“The door has opened”: moving forward with menstrual health programming in Bangladesh

Abstract

Purpose In Bangladesh, as elsewhere, menstruation is surrounded by stigma, silence, and shame. Despite being a critical part of women’s and girls’ sexual and reproductive health and rights (SRHR), it remains significantly under-researched and addressed. However, the focus on menstrual health (MH) programming is growing globally, with increased awareness of the importance of holistic and rights-based approaches. This case study aims to examine and reflect upon the MH landscape and programming in Bangladesh, assessing the progress, challenges, and potential ways forward. Design/methodology/approach This case study is based on a non-systematic review of recent global and national literature, eight semi-structured interviews, a review of national television adverts and the authors’ experiences of MH research and programming in Bangladesh. Findings Hygiene-based education delivered through schools is a common entry point for MH programming in Bangladesh, with limited activities conducted in communities (including with men and boys) and through media. The focus of MH programming has tended to be narrow, with insufficient recognition of the wider gender equality and health implications of menstruation. There are growing efforts to coordinate MH work by different agencies and to collectively advocate for increased government engagement. While significant progress has been made, this case study identifies several gaps and tensions that reflect the complexity of addressing MH. Originality/value This case study presents an overview of recent MH experiences and programming in Bangladesh. It recognises the different sectors, sites and stakeholders involved, and includes experiences and perspectives of practitioners, academics, and programme participants.

Changes in the menstrual hygiene management facilities and usage among Bangladeshi school girls and its effect on school absenteeism from 2014 to 2018

“…The findings of our study are consistent with the evolving nature of school attendance since both urban and rural students’ absence from school decreased from 25% to 14% throughout this time. Remarkably, these findings reflect the findings of an article, how MHM programme is contributing to reduced absenteeism over time [ 32 ]. Notably, our findings are similar to previous studies undertaken in South Africa and Ghana [ 33 , 34 ].…”

A Qualitative Content Analysis of Rural and Urban School Students’ Menstruation-Related Questions in Bangladesh

“…Indications within the submitted questions that girls had heard they should not take pain relief medicine for menstrual cramps is consistent with studies in other countries such as Uganda [ 43 ] and Malawi [ 44 ] that have reported concerns that taking pain medication for menstrual cramps could negatively affect a girl’s health and fertility. Menstrual pain is a significant concern of schoolgirls but has been under-addressed by menstrual health and hygiene programming [ 45 ] and under-researched in LMICs [ 46 ], where attention has been more narrowly focused on the impact of poor access to sanitation facilities and reliable menstrual materials on girls’ attendance at school [ 47 , 48 ]. Notably, questions about menstrual pain and its management were substantially more common in our study than questions about menstrual hygiene practices.…”

“…Bangladesh is a Muslim-majority country, and menstruating women are considered impure to undertake rituals within Islam [ 56 ]. Further, many of the questions requested clarifications about food restrictions which are common in Bangladesh [ 36 , 45 , 57 ].…”

Protocol for the Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study in Khulna, Bangladesh: A Prospective cohort to quantify the influence of menstrual health on adolescent girls’ health and education outcomes.

“…The AMEHC Study is situated in Bangladesh, a country with world-leading prioritisation of adolescent MH national strategy, and interventions delivered through national and international non-governmental organisations (NGOs). 38 Thus, findings from the AMEHC Study can be positioned to influence policy and programming nationally, while addressing global research questions about the relationships between MH exposures and outcomes. Our study brings together research institutions and NGO partners to support stakeholder engagement and rapid translation of the findings relevant to policy and practice.…”