Advancing the measurement agenda for menstrual health and hygiene interventions in low- and middle-income countries

Sommer, Marni, Zulaika, Garazi, Schmitt, Margaret L, Khandakji, Samantha and Phillips-Howard, Penelope ORCID: https://orcid.org/0000-0003-1018-116X (2020) 'Advancing the measurement agenda for menstrual health and hygiene interventions in low- and middle-income countries'. Journal of Global Health, Vol 10, Issue 1, e010323.

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Abstract

The issue of menstrual health has gained significant traction in recent years as a fundamental aspect of public health, with significant relevance in low- and middle-income countries (LMIC) [1]. Research, practice, and policy addressing menstrual hygiene management (MHM) engages a growing number of actors, including researchers, practitioners, donors, policy makers, social entrepreneurs, national governments, advocates, and civil society. Globally, these actors work to address the social, environmental, and political factors that reinforce menstruation-related challenges experienced by girls and women in varying contexts.

To date, the largest body of evidence in the space collectively referred to here as menstrual health and hygiene (MHH) originates from descriptive qualitative and quantitative studies among girls in school, exploring the barriers they face with the onset of menstruation [2,3]. These challenges often reflect the insufficient education and guidance girls receive prior to their first menstrual period (menarche) from their families, communities or the education system. Other barriers are tied to the on-going stigma and taboos relating to menstruation that reinforce the need for secrecy and silence on menstrual management and enforce behavioral restrictions around (1) sleeping arrangements, (2) engaging in prayers or household chores, and (3) school participation. Additionally, inadequate access to clean and safe toilets with water, lacking disposal mechanisms for used menstrual materials, and inadequate menstrual products and related supplies, such as underwear, leave girls with limited agency to manage their menstrual periods [3].

In recent years, additional evidence has emerged from pilot intervention trials conducted with schoolgirls that have assessed the impact of the delivery of menstrual products and information on sexual and reproductive health outcomes, and educational performance [4,5]. There is an urgent need to rigorously assess the impact of the many MHH interventions currently being deployed in numerous LMIC. Another emerging area is humanitarian contexts, with researchers and practitioners focusing on the MHH needs of the over 30 million internally displaced and refugee girls and women around the world, and how to more effectively deliver holistic MHH solutions in such contexts [6]. Additional MHH learnings are needed in countries and contexts where the menstruation-related challenges facing girls have not yet been explored, and although some studies have included the MHH needs of out of school girls [7] and girls with disabilities [8], these are areas in need of additional exploration.

Item Type:	Article
Subjects:	WA Public Health > WA 20.5 Research (General) WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WP Gynecology > Anatomy. Diseases. Injuries > WP 400 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.7189/jogh.10.010323
Depositing User:	Cheryl Giddings
Date Deposited:	04 May 2020 13:08
Last Modified:	14 Dec 2021 15:59
URI:	https://archive.lstmed.ac.uk/id/eprint/14377

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