Menstrual hygiene management among women and adolescent girls in the aftermath of the earthquake in Nepal

Abstract

BackgroundMenstrual hygiene management (MHM) is an essential aspect of hygiene for women and adolescent girls between menarche and menopause. Despite being an important issue concerning women and girls in the menstruating age group MHM is often overlooked in post-disaster responses. Further, there is limited evidence of menstrual hygiene management in humanitarian settings. This study aims to describe the experiences and perceptions of women and adolescent girls on menstrual hygiene management in post-earthquake Nepal.MethodsA mixed methods study was carried out among the earthquake affected women and adolescent girls in three villages of Sindhupalchowk district of Nepal. Data was collected using a semi-structured questionnaire that captured experiences and perceptions of respondents on menstrual hygiene management in the aftermath of the Nepal earthquake. Quantitative data were triangulated with in-depth interview regarding respondent’s personal experiences of menstrual hygiene management.ResultsMenstrual hygiene was rated as the sixth highest overall need and perceived as an immediate need by 18.8% of the respondents. There were 42.8% women & girls who menstruated within first week of the earthquake. Reusable sanitary cloth were used by about 66.7% of the respondents before the earthquake and remained a popular method (76.1%) post-earthquake. None of the respondents reported receiving menstrual adsorbents as relief materials in the first month following the earthquake. Disposable pads (77.8%) were preferred by respondents as they were perceived to be clean and convenient to use. Most respondents (73.5%) felt that reusable sanitary pads were a sustainable choice. Women who were in the age group of 15-34 years (OR = 3.14; CI = (1.07-9.20), did not go to school (OR = 9.68; CI = 2.16-43.33), married (OR = 2.99; CI = 1.22-7.31) and previously used reusable sanitary cloth (OR = 5.82; CI = 2.33-14.55) were more likely to use the reusable sanitary cloth.ConclusionsIn the immediate aftermath of the earthquake, women and girls completely depended on the use of locally available resources as adsorbents during menstruation. Immediate relief activities by humanitarian agencies, lacked MHM activities. Understanding the previous practice and using local resources, the reusable sanitary cloth is a way to address the menstrual hygiene needs in the post-disaster situations in Nepal.

A Systematic Review of Water and Gender Interlinkages: Assessing the Intersection With Health

“…Sanitation facilities were commonly cited to not be safe, clean, and accessible (Kwiringira et al, 2014;Sato et al, 2016;Khan et al, 2017;Aluko et al, 2018;Angoua et al, 2018;Dendup et al, 2018;Desalegn et al, 2018;Njuguna, 2019;Winter et al, 2019). Basic needs, such as soap and washing facilities, and hygienic products, such as toothpaste were documented as hygiene barriers (Budhathoki et al, 2018;Lubon et al, 2018). Moreover, women and girls often cited that critical challenges No 22.7% of students possessed genito-urinal schistosomiasis.…”

“…A small fraction (6%) of studies focused on the role of MHM, where women reported a lack of proper MHM products, such as clean pads, in addition to private areas and an absence of water provisioning for cleaning and sanitation needs (Khan et al, 2017;Budhathoki et al, 2018;Davis et al, 2018). Davis et al (2018) demonstrated how one in 10 students missed school due to menstruation, and this could, in part be attributed to menstrual stigma.…”

“…Women lack access to sustainable sanitation and hygiene facilities and resources. Kwiringira et al, 2014;Sato et al, 2016;Khan et al, 2017;Aluko et al, 2018;Angoua et al, 2018;Budhathoki et al, 2018;Dendup et al, 2018;Desalegn et al, 2018;Lubon et al, 2018;Winter et al, 2019 Gender differences in accessing a latrine were largely unremarkable. Ugbomoiko et al, 2009;Al-Delaimy et al, 2014;Alemu et al, 2017;Baker et al, 2018 Women and girls were burdened by latrines which lacked privacy and security.…”

“…Kwiringira et al, 2014;O'Reilly and Louis, 2014;Winter et al, 2019 Male-headed households were more likely to have a household latrine. Aiemjoy et al, 2017;Njuguna, 2019 Girls had less access than boys to hand and oral hygiene Nasr et al, 2013;Oberoi et al, 2014 Women and girls lack access to MHM Khan et al, 2017;Budhathoki et al, 2018;Davis et al, 2018 Gender WASH and Health…”

“…Additionally, a lack of latrines that are safe, secure, and private represents a major engendered barrier. The absence of such facilities forces women and girls to avoid practicing sustainable sanitation, hygiene, and MHM due to a fear of violence, or as a result of stigmatization (Kwiringira et al, 2014;Khan et al, 2017;Budhathoki et al, 2018;Davis et al, 2018;Winter et al, 2019). Poor WASH, in general, was linked to a multitude of health burdens, and particularly childhood diseases, including schistosomiasis, under-5 mortality, and stunting (Ahmed et al, 2016;Atalabi et al, 2016;Acheampong et al, 2017Acheampong et al, , 2018Akombi et al, 2017;Donohue et al, 2017;Vos et al, 2017;Baker et al, 2018;Marinda et al, 2018).…”