Everywhere is Nowhere: A Systematic Review of Menstrual Health and Hygiene Management (MHHM) as a Human Right
Abstract Background: In many countries, stigma surrounds menstruation, which impacts several Sustainable Development Goals, including good health, quality education, gender equality, and water and sanitation. Despite its relationship with several development issues, menstrual health and hygiene management among adolescents has until recently been ignored by practitioners and researchers. This paper is a systematic review of existing literature and argues that menstrual health and hygiene management is a human rights issue, cross-cutting through development domains of health, education, nutrition, child protection, and water, sanitation, and hygiene. Methods: Four coders independently screened PubMed, Academic OneFile, and Google Scholar to obtain articles using iterations of the key terms: menstrual health; adolescents; health outcomes; education; nutrition; water, sanitation, and hygiene; and child protection. English language primary studies in peer-reviewed or grey literature articles published after 2000, that mentioned adolescents, health or hygiene, and menstruation or menstrual were included. A 9-item scale was used to rate selected full-text articles as strong, moderate, or weak. Synthesis of the results were narrative and examined the relationships between menstrual health and hygiene management and the cross-cutting domains.Results: In total, 28,745 articles were screened, with 84 articles included in the full-text review and quality assessment. Nine articles were coded as “strong” (10.8%), 46 (55.4%) as “moderate,” and 28 (33.7%) as “weak.” More than 60% of the articles examined the relationship between menstrual health and hygiene management and health (37.3%) or water, sanitation, and hygiene (25.3%). Only 11 manuscripts examined menstrual health and hygiene management as a cross-cutting issue impacting more than one development domain.Conclusions: Access to adequate facilities and menstrual health and hygiene management resources are the most common relationships documented within literature. However, there is little focus on menstrual health and hygiene management in the context of other development domains, highlighting the fact that poor menstrual health and hygiene management has not been studied as a human rights issue, negatively impacting millions of girls. Using a cross-cutting, human rights framework to address inadequate menstrual health and hygiene management is fundamental to promoting menstrual health and hygiene management with dignity among girls and women across the globe.