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Menstrual health management -

Research has shown that approaches that can effectively combine information and education with appropriate infrastructure and menstrual products, in a conducive policy environment, are more successful in avoiding the negative effects of poor MHH — in short, a holistic approach requiring collaborative and multi-dimensional responses.

Priority Areas. In low-income countries, half of the schools lack adequate water, sanitation, and hygiene services crucial to enable girls and female teachers to manage menstruation UNICEF Schools that have female-friendly facilities and incorporate information on menstruation into the curriculum for both girls and boys can reduce stigma and contribute to better education and health outcomes.

When girls and women have access to safe and affordable sanitary materials to manage their menstruation, they decrease their risk of infections. This can have cascading effects on overall sexual and reproductive health, including reducing teen pregnancy, maternal outcomes, and fertility.

Poor menstrual hygiene, however, can pose serious health risks, like reproductive and urinary tract infections which can result in future infertility and birth complications.

Neglecting to wash hands after changing menstrual products can spread infections, such as hepatitis B and thrush. Awareness of MHH contributes to building an enabling environment of nondiscrimination and gender equality in which female voices are heard, girls have choices about their future, and women have options to become leaders and managers.

In addition, feminine hygiene products are a multibillion-dollar industry, which, if properly tapped into, can generate income for many and significantly boost economic growth.

Disposable sanitary products contribute to large amounts of global waste. Ensuring women and girls have access to sustainable and quality products, and improving the management of the disposal of menstrual products, can make a big difference to the environment.

In India alone, roughly million women and girls use an average of eight disposable and non-compostable pads per month, generating 1. Country Examples. Enhancing opportunities for women to access adequate menstrual health and hygiene is central to the World Bank Group in achieving its development outcomes.

In addition, the project is facilitating behavior change sessions and training on the importance of menstrual hygiene and safely managed WASH facilities. Access to finance will be provided to women entrepreneurs to help them market and sell soaps, disinfectants and menstrual hygiene products at household doorsteps.

This will improve menstrual hygiene practices, especially among those who are too shy and reluctant to purchase them at public markets. This includes gender-separated facilities with door locks, lighting, disposal bins, and handwashing stations with soap and water.

Behavior changes and hygiene promotion campaigns incorporating MHH will be undertaken, targeting students, teachers, parents and the larger community. Under the project, sanitation facilities were constructed at more than schools across the Greater Accra Metropolitan Area.

In: Background paper on measuring WASH and food hygiene practices—definition of goals to be tackled post by the joint monitoring Programme. London: London School of Hygiene and Tropical Medicine; Google Scholar. Sahin M. Tackling the stigma and gender marginalization related to menstruation via WASH in schools programmes.

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Mumbai: Junction Social; Kaur K, Arora B, Singh GK, Neki NS. Social beliefs and practices associated with menstrual hygiene among adolescent girls of Amritsar, Punjab. India J Int Med Sci Acad. Ranabhat C, Kim C-B, Choi EH, Aryal A, Park MB, Doh YA. Chhaupadi culture and reproductive health of women in Nepal.

Asia-Pacific J Public Heal. Sebastian A, Hoffmann V, Adelman S. Menstrual management in low-income countries: needs and trends.

Saeed T, Naghma S. Menstrual knowledge and practices of female adolescents in urban Karachi, Pakistan. J Adolesc. Sapkota D, Sharma D, Budhathoki SS, Khanal VK, Pokharel HP. Knowledge and practices regarding menstruation among school going adolescents of rural Nepal.

J Kathmandu Med Coll. Budhathoki SS, Bhattachan M, Pokharel PK, Bhadra M, van Teijlingen E. Reusable sanitary towels: promoting menstrual hygiene in post-earthquake Nepal.

J Fam Plan Reprod Heal Care. Alam M-U, Luby SP, Halder AK, Islam K, Opel A, Shoab AK, et al. Menstrual hygiene management among Bangladeshi adolescent schoolgirls and risk factors affecting school absence: results from a cross-sectional survey. BMJ Open. Khanna A, Goyal RS, Bhawsar R.

Menstrual practices and reproductive problems: a study of adolescent girls in Rajasthan. J Health Manag. van Eijk AM, Sivakami M, Thakkar MB, Bauman A, Laserson KF, Coates S, et al.

Menstrual hygiene management among adolescent girls in India : a systematic review and meta-analysis. Davidson A. Narratives of menstrual product consumption: convenience, culture, or commoditization? Bull Sci Technol Soc. Das P, Baker KK, Dutta A, Swain T, Sahoo S, Das BS, et al.

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Thacker P. After earthquake in Nepal, sanitary menstruation practice at risk [internet]. New York Times. Sommer M, Kjellen M, Pensulo C. J Water Sanit Hyg Dev. Caruso BA, Clasen TF, Hadley C, Yount KM, Haardörfer R, Rout M, et al.

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Beyond menstrual hygiene: addressing vaginal bleeding throughout the life course in low and middle-income countries. Download references. We acknowledge the support from BPKIHS, participants of the study and the community people to conduct this study.

None declared. ECS is affiliated with the National Institute for Health Research NIHR Health Protection Research Unit HPRU in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London in partnership with Public Health England PHE , and the NIHR Imperial Patient Safety Translational Research Centre.

ECS has received an Early Career Research Fellowship from the Antimicrobial Research Collaborative at Imperial College London and acknowledges the support of the Florence Nightingale Foundation.

The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health, or Public Health England.

It holds sessions on sexual and reproductive health and rights for adolescent boys and girls as well as parents, which include information on family planning, menstruation, hygiene, malnutrition and family values.

Learning about the menstrual cycle has helped Anne-Marie, 16, count the days and predict when her next period is likely to start.

Involving boys in the Mutima sessions makes them realize that girls are smart and have value, she says. When girls and women look after their health, it often improves their standing in new areas, she says, such as participating in household decision-making. This change in dynamics is critical in Burundi, which she notes is ranked as one of the lowest countries on the Human Development Index.

A project supported by GAC called HerWASH, which is being implemented in Pakistan, Burkina Faso, Liberia and Sierra Leone by WaterAid Canada, focuses on improving menstrual hygiene to enhance the sexual and reproductive health and rights of women and adolescent girls.

Youth leaders dispel myths and misconceptions around menstruation, holding sessions where they help girls understand their menstrual cycles and the changes in their bodies. She says the program is working to change attitudes at the government level so that the importance of menstrual health is explicitly stated in policy guidelines.

This would mean that girls and women would have access to water and sanitation facilities even in the most remote and vulnerable communities, adds Schattmann, who is optimistic that change is possible.

Reproductive Health volume 17Article number: Menstrual health management Cite this article. Metrics details. There has Cleansing Teas and Tonics increased gealth to the menstrual health Menetrual MHM Menstrual health management of girls and helth women in Eastern and Southern Africa, relating to dignity, and to the potential link between the lack of access to sanitary products and school absenteeism. In the South Africa, there is inadequate evidence to guide appropriate national responses. This study explored the extent of access to modern sanitary products amongst female high school learners and the range of needs and challenges that they face in managing their menses in school settings in Gauteng, South Africa.

Menstrual health management -

The onset of menstruation means a new phase — and new vulnerabilities — in the lives of adolescents. Yet, many adolescent girls face stigma, harassment and social exclusion during menstruation. Transgender men and non-binary persons also face discrimination due to their gender identity, depriving them of access to the materials and facilities they need.

Gender inequality, discriminatory social norms, cultural taboos, poverty and lack of basic services like toilets and sanitary products can all cause menstrual health and hygiene needs to go unmet. This has far-reaching consequences for millions of people.

It restricts their mobility and personal choices. It affects attendance in school and participation in community life. And it compromises their safety, causing additional stress and anxiety.

These challenges are particularly acute in humanitarian crises. Menstrual health and hygiene interventions can help overcome these obstacles.

Not only do they fulfil the unmet demand for menstrual hygiene products; they also protect dignity, build confidence, and strengthen sexual and reproductive health, particularly among adolescents.

UNICEF is a global leader in menstrual health and hygiene activities through development and humanitarian programmes across the world. We commit to building programmes that increase confidence, knowledge, and skills — and improve access to materials and facilities — for adolescent girls, women, transgender and non-binary individuals to manage their menstruation safely and with dignity.

UNICEF primarily supports governments in building national strategies across sectors, like health and education, that account for menstrual health and hygiene. Our programmes are developed to reinforce gender equality.

We recognize and implement special efforts to reach and co-design solutions with girls with disabilities, girls from minority groups, and transgender and non-binary menstruators.

By strengthening confidence and negotiation skills, menstrual health and hygiene programmes can help people who menstruate overcome obstacles to their health, freedom and development. In Senegal, UNICEF is exploring new and creative ways to locally produce menstrual supply kits, so girls won't miss out on learning.

How advocacy in schools help destigmatize menstruation. An Urgent Call for Equitable Digital Skills Development. Our cross-sectional study found inadequate comprehensive knowledge of MHM among female college students in Bhutan.

Only one-quarter still agreed with beliefs such as not entering shrines or not touching holy books during menstruation and menstruation being dirty. In spite of this, almost all students expressed their interest to talk further on MHM.

There was a notable lack of MHM facilities observed at the colleges that correlated with reports from the students.

We expected a higher level of education of the participants to correspond with a higher knowledge of menstruation. This was true, despite an overall low score on comprehensive knowledge. This finding was further confirmed by comparing sub-groups.

Final year students had higher comprehensive knowledge compared to first year students, possibly due to the influence of peers. Similar evidence from a study of Saudi nursing students linked an increase in education level to increased knowledge of menstruation, although no reason was given for the association The effect of the practices getting better with years spent in college could be attributed to peer support.

Studies in China and Bangladesh found adequate and accurate information on menstruation, which is important to improve practice on MHM 27 , 28 , The proportion of the female college students agreeing with socio-cultural beliefs, such as not entering a shrine or menstruation being dirty, is small but similar to a study among school girls in Bhutan This may indicate that beliefs do not change with an increase in educational level, although our study did not find the association between the two.

A similar study in Nepal found that cultural beliefs lead girls to practice self-imposed restrictions like not entering temples or joining prayer ceremonies These beliefs and taboos remained as menstruation was not discussed and these perceptions are passed through generations 20 , However, our findings show how women that are having at least a little knowledge about menstruation may not endorse such taboos.

Gender issues seem to be an important result of this study due to the sense of injustice felt as most participant say that men have an advantage over women of not having menstruation. While menstruation is a healthy and integral part of female identity, the cultural message of menstruation to be gross, troubling, or shameful has created a dominant narrative of menstruation as a negative, troubling, and problematic experience for those who menstruate 22 , It indicates that there is a need to provide an adequate information package that will normalize menstruation, change attitudes, and end negative social norms 24 , Approximately half of our participants claimed that menstruation affected their usual activities.

The majority rated pain as the main reason for absenteeism from college. This is comparable to the assessment conducted among school-going girls in Bhutan A similar study in Mumbai found that the most common problems faced during menstruation were menstrual cramps.

In the survey, Absenteeism was noted with an increase in education in our study. However, further analyses would be needed to explore the correlation between absenteeism and educational level along with other variables that were not included in our data collection.

Absenteeism due to menstrual cramps may affect the academic performance of a student. Studying a correlation between academic performance and menstrual cramps was beyond the scope of our study, and future research studies in this area would be interesting.

Another key finding of this study was inadequate MHM facilities like water, soap, and bins for disposal of absorbents in both hostels and college toilets, compromising the ability of the students to practice proper hygiene. These findings have been corroborated by a systematic review carried out in low- and middle-income countries where women and girls were unable to undertake their preferred menstrual practices due to inadequate MHM infrastructure 6 , 32 , Lack of safe spaces for MHM may affect the health and dignity of women and girls Issues of access to facilities and attitudes go hand in hand in causing exclusion, stigma, and disadvantage The participants expressed a strong wish for platforms to talk about menstruation in their college, and only a small proportion said they were uncomfortable in discussing it.

Studies in China, Bangladesh, and elsewhere have shown that educational sessions have enhanced knowledge, promoted a more positive attitude, and improved practices such as managing menstrual cramps 6 , 15 , Significant increases in menstrual knowledge and confidence among women were observed following a more open discourse This study had some strengths and limitations.

First, college women in Bhutan are chosen based on merit and come from different socioeconomic classes. This improves its generalizability. Second, the study sample was taken from the female college population in all Bhutanese government colleges; therefore, it is generalizable at a national level.

Third, we used direct observation of WASH facilities to triangulate with the reports from the students. The main limitation of our study is that it was a self-administered survey, possibly subject to social desirability bias, with no indication of how participants interpreted the questions.

We mitigated this limitation considerably by conducting a pre-test to adjust the questions and also by having the research team stay at the site during data collection to clarify any questions for the participants. Finally, although we observed WASH facilities in each of the colleges, we could not include the associations between the MHM facilities and the practices of the participants in our analyses, as the observations of MHM facilities were not sufficiently representative.

The study has the following implications: First, increased educational sessions in schools and colleges could improve MHM practices. The focus should be on evidence-based hygiene practices and demystifying false beliefs that limit the participation of women and girls in education and other socio-cultural activities, such as eating certain foods 1 , 18 , Second, adequate physical facilities to practice MHM are crucial in improving hygiene practices.

This should be followed by timely monitoring of these facilities Sensitization of men may be a logical outcome. Men on campus and in the community could ensure adequate menstrual supplies are available for female students Also, colleges could ensure that a healthcare provider is available who can help women when they feel unwell, treat the side effects of menstruation, and assess their urogenital health in case of infections.

The college and management should take immediate action to ensure the availability of clean running water and soaps, bins with lids for disposal of sanitary bins, and secure, lockable doors in the toilet facilities. This study of KAP related to MHM found significant knowledge and belief gaps but some encouraging practices among female students in government colleges of Bhutan.

It also revealed important inadequate physical and psychosocial facilities to support the practices of these students, leading to absenteeism. There are clear ways forward to tackle these problems, and we encourage college administrations to address them.

However, anonymized datasets are available from corresponding author on reasonable request. The study was reviewed and approved by Research Ethics Board of Health REBH Approval no: Ref.

The participants provided their written informed consent to participate in this study. TT, SS, PM, MG, JT, and RW conceptualized the study.

TT collected and cleaned the primary data. TT and JG-C conducted the analysis and interpretation of the data. TT, JG-C, and SS drafted the manuscript. TT, MG, JG-C, PM, and SS revised the manuscript. All authors approved the final manuscript. The fund for the data collection was supported by the Health Research and Epidemiology unit, under the MoH in Bhutan.

The training program and open access publication costs were funded by the La Fondation Veuve Emile Metz-Tesch Luxembourg. The funders had no role in study design, data collection and analysis, decision to publish, or the preparation of the manuscript.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers.

Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. The specific SORT IT program that resulted in this publication was managed by the MSF and the Public Health Agency of Canada.

We are grateful to the Ministry of Education, faculties, and students from the RIM, RUB, and KGUMSB for cooperation and support during data collection.

We thank data collectors and research officers of each college for support during data collection. We are especially grateful to Tony Reid, Rafael Van Den Bergh, Samuel Sieber, Claire Braun, and Rob D'hondt for their input and guidance during this manuscript preparation.

Most of all, we are grateful to the participants who volunteered to be in this study and provide data for the purposes of this study and further learning.

KAP, Knowledge Attitude and Practice; KGUMSB, Khesar Gyalpo University of Medical Sciences of Bhutan; MHM, Menstrual Hygiene Management; MSF, Medécins Sans Frontières; Nu, Ngultrum Bhutanese Currency ; REBH, Research Ethics Board of Health; RUB, Royal University of Bhutan; SD, Standard Deviation; SORT IT, Structured Operational Research and Training Initiative; STROBE, Strengthening the Reporting of Observational Studies in Epidemiology; WASH, Water and Sanitation; WHO, World Health Organization.

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Mangaement Menstrual health management this contributes to our overarching goal: to build a world where no Menstrual health management is held back because Restore and renew your skin menstruate by Menstrual health management Managekent, to better represent menstruation, we mansgement using a bright and bold shade of blood red across our digital channels, in our materials and in our new logo. All you need to do is share a photo of yourself online featuring a digital menstruation bracelet. Get digital bracelet and join campaign New MH Day logo. Our new sticker-style logo is perfect to add to your own content. Add it to photos, social media posts, presentations and much more. Menstrual health management month, 1. Millions of Longevity and lifelong learning girls, women, transgender men and non-binary persons are Mentrual to manage their menstrual cycle in a dignified, hea,th way. The onset of menstruation means Menstrual health management new phase — and managmeent vulnerabilities — in the lives of adolescents. Yet, many adolescent girls face stigma, harassment and social exclusion during menstruation. Transgender men and non-binary persons also face discrimination due to their gender identity, depriving them of access to the materials and facilities they need. Gender inequality, discriminatory social norms, cultural taboos, poverty and lack of basic services like toilets and sanitary products can all cause menstrual health and hygiene needs to go unmet.