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Reading in the book "Growth and change" about menstruation and puberty (Tanzania)

Menstrual hygiene management (MHM) is about access to feminine hygiene products to absorb or collect menstrual blood, privacy to change the materials, and access to facilities to dispose of used menstrual management materials. Menstrual hygiene management can be particularly challenging for girls and women in developing countries, where clean water and toilet facilities are often inadequate. Menstrual waste is largely ignored in schools in developing countries, despite it being a significant problem. Menstruation can be a barrier to education for many girls, as a lack of effective sanitary products restricts girls' involvement in educational and social activities.

Terminology

An accepted definition of menstrual hygiene management (MHM) is:

  • "Women and adolescent girls use a clean material to absorb or collect menstrual blood, and this material can be changed in privacy as often as necessary for the duration of menstruation.
  • MHM also includes using soap and water for washing the body as required; and having access to facilities to dispose of used menstrual management materials."[1]

The "value chain" related to menstrual hygiene management includes four aspects: awareness, access, use as well as waste management.[2]

The term “menstrual health” is broader than menstrual hygiene. It encompasses both the menstrual hygiene management practices and the broader systemic factors that link menstruation with health, well-being, gender, education, equity, empowerment, and human rights (in particular the human right to water and sanitation).[3]

Challenges

Celebration of Menstrual Hygiene Day in Amra Padatik, India

Menstrual hygiene management can be particularly challenging for girls and women in developing countries, where clean water and toilet facilities are often inadequate. In addition, traditional cultures make it difficult to discuss menstruation openly. This limits women’s and adolescent girls’ access to relevant and important information about the normal functions of their own body. This directly affects their health, education and dignity. Access to information can be considered a human right.[4][5]

Currently there are about 3.73 billion women in the world. According to the World Health Organization (WHO), 52% , or 1.9 billion, of those women are of reproductive age, thus menstruating (WHO,2018)[6]. Women at some point in their life will go thru the reproductive age and thus, will experience menstruation. In 2016, Loughnan, Libbet C., Rob Bain, Rosemary Rop, Marni Sommer, and Tom Slaymaker.[7] discussed findings by the Water Supply and Sanitation Council (WSSCC) having estimated that daily 300 million women are menstruating. One average according to the WSSCC, a women will spend about 3,500 days during their life menstruating.

Many young girls and women of menstruating age live in poor socio-economic environments. WIlber, Torondel,Hameed, Mahon and Kuper (2019) [8] state that 663 million people lack basic access to safe water and 2.4 billion people lack adequate access to basic sanitary conditions. For women and girls, the lack of safe, accessible water, sanitation and hygiene (WASH) is particularly troubling during menstruation and child birth. According to data collected and reported on, Loughnan (2017)[9] points out that half a billion (or 13%) of women lacked a place to defecate, have little to no privacy for menstrual hygiene management (MHM) and 3/4 of those lacked access to soap and water.

In a 2014 study conducted in India, the researchers found that as many as 42% of women who participated in the study did not know about sanitary pads or from where in their anatomy menstruation originated. "Most of them were scared or worried on first menstruation."[10] Worldwide, in 2018, one in three women does not have access to a working toilet at all.[11] Menstrual hygiene management issues have been ignored by professionals in the water, sanitation and hygiene (WASH) sector, and in the health and education sectors, too.[12][13]

School toilets for girls in Tanzania, if they exist, often have no facilities to dispose of pads.
Celebration of Menstrual Hygiene Day in Bangladesh

Health and psycho-social aspects

Poor MHM may affect the reproductive tract but the specific infections, the strength of effect, and the route of transmission, remain unclear.[13] In India, a majority of girls are at risk for reproductive tract infections (RTI) because of poor MHM and RTI can lead to various disabilities if not treated early on.[14] Reproductive tract infections are the cause of 30–50% of prenatal infection.[15] Due to prejudices surrounding the issue, some women in India do not eat or take showers during their menstruation.[16]

Girls' self-image may be negatively impacted by adverse attitudes towards menstruation.[17][18]

Sanitation facilities at schools

In many parts of sub-Saharan Africa, girls can miss up to 5 days of school a month or drop out entirely due to insufficient access to water, sanitation and hygiene (WASH) facilities and menstrual hygiene products.[19][20] Improving access to WASH facilities can actually increase girls' attendance at school. A program for school sanitation in Bangladesh increased girls' enrollment at school by 11%.[21]

Menstrual waste is largely ignored in schools in developing countries, despite it being a significant problem. Girls' access to water and sanitation at school is only available at 47% and 46% of all schools globally.[4] Often, school toilets for girls (if they even exist) are missing bins for menstrual waste collection with the result that pads may be spread all around the school compound area.[22] This pollutes the environment and also causes embarrassment for the school girls.

In the United States, among other countries, girls who are unable to afford feminine hygiene products may miss school in order "to avoid the embarrassment of staining their clothes."[23]

Access to materials

In low-income countries, girls’ choices of menstrual hygiene materials are often limited by the costs, availability and social norms.[24][25]

A lack of affordable hygiene products means inadequate, unhygienic alternatives are used, which can present a serious health risk.[26][27] Menstrual cups offer a long-term solution compared to some other feminine hygiene products because they do not need to be replaced monthly. The quality of the material also makes them a reliable and healthy menstrual hygiene solution, as long as there is access to clean water for washing them.

Girls and women in the workplace often miss work because they don't have access to sanitary materials and places of employment in some countries don't provide resources for women or even have "proper toilets."[18] Women in Bangladesh who work in factories have reported that due to the cost of sanitary products for menstruation which they could not afford, they have resorted to using "factory-floor rags in place of pads and tampons, leading to dangerous infections and missed work."[28]

Menstruation can be a barrier to education for many girls, as a lack of effective sanitary products restricts girls' involvement in educational and social activities.[29][30] Often they do not attend school due to fear of leaking, shame or embarrassment, period pain or inadequate sanitation facilities that do not allow them to wash or change in privacy.[31] This applies mainly to schoolgirls from low-income families, since disposable hygiene products are a monthly expense that many females simply cannot afford.[32]

Adequate sanitation facilities and access to menstrual hygiene products are just one part of the solution to menstrual taboos that impede women's progress in many developing countries. Knowledge is critical for girls to feel comfortable with menstruation and to gain a positive awareness of their bodies.[33]

U.S. and UK

Even many low-income and/or homeless girls and women in the inner cities of the United States cannot afford sanitary supplies.[23][34] Food Banks in New York report that feminine hygiene products are in high demand.[23] Homeless women in the United States face the challenge of not being able to shower or use the communal toilet in homeless shelters as often as they need to in cases where there are restrictions on toilet usage.[34] In New York, proposals to help lower income women access menstrual sanitary supplies includes proposals to remove the sales tax on feminine hygiene products and "distributing free tampons in public schools."[23] Sales tax are levied on menstrual supplies in 36 states.[35] On May 1, 2018 The National Diaper Bank Network, which provides millions of diapers to poor and low income parents and advocates for policy change around basic needs, launched the Alliance for Period Supplies and began distributing free period products through allied organizations across the U.S.[36] Homeless women in other industrialized countries, such as the United Kingdom, face problems affording tampons and sanitary napkins.[37]

Taboos

Main article: Culture and menstruation

Despite the fact that menstruation is a healthy biological process, it is approached with hesitance and misinformation because of deeply-rooted cultural taboos surrounding menstruation.

Cultural, religious and traditional beliefs — particularly in developing countries — can lead to restrictions that women or girls face during their period. In some societies, women do not wash their bodies, shower or bathe during menstruation. They may not be allowed to use water sources during menstruation. Even if they have access to toilets, they might not use them because of the fear of staining the toilet bowls (in the case of dry toilets or flush toilets where the flush is not powerful).[32] This impairs the use of menstrual cups compared to pads as the cups are normally emptied into toilets.

Expanding the discussion to include consideration of waste management is part of the attempt to "normalize" conversations about menstruation.[2]

History

In 2012, several important groups involved in public health began to break the silence on MHM and turn their attention to the issue globally, including grassroots organizers, social entrepreneurs and United Nations agencies.[4]

In May 2013, WASH United used a 28-day social media campaign, for example on Twitter, called "May #MENSTRAVAGANZA" to generate awareness about menstruation and MHM as important considerations within water, sanitation and hygiene (WASH) development initiatives.[38][39] Those involved with the social media campaign, including WASH Advocates, Girls' Globe and Ruby Cup, were encouraged by the positive feedback for the "May #MENSTRAVAGANZA" and they decided to create a global awareness day for menstruation.[39]

On 28 May 2014, many people around the world celebrated Menstrual Hygiene Day for the first time with rallies, exhibitions, movie screenings, workshops and speeches.[40] There were 145 partners involved with the first MHD.[39][41]

For 2015, a hashtag campaign on social media lent a light-hearted look at challenging societal norms with the tag #IfMenHadPeriods.[42] The campaign by WaterAid, released in time for Menstrual Hygiene Awareness Day, created videos "spoof ads" where men are proud of having their periods and used "Manpons" instead of tampons.[42][43] The campaign helped "raise awareness about women who don't have access to 'safe water, hygiene and sanitation,' when their monthly visitor comes along."[43] Another aspect of the campaign is that it helped bring men into the conversation so that they could "help tackle the stigma in largely patriarchal societies and encourage women and girls to embrace their cycle with pride instead of shame."[28] In Uganda, 2015 celebrations kicked off with a march to Parliament where a charter on MHM was signed and then the march continued to the National theatre for presentations by primary and secondary schools.[20]

See also


References

  1. ^ UNICEF, Columbia University (2012). WASH in Schools - Empowers Girls' Education - Proceedings of Menstrual Hygiene Management in Schools Virtual Conferences. UNICEF and Columbia University, USA, p. 2
  2. ^ a b "Normalizing Menstruation: Pushing the Boundaries of the MHM dialogue in India" (PDF). {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  3. ^ Keith, B. (2016). Girls’ and women’s right to menstrual health: Evidence and opportunities - Outlook on reproductive health. PATH, Seattle, USA, ISSN 0737-3732
  4. ^ a b c Sommer, Marni; Hirsch, Jennifer; Nathanson, Constance; Parker, Richard G. (July 2015). "Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue". American Journal of Public Health. 105 (7): 1302–1311=. doi:10.2105/AJPH.2014.302525. PMC 4463372. PMID 25973831.
  5. ^ Imran, Myra (29 May 2015). "World Menstrual Hygiene Day Observed". The International News. Retrieved 29 June 2015.
  6. ^ World Health Organization. (2018). Retrieved from:http://www.euro.who.int/en/health- topics/Life-stages/sexual-and-reproductive-health/news/news/2018/11/tackling- the-taboo-of-menstrual-hygiene-in-the-european-region
  7. ^ Loughnan, Libbet C., Rob Bain, Rosemary Rop, Marni Sommer, and Tom Slaymaker. "What Can Existing Data on Water and Sanitation Tell Us About Menstrual Hygiene Management?" Waterlines 35.3 (2016): 228-44. Web.
  8. ^ Wilbur, Jane; Torondel, Belen; Hameed, Shaffa; Mahon, Thérèse; Kuper, Hannah (2019). "Systematic review of menstrual hygiene management requirements, its barriers and strategies for disabled people". PLOS ONE. 14 (2): e0210974. Bibcode:2019PLoSO..1410974W. doi:10.1371/journal.pone.0210974. PMC 6365059. PMID 30726254.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  9. ^ Loughnan, Libbet. (2017, April ,17). Retrieved from: https://blogs.worldbank.org/water/lack-access- toilet-and-handwashing-materials-hits-women-and-girls-hardest-especially-when
  10. ^ Arumugam, Balaji; Nagalingam, Saranya; Varman, Priyadharshini Mahendra; Ravi, Preethi; Ganesan, Roshni (2014). "Menstrual Hygiene Practices: Is it Practically Impractical?". International Journal of Medicine and Public Health. 4 (4): 472–476. doi:10.4103/2230-8598.144120.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  11. ^ Bax, Tahmeena (28 May 2014). "Menstruation Misery for Schoolgirls as Sanitation Woes Hit Hopes for the Future". The Guardian. Retrieved 29 June 2015.
  12. ^ House, S., Mahon, T., Cavill, S. (2012). Menstrual hygiene matters - A resource for improving menstrual hygiene around the world. Wateraid, UK, p.8
  13. ^ a b Sumpter, Colin; Torondel, Belen; RezaBaradaran, Hamid (26 April 2013). "A Systematic Review of the Health and Social Effects of Menstrual Hygiene Management". PLOS ONE. 8 (4): e62004. Bibcode:2013PLoSO...862004S. doi:10.1371/journal.pone.0062004. PMC 3637379. PMID 23637945.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  14. ^ Juyal, R.; Kandpal, S.D.; Semwal, J. (April 2014). "Menstrual Hygiene and Reproductive Morbidity in Adolescent Girls in Dehradun, India". Bangladesh Journal of Medical Science. 13 (2): 170–174. doi:10.3329/bjms.v13i2.14257.
  15. ^ Garg, R.; Goyal, S.; Gupta, S. (2012). "India Moves Towards Menstrual Hygiene: Subsidized Sanitary Napkins for Rural Adolescent Girls—Issues and Challenges" (PDF). Maternal Child and Health Journal. 16 (4): 170–174. doi:10.1007/s10995-011-0798-5. PMID 21505773. Retrieved 30 March 2017.
  16. ^ Tomar, Shruti (31 May 2015). "The Periodic Misogyny of Tribal Madhya Pradesh". Hindustan Times. Retrieved 29 June 2015 – via Newspaper Source.
  17. ^ Gultie, Teklemariam; Hailu, Desta; Workineh, Yinager (30 September 2014). "Age of Menarche and Knowledge about Menstrual Hygiene Management among Adolescent School Girls in Amhara Province, Ethiopia: Implication to Health Care Workers & School Teachers". PLOS ONE. 9 (9): e108644. doi:10.1371/journal.pone.0108644. PMC 4182550. PMID 25268708.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  18. ^ a b Sadeque, Syeda Samira (31 May 2015). "Talking Menstruation: About Time?". Dhaka Tribune. Retrieved 29 May 2015.
  19. ^ Bosco, Ijoo (29 May 2014). "E. Equatoria Marks Global Menstrual Hygiene Day". Sudan Tribune. Retrieved 29 June 2015 – via Newspaper Source.
  20. ^ a b Amme, Grace (28 May 2015). "Uganda Celebrates Menstrual Hygiene Day". Uganda Radio Network. Retrieved 29 June 2015.
  21. ^ Domestos; WaterAid; WSSCC. We Can't Wait: A Report on Sanitation and Hygiene for Women and Girls (PDF). World Toilet Day. p. 7.
  22. ^ Kjellén, M., Pensulo, C., Nordqvist, P., Fogde, M. (2012). Global review of sanitation systems trends and interactions with menstrual management practices - Report for the menstrual management and sanitation systems project. Stockholm Environment Institute (SEI), Stockholm, Sweden, p. 25
  23. ^ a b c d De Bode, Lisa (17 June 2015). "New York City Wants to Provide Free Tampons to Address Menstruation Stigma". Al Jazeera America. Retrieved 1 July 2015.
  24. ^ UNESCO (2014). Puberty Education & Menstrual Hygiene Management - Good Policy and Practice in health Education - Booklet 9. United Nations Educational, Scientific and Cultural Organization, Paris, France, p. 32
  25. ^ Kaur, Rajanbir; Kaur, Kanwaljit; Kaur, Rajinder (2018). "Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries". Journal of Environmental and Public Health. 2018: 1730964. doi:10.1155/2018/1730964. ISSN 1687-9805. PMC 5838436. PMID 29675047.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  26. ^ African Population and Health Research Center (APHRC). Experiences and Problems with Menstruation Among Poor Women and Schoolgirls in Nairobi. In: Policy Brief No. 20. Nairobi, Kenya: APHRC, 2010.
  27. ^ Obiria M. Kenyan students could solve sanitary problem with banana-fibre pad. The Guardian. https://www.theguardian.com/global-development/2014/sep/26/kenyan-girls-sanitary-problem-banana-fibre-pad. 26 Sep 2014.
  28. ^ a b Cowan, Samantha (28 May 2015). "Ditch the Euphemisms: Menstrual Hygiene Day Calls Out Period Taboos". TakePart. Retrieved 29 June 2015.
  29. ^ UNESCO (2014). Puberty education & menstrual hygiene management - good policy and practice in health education - Booklet 9. Paris, France: United Nations Educational, Scientific and Cultural Organization (UNESCO).
  30. ^ Montgomery P, Ryus CR, Dolan CS, et al. (2012). "Sanitary pad interventions for girls' education Ghana: A pilot study". PLOS ONE. 7 (10): e48274. Bibcode:2012PLoSO...748274M. doi:10.1371/journal.pone.0048274. PMC 3485220. PMID 23118968.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  31. ^ Crofts, T. (2012). Menstruation hygiene management for schoolgirls in low-income countries. Loughborough: Water, Engineering and Development Center (WEDC), Loughborough University.
  32. ^ a b House, S.; Mahon, T.; Cavill, S. (2012). "Menstrual hygiene matters. A resource for improving menstrual hygiene around the world". London: WaterAid.
  33. ^ Kirk, J.; Sommer, M. (2006): Menstruation and Body Awareness. Linking Girls Health With Girls Education Archived 2015-02-26 at the Wayback Machine. Royal Tropical Institute (KIT), Amsterdam
  34. ^ a b Goldberg, Eleanor (14 January 2015). "For Homeless Women, Getting Their Period Is One of the Difficult Challenges". The Huffington Post. Retrieved 1 July 2015.
  35. ^ "More States Move To End 'Tampon Tax' That's Seen As Discriminating Against Women". NPR.org. Retrieved 2018-05-22.
  36. ^ Pollitt, Katha (2018-05-10). "Are We Finally Getting Over the Belief That Periods Are Embarrassing?". The Nation. ISSN 0027-8378. Retrieved 2018-05-22.
  37. ^ Isaac, Anna (5 June 2015). "The Homeless Period: It Doesn't Bear Thinking About and That's the Problem". The Guardian. Retrieved 29 May 2015.
  38. ^ "FAQ". Menstrual Hygiene Day. Archived from the original on 3 July 2015. Retrieved 29 June 2015. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  39. ^ a b c Keiser, Danielle (27 May 2014). "Menstrual Hygiene Day: A Milestone for Women and Girls Worldwide". Impatient Optimists. Bill & Melinda Gates Foundation. Retrieved 29 June 2015.
  40. ^ "'Menstrual Hygiene Day 2015 Observed in Kohima". Nagaland Post. 31 May 2015. Retrieved 29 June 2015.
  41. ^ Gyesi, Zadok Kwame (2 June 2015). "'Do Away With Taboos Surrounding Menstruation'". Graphic. Retrieved 29 June 2015.
  42. ^ a b Kentish, Francesca (27 May 2015). "Is #IfMenHadPeriods the Best Campaign Ever?". Metro.co.uk. Retrieved 29 June 2015.
  43. ^ a b Masculino, Maria Leonila (31 May 2015). "New Spoof Ad Shows Men Having Menstrual Periods". Food World News. Retrieved 29 June 2015.

External links

Retrieved from "https://en.wikipedia.org/w/index.php?title=Menstrual_hygiene_management&oldid=901608781"