scholarly journals Menstrual Hygiene Management and Waste Disposal in Low and Middle Income Countries—A Review of the Literature

2018 ◽  
Vol 15 (11) ◽  
pp. 2562 ◽  
Author(s):  
Myles Elledge ◽  
Arundati Muralidharan ◽  
Alison Parker ◽  
Kristin Ravndal ◽  
Mariam Siddiqui ◽  
...  
Keyword(s):  
Waste Management ◽  
Grey Literature ◽  
Middle Income ◽  
Menstrual Hygiene ◽  
Middle Income Countries ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Literature Reviews ◽  
Sanitation Systems ◽  
Low And Middle Income

Menstrual hygiene management (MHM) has gained some attention and several literature reviews have been published. However, both original papers and reviews tend to focus on absorbent access and use and not on the disposal of menstrual waste. This review aims to fill a gap in the water, sanitation and hygiene (WASH) sector by bringing a focus specifically on menstrual hygiene safe disposal in low- and middle-income countries (LMIC). We reviewed published literature since 2002 on menstrual hygiene with a focus on menstrual waste management and menstrual absorbent disposal in LMIC. Database searches were conducted of both peer reviewed literature and grey literature, in addition to hand searching of references of relevant earlier literature reviews. In total 152 articles and reports were identified and 75 met the inclusion criteria and was included in the final review. Existing polices on MHM was also reviewed with a focus on India and South Africa. The review showed that disposal of menstrual waste is often neglected MHM and sanitation value chains, leading to improper disposal and negative impacts on users, the sanitation systems and the environment. Findings call for further research to gain better understandings of MHM waste streams, disposal behaviors, absorbent materials and waste management technologies to deliver health, safety, mobility and dignity for women and girls.

scholarly journals Menstrual hygiene management among adolescent schoolgirls in low- and middle-income countries: research priorities

2016 ◽  
Vol 9 (1) ◽  
pp. 33032 ◽  
Author(s):  
Penelope A. Phillips-Howard ◽  
Bethany Caruso ◽  
Belen Torondel ◽  
Garazi Zulaika ◽  
Murat Sahin ◽  
...  
Keyword(s):  
Research Priorities ◽  
Middle Income ◽  
Menstrual Hygiene ◽  
Middle Income Countries ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Low And Middle Income

scholarly journals Understanding Period Poverty: Socio-Economic Inequalities in Menstrual Hygiene Management in Eight Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2571
Author(s):  
Laura Rossouw ◽  
Hana Ross
Keyword(s):  
Decomposition Methods ◽  
Middle Income ◽  
Menstrual Hygiene ◽  
Middle Income Countries ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Menstrual Health ◽  
Women And Girls ◽  
Sanitary Pads ◽  
Unequal Access

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.

scholarly journals Piloting an acceptable and feasible menstrual hygiene products disposal system in urban and rural schools in Bangladesh

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Farjana Jahan ◽  
Md. Nuruzzaman ◽  
Farhana Sultana ◽  
Mehjabin Tishan Mahfuz ◽  
Mahbubur Rahman ◽  
...  
Keyword(s):  
Rural Schools ◽  
Management Plan ◽  
Middle Income ◽  
Menstrual Hygiene ◽  
Middle Income Countries ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
First Choice ◽  
Disposal Options ◽  
Menstrual Products

Abstract Background Access to washroom facilities and a place to dispose of menstrual waste are prerequisites for optimal menstrual hygiene management in schools. Like other low- and middle-income countries, Bangladeshi schools lack facilities for girls to change and dispose of their menstrual absorbents. We explored existing systems for disposing of menstrual absorbent wastes in urban and rural schools of Bangladesh and assessed the feasibility and acceptability of alternative disposal options. Methods We explored how girls dispose of their menstrual products, identified girls’ preferences and choices for a disposal system and piloted four disposal options in four different schools. We then implemented one preferred option in four additional schools. We explored girls’, teachers’, and janitors’ perspectives and evaluated the acceptability, feasibility, and potential for sustainability of the piloted disposal system. Results Barriers to optimal menstrual hygiene management included lack of functional toilets and private locations for changing menstrual products, and limited options for disposal. Girls, teachers, and janitors preferred and ranked the chute disposal system as their first choice, because it has large capacity (765 L), is relatively durable, requires less maintenance, and will take longer time to fill. During implementation of the chute disposal system in four schools, girls, teachers, and janitors reported positive changes in toilet cleanliness and menstrual products disposal resulting from the intervention. Conclusions The chute disposal system for menstrual products is a durable option that does not require frequent emptying or regular maintenance, and is accepted by schoolgirls and janitors alike, and can improve conditions for menstrual hygiene management in schools. However, regular supervision, motivation of girls to correctly dispose of their products, and a long-term maintenance and management plan for the system are necessary.

scholarly journals Absorbency of Biodegradable Materials for Menstrual Hygiene Management Products in Low-and Middle-income Countries

2021 ◽  
Author(s):  
Jasmin Foster ◽  
Paul Montgomery
Keyword(s):  
Low Income ◽  
Middle Income ◽  
Menstrual Hygiene ◽  
Middle Income Countries ◽  
Menstrual Hygiene Management ◽  
Sanitary Products ◽  
Extraction Processes ◽  
And Gender ◽  
Complex Extraction ◽  
Low And Middle Income

Abstract IntroductionGirls in low-and middle-income countries struggle to maintain good menstrual hygiene in part due to a lack of affordable sanitary products. The unaffordability of reliable sanitary products can lead to school absenteeism and is a barrier to education attainment and gender equality for girls in low income contexts. Further the lack of adequate disposal facilities can lead to social embarrassment and environmental pollution.MethodsLow-cost biodegradable absorbents (cotton terry cloth, linen, hemp cloth and bamboo wadding) were investigated in gelatine solution in terms of their absorptivity for use in menstrual hygiene.ResultsBamboo wadding exhibits the highest absorptivity index (7.86), greater than cotton terry cloth (0.84), hemp cloth (1.4), linen (1.57) and a commercial sanitary pad (4.38).ConclusionsThough the absorptivity index of bamboo wadding is promising, especially in the light of the vast availability of bamboo in tropical low-and middle income countries, challenges lie in overcoming complex extraction processes from bamboo plants which is discussed.

Stock-Outs of Essential Medicines Among Community Health Workers (CHWs) In Low- And Middle-Income Countries (LMICs): A Systematic Literature Review of The Extent, Reasons, And Consequences

2021 ◽  
Author(s):  
Abimbola Olaniran ◽  
Jane Briggs ◽  
Ami Pradhan ◽  
Erin Bogue ◽  
Benjamin Schreiber ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Grey Literature ◽  
Community Level ◽  
Health Centers ◽  
Essential Medicines ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background: This paper explores the extent of community-level stock-out of essential medicines among Community Health Workers (CHWs) in Low- and Middle-Income Countries (LMICs) and identifies the reasons for and consequences of essential medicine stock-outs. Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. Five electronic databases were searched with a prespecified strategy and the grey literature examined, January 2006 - March 2021. Papers containing information on (i) the percentage of CHWs stocked out or (ii) reasons for stock-outs along the supply chain and consequences of stock-out were included and appraised for risk of bias. Outcomes were quantitative data on the extent of stock-out, summarized using descriptive statistics, and qualitative data regarding reasons for and consequences of stock-outs, analyzed using thematic content analysis and narrative synthesis. Results: Two reviewers screened 1083 records; 78 evaluations were included. Over the last fifteen years, CHWs experienced stock-outs of essential medicines nearly one third of the time and at a significantly (p < 0.01) higher rate than the health centers to which they are affiliated (28.93% [CI 95%: 28.79 - 29.07] vs 9.17 % [CI 95%: 8.64 - 9.70], respectively). A comparison of the period 2006-2015 and 2016-2021 showed a significant (p < 0.01) increase in CHW stock-out level from 26.36% [CI 95%: 26.22 -26.50] to 48.65% [CI 95%: 48.02- 49.28] while that of health centers increased from 7.79% [95% CI: 7.16 - 8.42] to 14.28% [95% CI: 11.22- 17.34]. Distribution barriers were the most cited reasons for stock-outs. Ultimately, patients were the most affected: stock-outs resulted in out-of-pocket expenses to buy unavailable medicines, poor adherence to medicine regimes, dissatisfaction, and low service utilization. Conclusion: Community-level stock-out of essential medicines constitutes a serious threat to achieving universal health coverage and equitable improvement of health outcomes. This paper suggests stock-outs are getting worse, and that there are particular barriers at the last mile. There is an urgent need to address the health and non-health system constraints that prevent the essential medicines procured for LMICs by international and national stakeholders from reaching the people who need them the most.

scholarly journals Vitamin and Mineral Supplementation During Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 491 ◽  
Author(s):  
Christina Oh ◽  
Emily C. Keats ◽  
Zulfiqar A. Bhutta
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Child Health ◽  
Low Birthweight ◽  
Grey Literature ◽  
Micronutrient Supplementation ◽  
Maternal Anemia ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Almost two billion people are deficient in key vitamins and minerals, mostly women and children in low- and middle-income countries (LMICs). Deficiencies worsen during pregnancy due to increased energy and nutritional demands, causing adverse outcomes in mother and child, but could be mitigated by interventions like micronutrient supplementation. To our knowledge, this is the first systematic review that aimed to compile evidence from both efficacy and effectiveness trials, evaluating different supplementation interventions on maternal, birth, child health, and developmental outcomes. We evaluated randomized controlled trials and quasi-experimental studies published since 1995 in peer-reviewed and grey literature that assessed the effects of calcium, vitamin A, iron, vitamin D, and zinc supplementation compared to placebo/no treatment; iron-folic (IFA) supplementation compared to folic acid only; multiple micronutrient (MMN) supplementation compared to IFA; and lipid-based nutrient supplementation (LNS) compared to MMN supplementation. Seventy-two studies, which collectively involved 314 papers (451,723 women), were included. Meta-analyses showed improvement in several key birth outcomes, such as preterm birth, small-for-gestational age (SGA) and low birthweight with MMN supplementation, compared to IFA. MMN also improved child outcomes, including diarrhea incidence and retinol concentration, which are findings not previously reported. Across all comparisons, micronutrient supplementation had little to no effect on mortality (maternal, neonatal, perinatal, and infant) outcomes, which is consistent with other systematic reviews. IFA supplementation showed notable improvement in maternal anemia and the reduction in low birthweight, whereas LNS supplementation had no apparent effect on outcomes; further research that compares LNS and MMN supplementation could help understand differences with these commodities. For single micronutrient supplementation, improvements were noted in only a few outcomes, mainly pre-eclampsia/eclampsia (calcium), maternal anemia (iron), preterm births (vitamin D), and maternal serum zinc concentration (zinc). These findings highlight that micronutrient-specific supplementation should be tailored to specific groups or needs for maximum benefit. In addition, they further contribute to the ongoing discourse of choosing antenatal MMN over IFA as the standard of care in LMICs.

scholarly journals A systematic review of employment outcomes from youth skills training programmes in agriculture in low- and middle-income countries

Nature Food ◽  
2020 ◽  
Vol 1 (10) ◽  
pp. 605-619 ◽  
Author(s):  
W. H. Eugenie Maïga ◽  
Mohamed Porgo ◽  
Pam Zahonogo ◽  
Cocou Jaurès Amegnaglo ◽  
Doubahan Adeline Coulibaly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Skills Training ◽  
Urban Migration ◽  
Youth Engagement ◽  
Middle Income ◽  
Middle Income Countries ◽  
Positive Effects ◽  
Training Programmes ◽  
Low And Middle Income

Abstract Engagement of youth in agriculture in low- and middle-income countries may offer opportunities to curb underemployment, urban migration, disillusionment of youth and social unrest, as well as to lift individuals and communities from poverty and hunger. Lack of education or skills training has been cited as a challenge to engage youth in the sector. Here we systematically interrogate the literature for the evaluation of skills training programmes for youth in low- and middle-income countries. Sixteen studies—nine quantitative, four qualitative and three mixed methods—from the research and grey literature documented the effects of programmes on outcomes relating to youth engagement, including job creation, income, productivity and entrepreneurship in agriculture. Although we find that skills training programmes report positive effects on our chosen outcomes, like previous systematic reviews we find the topic to chronically lack evaluation. Given the interest that donors and policymakers have in youth engagement in agriculture, our systematic review uncovers a gap in the knowledge of their effectiveness.

scholarly journals Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 531
Author(s):  
Zohra S Lassi ◽  
Zahra A Padhani ◽  
Amna Rabbani ◽  
Fahad Rind ◽  
Rehana A. Salam ◽  
...  
Keyword(s):  
Birth Weight ◽  
Obesity Prevention ◽  
Data Extraction ◽  
Child Outcomes ◽  
Grey Literature ◽  
Food Distribution ◽  
Dietary Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Optimal nutrition plays a crucial role in pregnancy. Maternal malnutrition is a risk factor for maternal, fetal, and neonatal complications and is more prevalent in low and middle-income countries (LMICs). This review aims to study the effectiveness of antenatal macronutrient nutritional interventions on maternal, neonatal, and child outcomes. We searched the CENTRAL, PubMed, Embase, and other databases for randomized controlled trials and quasi-experimental designs on healthy pregnant women in LMICs. We also searched grey literature and reports from Google Scholar, Web of Science, and websites of different organizations. Title/abstract screening, full-text screening, and data extraction filtered 15 studies for inclusion. Balanced energy protein (BEP) supplementation (n = 8) studies showed a reduced incidence of perinatal mortality, stillbirths, low birth weight (LBW) infants, small for gestational age (SGA) babies and increased birth weight. Food distribution programs (FDPs) (n =5) witnessed reduced rates of SGA, stunting, wasting, and increased birth weight and birth length. Studies on intervention for obesity prevention (n = 2) showed reductions in birth weight. Other findings were statistically insignificant. Subgroup analyses were conducted to study the effectiveness of supplementation between regions, location, the timing of supplementation and nutritional status; however, there were a limited number of studies in each subgroup. Data from our review supports the antenatal supplementation of BEP and FDP for the prevention of adverse maternal, neonatal, and child outcomes that can be utilized for future policymaking. However, more research is required before recommending obesity prevention programs.

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