Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue

Sommer, Marni; Hirsch, Jennifer S.; Nathanson, Constance A.; Parker, Richard

doi:10.2105/ajph.2014.302525

Cited by 233 publications

(219 citation statements)

References 22 publications

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“…[33] They also support the provision of menstrual absorbents and information about menstruation as effective avenues for intervention. It should be noted, however, that the effective and hygienic management of menstruation requires more than knowledge or reusable absorbents.…”

Section: Discussionmentioning

confidence: 92%

“…Increasingly governments, charities, and development organisations have sought to target menstruation as a barrier to school attendance. [31–33] However, there is sparse evidence for the effectiveness of such interventions. [34] The first randomised controlled trial, conducted in Nepal, used girls’ menstrual calendars (self-kept) and attendance records to estimate that only 0.4 days in 180 were missed due to menstruation.…”

Section: Introductionmentioning

confidence: 99%

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Menstruation and the Cycle of Poverty: A Cluster Quasi-Randomised Control Trial of Sanitary Pad and Puberty Education Provision in Uganda

et al. 2016

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BackgroundPoor menstrual knowledge and access to sanitary products have been proposed as barriers to menstrual health and school attendance. In response, interventions targeting these needs have seen increasing implementation in public and private sectors. However, there has been limited assessment of their effectiveness.ObjectivesAssess the impact of providing reusable sanitary pads and puberty education on girls’ school attendance and psychosocial wellbeing outcomes.MethodsA cluster quasi-randomised controlled trial was conducted across 8 schools, including 1124 girls, in rural Uganda. Schools were allocated to one of four conditions: the provision of puberty education alone; reusable sanitary pads alone; puberty education and reusable sanitary pads; and a control (no intervention). The primary outcome was school attendance. Secondary outcomes reflected psychosocial wellbeing.ResultsAt follow-up, school attendance had worsened for girls across all conditions. Per-protocol analysis revealed that this decline was significantly greater for those in the control condition d = 0.52 (95%CI 0.26–0.77), with those in control schools having a 17.1% (95%CI: 8.7–25.5) greater drop in attendance than those in any intervention school. There were no differences between the intervention conditions. High rates of school drop-out and transfer meant the trial suffered from substantial participant drop-out. Intention-to-treat analyses using two different imputation strategies were consistent with the main results, with mean differences of 5.2% attendance in best-case and 24.5% in worst-case imputations. Results were robust to adjustments for clustering. There was no impact of the interventions on girls’ self-reported shame or insecurity during menstruation.ConclusionResults of the trial support the hypothesised positive impact of providing sanitary pads or puberty education for girls’ school attendance in a developing country context. Findings must be interpreted with caution in light of poor participant retention, intervention fidelity, and the attendance measures used.Trial RegistrationPan African Clinical Trials Registry PACTR201503001044408

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Menstruation and the Cycle of Poverty: A Cluster Quasi-Randomised Control Trial of Sanitary Pad and Puberty Education Provision in Uganda

et al. 2016

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“…Despite recent momentum and a codified definition of what menstrual hygiene management (MHM) necessitates (see Box 1), a lack of adequate guidance on MHM; poor quality and an inadequate supply of water, disposal facilities, and privacy for changing in many schools continue to leave girls with limited options for safe and proper personal hygiene (8–14). In addition, a lack of adequate sanitary hygiene products forces some girls to use unhygienic materials (11, 13, 15, 16), potentially increasing urogenital symptoms and infections (17).…”

Section: Introductionmentioning

confidence: 99%

Menstrual hygiene management among adolescent schoolgirls in low- and middle-income countries: research priorities

Phillips-Howard

Caruso

Torondel

et al. 2016

Global Health Action

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BackgroundA lack of adequate guidance on menstrual management; water, disposal, and private changing facilities; and sanitary hygiene materials in low- and middle-income countries leaves schoolgirls with limited options for healthy personal hygiene during monthly menses. While a plethora of observational studies have described how menstrual hygiene management (MHM) barriers in school impact girls’ dignity, well-being, and engagement in school activities, studies have yet to confirm if inadequate information and facilities for MHM significantly affects quantifiable school and health outcomes influencing girls’ life chances. Evidence on these hard outcomes will take time to accrue; however, a current lack of standardized methods, tools, and research funding is hampering progress and must be addressed.ObjectivesCompile research priorities for MHM and types of research methods that can be used.ResultsIn this article, we highlight the current knowledge gaps in school-aged girls’ MHM research, and identify opportunities for addressing the dearth of hard evidence limiting the ability of governments, donors, and other agencies to appropriately target resources. We outline a series of research priorities and methodologies that were drawn from an expert panel to address global priorities for MHM in schools for the next 10 years.ConclusionsA strong evidence base for different settings, standardized definitions regarding MHM outcomes, improved study designs and methodologies, and the creation of an MHM research consortia to focus attention on this neglected global issue.

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“…Women's attitudes towards menstruation are complex and need to be explored in the context of their lived experiences (Chothe et al ., 2014;Kumar & Srivastava, 2011;Sommer, Hirsch, Nathanson, & Parker, 2015;Wong & Khoo, 2011) . The present study focused on investigating the attitudes and experiences regarding menstruation among a sample of young women attending a historically disadvantaged 1 South African university that predominantly caters to students from black communities.…”

Section: Introductionmentioning

confidence: 99%

The menstruation experience: Attitude dimensions among South African students

Padmanabhanunni

Fennie

2017

Journal of Psychology in Africa

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This study aimed to investigate the attitudes and experiences regarding menstruation among undergraduate women at a historically disadvantaged South African university. A total of 255 women participated in the study. The majority of participants were black women (coloured = 55%; African = 29 .2%). They responded to the Menstrual Attitudes Questionnaire (MAQ) and a demographic questionnaire. Data were analysed using descriptive statistics and ANOVA with post-hoc tests. The majority of women in the study (78%) had positive attitudes towards menstruation, viewing it as a natural event that can be anticipated and predicted. However, many of the women (51-58%) perceived it as debilitating and bothersome to everyday living. Menstruation was perceived by women as impacting on participation and performance in higher education, suggesting that the provision of tertiary education for previously disadvantaged groups needs to consider the needs of women who experience difficulty managing menstruation. The provision of material resources, education in self-care strategies and distribution of information to normalise menstruation may assist the adverse impact of menstruation on their higher education experience .

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Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue

Cited by 233 publications

References 22 publications

Menstruation and the Cycle of Poverty: A Cluster Quasi-Randomised Control Trial of Sanitary Pad and Puberty Education Provision in Uganda

Menstruation and the Cycle of Poverty: A Cluster Quasi-Randomised Control Trial of Sanitary Pad and Puberty Education Provision in Uganda

Menstrual hygiene management among adolescent schoolgirls in low- and middle-income countries: research priorities

The menstruation experience: Attitude dimensions among South African students

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