scholarly journals Feasibility Study of a Menstrual Hygiene Management Intervention for People with Intellectual Impairments and Their Carers in Nepal

2019 ◽  
Vol 16 (19) ◽  
pp. 3750
Author(s):  
Jane Wilbur ◽  
Thérèse Mahon ◽  
Belen Torondel ◽  
Shaffa Hameed ◽  
Hannah Kuper
Keyword(s):  
Small Sample ◽  
Post Intervention ◽  
Menstrual Hygiene ◽  
Management Intervention ◽  
Left Behind ◽  
Menstrual Hygiene Management ◽  
Intervention Process ◽  
Hygiene Management ◽  
Before And After ◽  
Depth Interviews

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.

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 ◽  
...  
Keyword(s):  
Public Health ◽  
People With Disabilities ◽  
Menstrual Hygiene ◽  
Left Behind ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Purposeful Sampling ◽  
Educational Issue ◽  
Support Mechanisms ◽  
Depth Interviews

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’.

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 

2020 ◽  
Author(s):  
Jane Wilbur ◽  
Shubha Kayastha ◽  
Thérèse Mahon ◽  
Belen Torondel ◽  
Shaffa Hameed ◽  
...  
Keyword(s):  
Public Health ◽  
People With Disabilities ◽  
Menstrual Hygiene ◽  
Left Behind ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Purposeful Sampling ◽  
Educational Issue ◽  
Support Mechanisms ◽  
Depth Interviews

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’.

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

2020 ◽  
Author(s):  
Jane Wilbur ◽  
Shubha Kayastha ◽  
Thérèse Mahon ◽  
Belen Torondel ◽  
Shaffa Hameed ◽  
...  
Keyword(s):  
People With Disabilities ◽  
User Preference ◽  
Menstrual Hygiene ◽  
Left Behind ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Purposeful Sampling ◽  
Educational Issue ◽  
Sanitation And Hygiene ◽  
Support Mechanisms

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’.

scholarly journals Knowledge and practice of menstrual hygiene among adolescent school girls in Umunna, Imo State, Southeast Nigeria: implications for parents, healthcare providers and policy makers

2021 ◽  
Vol 10 (2) ◽  
pp. 458
Author(s):  
Chika O. Duru ◽  
Eugene M. Ikeanyi ◽  
Irene Merenu
Keyword(s):  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Age At Menarche ◽  
Cross Sectional ◽  
School Activities ◽  
Menstrual Hygiene ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Before And After ◽  
School Girls

Background: Menstrual hygiene management is critical in the life of the woman. For optimal attendance and participation in school activities, future reproductive and sexual health; quality menstrual hygiene practice is crucial. The objective of this study was designed to assess the knowledge, practice and challenges of menstrual hygiene management among the adolescentsMethods: A cross-sectional study was conducted on a community secondary school girls from 1st May to 30th June 2016.  Data was collected with a semi-structured pre-tested questionnaire and analyzed with statistical software as appropriate.Results: A total of 416 (97.4%) of the respondents were analyzed. Their mean chronological age and age at menarche were 15±2.1 years and 12.9±0.7 years respectively. Most (77.9%) of the respondents had premenarchal menstrual hygiene knowledge and mothers (68.8%) were the main source of information. Sanitary pad (56.3%) and cloth (31.2%) were the most commonly used absorbents.  Sanitary pad use was higher in respondents whose mothers had higher level education (RR=6.3, p<0.001). Most of the respondents changed absorbent twice or less daily (77.4%), bathed at least twice (77.4%), washed vulvoperineal region with soap and water (50.2%) and wiped perineum front to back (72.8%).  Burning (51.9%) and refuse dump (26.0%) were the main disposal methods and 48.1% washed hands before and after changing menstrual absorbent materials. Main menstrual disturbances were abdominal pain (37.7%) and malaise (18.5%) and main intervention was medication from patent medicine store (47.2%). Menstruation-related school absenteeism was 30.8%.Conclusions: There was poor premenarchal menstrual awareness and inappropriate menstrual hygiene practices among adolescent schoolgirls.

Menstrual Hygiene Management and Practices in Campuses

2020 ◽  
Vol 8 ◽  
pp. 73-84
Author(s):  
Madhavi Gautam Ghimire
Keyword(s):  
Higher Education ◽  
Life Experiences ◽  
Group Discussions ◽  
Menstrual Hygiene ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Sanitation And Hygiene ◽  
Multiple Issues ◽  
School Girls ◽  
Depth Interviews

 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.  

scholarly journals The Bishesta campaign: a menstrual hygiene management intervention for people with intellectual impairments and their carers

Waterlines ◽  
2021 ◽  
Vol 40 (3) ◽  
pp. 209-224
Author(s):  
Jane Wilbur ◽  
Islay Mactaggart ◽  
Thérèse Mahon ◽  
Belen Torondel ◽  
Shaffa Hameed ◽  
...  
Keyword(s):  
Young People ◽  
Scale Up ◽  
Young Person ◽  
Small Scale ◽  
Intellectual Impairment ◽  
Menstrual Hygiene ◽  
Management Intervention ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Training Modules

This paper describes the components of the Bishesta campaign: a behaviour change intervention for menstrual hygiene management (MHM), targeting young people with intellectual impairments, and their carers in Nepal. The campaign uses two fictitious characters: Bishesta (a young person with an intellectual impairment) and Perana (her carer), and consists of three group training modules. ‘Period packs’, designed to make MHM behaviours attractive and easy to adopt, are given to the young people. Packs include storage bags, a bin, and stories about Bishesta menstruating and learning to manage as independently as possible, with Perana’s support. Carers receive a calendar to track the young person’s menstrual cycle. A Bishesta doll, with removable clothes, underwear, and a miniature ‘period pack’ is used in training to demonstrate MHM. Evaluation findings show the intervention is feasible at small scale, so further research on how to scale up the intervention in an evidence-based way is required.

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.

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