scholarly journals Qualitative study exploring the barriers to menstrual hygiene management faced by adolescents and young people with a disability, and their carers in the Kavrepalanchok district, Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jane Wilbur ◽  
Shubha Kayastha ◽  
Thérèse Mahon ◽  
Belen Torondel ◽  
Shaffa Hameed ◽  
...  

Abstract Background Menstrual hygiene management (MHM) is a recognised public health, social and educational issue, which must be achieved to allow the realisation of human rights. People with disabilities are likely to experience layers of discrimination when they are menstruating, but little evidence exists. Methods The study aims to investigate barriers to MHM that people with disabilities and their carers face in the Kavrepalanchok, Nepal, using qualitative methods. Twenty people with disabilities, aged 15–24, who menstruate and experience ‘a lot of difficulty’ or more across one or more of the Washington Group functional domains were included, as well as 13 carers who provide menstrual support to these individuals. Purposeful sampling was applied to select participants. Different approaches were used to investigating barriers to MHM and triangulate data: in-depth interviews, observation, PhotoVoice and ranking. We analysed data thematically, using Nvivo 11. Results Barriers to MHM experienced by people with disabilities differ according to the impairment. Inaccessible WASH facilities were a major challenge for people with mobility, self-care and visual impairments. People with intellectual impairments had difficulty accessing MHM information and their carers despaired when they showed their menstrual blood to others, which could result in abuse. No support mechanisms existed for carers for MHM, and they felt overwhelmed and isolated. Menstrual discomfort was a major challenge; these were managed with home remedies, or not at all. Most participants followed menstrual restrictions, which were widespread and expected; many feared they would be cursed if they did not. As disability is often viewed as a curse, this demonstrates the layers of discrimination faced. Conclusion Issues related to MHM for people with disabilities is more complex than for others in the population due to the additional disability discrimination and impairment experienced. Research exploring these issues must be conducted in different settings, and MHM interventions, tailored for impairment type and carers requirements,should be developed. Attention to, and resourcing for disability inclusive MHM must be prioritised to ensure ‘no one is left behind’.

2020 ◽  
Author(s):  
Jane Wilbur ◽  
Shubha Kayastha ◽  
Thérèse Mahon ◽  
Belen Torondel ◽  
Shaffa Hameed ◽  
...  

Abstract Background: Menstrual hygiene management (MHM) is a recognised public health, social and educational issue, which must be achieved to allow the realisation of human rights. People with disabilities are likely to experience layers of discrimination when they are menstruating, but little evidence exists. Methods: The study aims to investigate barriers to MHM that people with disabilities and their carers, face in the Kavrepalanchok, Nepal, using qualitative methods. Twenty people with disabilities, aged 15-24, who menstruate and experience ‘a lot of difficulty’ or more across one or more of the Washington Group functional domains were included, as well as 13 carers who provide menstrual support to these individuals. Purposeful sampling was applied to select participants. Different approaches were used to investigating barriers to MHM and triangulate data: in-depth interviews, observation, PhotoVoice and ranking. We analysed data thematically, using Nvivo 11. Results: Barriers to MHM experienced by people with disabilities differ according to the impairment. Inaccessible WASH facilities were a major challenge for people with mobility, self-care and visual impairments. People with intellectual impairments had difficulty accessing MHM information and their carers despaired when they showed their menstrual blood to others, which could result in abuse. No support mechanisms existed for carers for MHM, who overwhelmed and isolated. Menstrual discomfort was a major challenge; these were managed with home remedies, or not at all. Most participants followed menstrual restrictions, which were widespread and expected, for fear of being cursed if they did not. As disability is often viewed as a curse, this demonstrates the layers of discrimination faced. Conclusion: Issues related to MHM for people with disabilities is more complex than for others in the population due to the additional disability discrimination and impairment experienced. Research exploring these issues must be conducted in different settings, and MHM interventions, tailored for impairment type and carers requirements, must be developed. Attention to, and resourcing for disability inclusive MHM must be prioritised to ensure ‘no one is left behind’.


2020 ◽  
Author(s):  
Jane Wilbur ◽  
Shubha Kayastha ◽  
Thérèse Mahon ◽  
Belen Torondel ◽  
Shaffa Hameed ◽  
...  

Abstract Background: Menstrual hygiene management (MHM) is a recognised public health, social and educational issue, which must be achieved to allow the realisation of human rights. People with disabilities are likely to experience layers of discrimination when they are menstruating, but little evidence exists.Methods: The study aims to investigate barriers to MHM that people with disabilities and their carers, face in the Kavrepalanchok, Nepal, using qualitative methods. Twenty people with disabilities, aged 15-24, who menstruate and experience ‘a lot of difficulty’ or more across one or more of the Washington Group functional domains were included, as well as 13 carers who provide menstrual support to these individuals. Purposeful sampling was applied to select participants. Different approaches were used to investigating barriers to MHM and triangulate data: in-depth interviews, PhotoVoice and ranking, market survey, product attribute assessment and user preference with ranking, observation of the water, sanitation and hygiene (WASH) facilities used. We analysed data thematically, using Nvivo 11.Results: Barriers to MHM experienced by people with disabilities differ according to the impairment. Inaccessible WASH facilities were a major challenge for people with mobility, self-care and visual impairments. People with intellectual impairments had difficulty accessing MHM information and their carers despaired when they showed their menstrual blood to others, which could result in abuse. No support mechanisms existed for carers for MHM, who overwhelmed and isolated. Menstrual discomfort was a major challenge; these were managed with home remedies, or not at all. Most participants followed menstrual restrictions, which were widespread and expected, for fear of being cursed if they did not. As disability is often viewed as a curse, this demonstrates the layers of discrimination faced.Conclusion: Issues related to MHM for people with disabilities is more complex than for others in the population due to the additional disability discrimination and impairment experienced. Research exploring these issues must be conducted in different settings, and MHM interventions, tailored for impairment type and carers requirements, must be developed. Attention to, and resourcing for disability inclusive MHM must be prioritised to ensure ‘no one is left behind’.


Author(s):  
Jane Wilbur ◽  
Thérèse Mahon ◽  
Belen Torondel ◽  
Shaffa Hameed ◽  
Hannah Kuper

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.


2015 ◽  
Vol 105 (7) ◽  
pp. 1302-1311 ◽  
Author(s):  
Marni Sommer ◽  
Jennifer S. Hirsch ◽  
Constance Nathanson ◽  
Richard G. Parker

2020 ◽  
Author(s):  
Jane Wilbur ◽  
Shubha Kayastha ◽  
Thérèse Mahon ◽  
Belen Torondel ◽  
Shaffa Hameed ◽  
...  

Abstract Background Menstrual hygiene management (MHM) is a recognised public health, social and educational issue, which must be achieved to allow the realisation of human rights. People with disabilities are likely to experience layers of discrimination when they are menstruating, but little evidence exists on this topic. Methods The study aims to investigate the barriers to MHM that people with a disability, and their carers, face in the Kavrepalanchok, Nepal, using qualitative methods. Twenty people with disabilities, aged 15 to 24, who menstruate and experience ‘a lot of difficult’ or more across one or more of the Washington Group functional domains were included, as well as 13 carers who provide menstrual support to these individuals. Two stages of purposive sampling and snowball sampling were applied to identify participants. We used different approaches to investigating barriers to MHM including: in-depth interviews, PhotoVoice and ranking, market survey of menstrual products and user preference with ranking, accessibility and safety audits of the water and sanitation facilities. We analysed data thematically, using Nvivo 11. Results Barriers to MHM experienced by people with disabilities differ according to the functional limitation. Inaccessible water, sanitation and hygiene facilities were a major challenge for people with mobility, self-care and visual limitations. People with intellectual impairments had difficulty accessing MHM information and their carers despaired when they showed their menstrual blood to others, which could result in abuse. No support mechanisms exist for carers for MHM and they felt overwhelmed and isolated. Menstrual discomfort was a major challenge; these were managed with home remedies, or not at all. Most participants followed menstrual restrictions, which were widespread and expected, for fear of being cursed if they did not. As disability is often viewed as a curse, this demonstrates the layers of discrimination faced. Conclusion Issues related to MHM for people with disabilities is more complex than for others in the population due to the additional disability discrimination and functional limitations experienced. Attention to, and resourcing for disability inclusive MHM must be prioritised for progress to be made towards the Sustainable Development Goals, which aims to ‘Leave No One Behind’.


2020 ◽  
Vol 8 ◽  
pp. 73-84
Author(s):  
Madhavi Gautam Ghimire

 Studies on menstruation hygiene management (MHM) in education have focused mostly on adolescent school girls indicating the need to investigate this particular phenomenon in the context of higher education. In this study, I wanted to explore the experiences of female students and teachers during menstruation while they are at the campus and document them to unpack the realities of the phenomenon to persuade the campus authorities for better MHM on the campuses. Using the qualitative design, the study is aimed at exploring and probing students and teachers on their MHM practices. This research has nested the life experiences of myself and participants of purposively selected two constituent and one affiliated campuses of Tribhuvan University in the Kathmandu Valley. In-depth interviews with six teachers and focus group discussions with six groups of students were included in this study. The research revealed multiple issues during menstrual hygiene management that include lack of appropriate water sanitation and hygiene (WASH) facilities, no access to emergency absorbent during menstruation, no provision of pain killer medicines during uterine cramps (dysmenorrhea) and back-aches and no provision of dust bin for absorbent disposal. This indicates that higher education institutions in Nepal need to pay more attention to ensure dignified menstruation on campus.  


Author(s):  
Laura Rossouw ◽  
Hana Ross

Menstrual hygiene management and health is increasingly gaining policy importance in a bid to promote dignity, gender equality and reproductive health. Effective and adequate menstrual hygiene management requires women and girls to have access to their menstrual health materials and products of choice, but also extends into having private, clean and safe spaces for using these materials. The paper provides empirical evidence of the inequality in menstrual hygiene management in Kinshasa (DRC), Ethiopia, Ghana, Kenya, Rajasthan (India), Indonesia, Nigeria and Uganda using concentration indices and decomposition methods. There is consistent evidence of wealth-related inequality in the conditions of menstrual hygiene management spaces as well as access to sanitary pads across all countries. Wealth, education, the rural-urban divide and infrastructural limitations of the household are major contributors to these inequalities. While wealth is identified as one of the key drivers of unequal access to menstrual hygiene management, other socio-economic, environmental and household factors require urgent policy attention. This specifically includes the lack of safe MHM spaces which threaten the health and dignity of women and girls.


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