What’s missing in MHM? Moving beyond hygiene in menstrual hygiene management

Thomson, Jennifer; Amery, Fran; Channon, Melanie; Puri, Mahesh

doi:10.1080/26410397.2019.1684231

Cited by 34 publications

(35 citation statements)

References 6 publications

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“…For instance, a survey conducted in Achham [ 1 ] reported a slightly low prevalence (72%) of Chhaupadi among Adolescent girls. Consistent with the findings of this study, another study conducted in the adjoining Dailekh district [ 23 ] reported 77% of women and girls practising Chhaupadi despite 60% of surveyed girls knowing Chhaupadi was illegal [ 48 ]. However, studies conducted in other parts of Nepal have reported lower prevalence [ 7 , 29 , 49 ].…”

Section: Discussionsupporting

confidence: 89%

A harmful religio-cultural practice (Chhaupadi) during menstruation among adolescent girls in Nepal: Prevalence and policies for eradication

Thakuri¹,

Thapa²,

Singh³

et al. 2021

PLoS ONE

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Background Chhaupadi is a deeply rooted tradition and a centuries-old harmful religio-cultural practice. Chhaupadi is common in some parts of Karnali and Sudurpaschim Provinces of western Nepal, where women and girls are considered impure, unclean, and untouchable in the menstrual period or immediately following childbirth. In Chhaupadi practice, women and girls are isolated from a range of daily household chores, social events and forbidden from touching other people and objects. Chhaupadi tradition banishes women and girls into menstruation huts’, or Chhau huts or livestock sheds to live and sleep. These practices are guided by existing harmful beliefs and practices in western Nepal, resulting in poor menstrual hygiene and poor physical and mental health outcomes. This study examined the magnitude of Chhaupadi practice and reviewed the existing policies for Chhaupadi eradication in Nepal. Methods We used both quantitative survey and qualitative content analysis of the available policies. First, a quantitative cross-sectional survey assessed the prevalence of Chhaupadi among 221 adolescent girls in Mangalsen Municipality of Achham district. Second, the contents of prevailing policies on Chhaupadi eradication were analysed qualitatively using the policy cube framework. Results The current survey revealed that most adolescent girls (84%) practised Chhaupadi in their most recent menstruation. The Chhaupadi practice was high if the girls were aged 15–17 years, born to an illiterate mother, and belonged to a nuclear family. Out of the girls practising Chhaupadi, most (86%) reported social and household activities restrictions. The policy content analysis of identified higher-level policy documents (constitution, acts, and regulations) have provisioned financial resources, ensured independent monitoring mechanisms, and had judiciary remedial measures. However, middle (policies and plans) and lower-level (directives) documents lacked adequate budgetary commitment and independent monitoring mechanisms. Conclusion Chhaupadi remains prevalent in western Nepal and has several impacts to the health of adolescent girls. Existing policy mechanisms lack multilevel (individual, family, community, subnational and national) interventions, including financial and monitoring systems for Chhaupadi eradication. Eradicating Chhaupadi practice requires a robust multilevel implementation mechanism at the national and sub-national levels, including adequate financing and accountable systems up to the community level.

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Section: Discussionsupporting

confidence: 89%

A harmful religio-cultural practice (Chhaupadi) during menstruation among adolescent girls in Nepal: Prevalence and policies for eradication

Thakuri¹,

Thapa²,

Singh³

et al. 2021

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Menstrual hygiene was also included in the recent Lancet-Guttmacher definition of reproductive health. 10 , 51 As the field has grown, however, there is a recognised need for new terminology that (1) avoids unintentionally reinforcing menstruation as dirty or impure, which has been voiced as a critique of “hygiene” terminology, 5 , 52 (2) goes beyond the care of menstrual bleeding to include the many social and psychological components of menstrual experience, as well as needs related to health and social inclusion, and (3) is inclusive of gender-diverse populations. 6 The term “menstrual health” has been used by a range of stakeholders in the absence of a self-contained or established definition.…”

Section: Discussionmentioning

confidence: 99%

Menstrual health: a definition for policy, practice, and research

Hennegan

Winkler

Bobel

et al. 2021

Sexual and Reproductive Health Matters

175

157

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The term “menstrual health” has seen increased use across advocacy, programming, policy, and research, but has lacked a consistent, self-contained definition. As a rapidly growing field of research and practice a comprehensive definition is needed to (1) ensure menstrual health is prioritised as a unified objective in global health, development, national policy, and funding frameworks, (2) elucidate the breadth of menstrual health, even where different needs may be prioritised in different sectors, and (3) facilitate a shared vocabulary through which stakeholders can communicate across silos to share learning. To achieve these aims, we present a definition of menstrual health developed by the Terminology Action Group of the Global Menstrual Collective. We describe the definition development process, drawing on existing research and terminology, related definitions of health, and consultation with a broad set of stakeholders. Further, we provide elaboration, based on current evidence, to support interpretation of the definition.

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“…A study conducted in the Central Development Region, where this study was conducted, showed that in the aftermath of the 2015 earthquake, menstrual hygiene management was rated as the sixth highest overall need by study participants (after food, shelter, water, clothes and information about family members) [14,15]. Thomson and colleagues [16] emphasized the need to reframe menstrual hygiene management as a question of rights as opposed to hygiene, acknowledging that a wide range of issues linked to menstruation beyond hygiene, e.g. security, stigma, safety, taboo and policy ownership.…”

Section: Introductionmentioning

confidence: 93%

Acceptability and feasibility of using vaginal menstrual cups among schoolgirls in rural Nepal: a qualitative pilot study

et al. 2021

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Introduction Menstrual hygiene management can be challenging in low-income settings and among school-aged girls due to traditional beliefs, lack of knowledge and information on best hygienic practices, and limited access to appropriate and affordable menstrual hygiene products. An alternative method for menstrual hygiene management, instead of sanitary pads or tampons, is the vaginal menstrual cup. As evidence on the use of menstrual cups is relatively limited, this study aimed to explore the acceptability and feasibility of using vaginal menstrual cups among school-aged girls in Thokarpa, Sindupalchowk, Nepal. Methods This is an exploratory study based on four focus group discussions with a purposive sample of 28 schoolgirls between 13 and 19 years of age who were provided with vaginal menstrual cups in Thokarpa, Sindupalchowk, Nepal. The data were collected between February and March 2019, i.e. approximately three months after the distribution of the menstrual cup. Participants were included in the study if they had started their menstruation and never given birth. Conventional content analysis was applied. Results Most participants perceived the menstrual cup positively. Not missing a single class in school due to problems related to menstrual hygiene management was described as a major benefit. The participants found using the menstrual cup easy and convenient, and described economic and environmental advantages of using it. Cleaning the menstrual cup did not cause any problems, according to the participants. Discomforts mentioned by the participants were: pain when inserting the menstrual cup, feeling the menstrual cup sticking out of the vagina, feeling a constant urge to urinate and leakage. Concerns were related to the size, shape and texture of the menstrual cup, and that it may “get stuck” in the vagina, while relatives were said to be concerned about the use of the menstrual cup leading to reduced fertility or losing virginity. Conclusion The use of vaginal menstrual cups for menstrual hygiene management among schoolgirls in Thokarpa, Sindupalchowk, Nepal, appears feasible and acceptable, as it involves practical, economic and environmental advantages. However, the scale-up of menstrual cups will require resolving described concerns and discomforts and fostering peer and family support.

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What’s missing in MHM? Moving beyond hygiene in menstrual hygiene management

Cited by 34 publications

References 6 publications

A harmful religio-cultural practice (Chhaupadi) during menstruation among adolescent girls in Nepal: Prevalence and policies for eradication

A harmful religio-cultural practice (Chhaupadi) during menstruation among adolescent girls in Nepal: Prevalence and policies for eradication

Menstrual health: a definition for policy, practice, and research

Acceptability and feasibility of using vaginal menstrual cups among schoolgirls in rural Nepal: a qualitative pilot study

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