stigma pertains to the normalization of prejudices, beliefs, and ideologies about menstruation that render it humiliating, shameful, or embarrassing, and reinforces the notion that women should hide the evidence of bodily fluid to claim respectability (Johnston-Robledo and Chrisler, 2013;Bobel, 2019;Alhelou et al, 2021). Technological passing is a framework that describes how women's use of menstrual products help them to pass as if they were non-menstrual (Vostral, 2008).…”

Section: Stigma and Passingmentioning

confidence: 99%

Periods and the Menstrualscape: Menstrual Products and Menstrual Manifestations in Scotland, 1870–2020

Vostral

2022

Open Library of Humanities

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The Free Provisions Act is the first national legislation of its kind to provide menstrual products at no cost to women and menstruators throughout Scotland. Yet, this did not happen by accident, and follows historical trends in technoscientific progress and social change. This essay tracks the relationship of women’s acceptance of menstrual technologies with prevailing social and political vectors in United States and Scotland. There are four significant historical moments marking technological change and adoption: the late-Victorian period and the first menstrual product commodities; the modern period marked by World War I through the 1930s that included broadly produced and advertised sanitary napkins; World War II to the mid-twentieth century and the acceptance of tampons; and the 1970s women’s rights movement including the emerging transition to menstrual cups. Within each are differing pressures exerted by both world events and internal societal changes that encourage women to adopt new products. But at moments when wage labor benefits the state, some institutions, heath providers, and educators exert pressure to disregard forms of menstrual stigma and use menstrual products instead. These shifts and movements, along with the prevailing visual culture of advertising and product branding, encompass the menstrualscape. These historical moments and the contemporary menstrualscape signal a current transition in the making, with the promotion of menstrual cups as an environmentally sustainable way to manage menstruation. This aligns with the Free Provisions Act, in which state-sponsored provision of menstrual products serve the needs of the economy, the environment, and concern for gender equity.

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‘We like things tangible:’ A critical analysis of menstrual hygiene and health policy-making in India, Kenya, Senegal and the United States

Cited by 19 publications

References 28 publications

It’s not just about pads! Adolescent reproductive health in Kenya:A qualitative secondary analysis

It’s not just about pads! Adolescent reproductive health in Kenya:A qualitative secondary analysis

The persistent power of stigma: A critical review of policy initiatives to break the menstrual silence and advance menstrual literacy

Periods and the Menstrualscape: Menstrual Products and Menstrual Manifestations in Scotland, 1870–2020

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