Feasibility Study of a Menstrual Hygiene Management Intervention for People with Intellectual Impairments and Their Carers in Nepal

Abstract

Background: The Bishesta campaign is a menstrual hygiene management (MHM) intervention developed to meet the specific needs of people with intellectual impairments and their carers. It was designed and delivered in the Kavre district, Nepal. This paper explores the campaign’s feasibility and acceptability. Methods: The Bishesta campaign was delivered to ten people with an intellectual impairment and their eight carers. Data on the feasibility and acceptability of the intervention was collected through: Structured questionnaire to participants before and after the intervention, process monitoring data, post-intervention in-depth interviews with all carers, observation of people with intellectual impairments, key informant interviews with all facilitators and staff involved in the campaign, as well as ranking of the perceived appropriateness and acceptability of campaign components by carers and facilitators. Results: The Bishesta campaign was acceptable for the target groups, facilitators, and implementers. It was largely delivered with fidelity. Participants used most of the campaign components; these made the target behaviours attractive and enabled participants to carry them out with ease. There were improvements across all target behaviours. The focus of this study was feasibility, not limited-efficancy; however, indicative positive outcomes from this small sample were observed, such as an increase in young people’s levels of confidence, comfort, and autonomy during menstruation. Conclusion: Within the sample, the Bishesta campaign appears to be a feasible intervention to ensure that one of the groups most vulnerable to exclusion from MHM interventions is not left behind.

‘Flower of the body’: menstrual experiences and needs of young adolescent women with cerebral palsy in Bangladesh, and their mothers providing menstrual support

“…More than half of participants in the present study reported intellectual impairment; previous research indicates that with support women with intellectual impairment(s) and/or high support needs can understand and accept their menstruation [2,23] however, this is best achieved via the provision of menstrual education in the years leading up to menarche allowing time for knowledge acquisition and practice [12], and if the teaching tools and approaches are adapted to meet participants specific learning needs [31]. Menstrual interventions in Bangladesh for young adolescent women with CP and their mothers need to address these considerations and the conflicting requirement of menarche as a pathway to knowledge, as well as be physically, financially and socially accessible and inclusive.…”

Barriers to Menstrual Hygiene Management Faced by Adolescents and Young People with a Disability, and their Carers in the Kavrepalanchok District, Nepal

“…This can negatively affect carer's wellbeing, which in turn could impact on the person they support (5). As a result of this research, we developed, delivered and evaluated the Bishesta campaign: a MHM behaviour change intervention for people with intellectual impairments and their carers in Nepal (33,52). It promotes communication between young people and carers about what menstruation is, and how to manage it hygienically and with dignity.…”

Water, women and disability: Using mixed-methods to support inclusive WASH programme design in Vanuatu

“…Among people with disabilities, a limited evidence base suggests that older people, people with more significant activity limitations and those with mobility or self-care limitations are most likely to face WASH barriers [ [1] , [2] , [3] , 8 , 9 ]. In addition, people who experience incontinence, and women and girls who menstruate (see Table 1 for definitions of key terms), may have further unmet requirements for water and adequate WASH facilities [10] , [11] , [12] .…”