The water and sanitation community, in partnership with the educator sector, is long overdue in taking ownership of the menstrual hygiene management agenda for schools in low-income settings. While the global community writ large is implementing numerous interventions aimed at closing the gender gap in education, attention to assuring schools are non-discriminating structural environments where both girls and boys can succeed academically continues to be limited. Engaging schoolgirls in the assessment process to determine the essential water and sanitation interventions needed to enable comfortable school attendance and participation during monthly menses is critical. Solutions can be cost effective, but must be grounded in the local context, and designed according to the recommendations of school-going girls.
Over the last 15 years there has been increasing attention to adolescent girls' and women's menstrual hygiene management (MHM) needs in humanitarian response contexts. A growing number of donors, non-governmental organizations, and governments are calling attention to the importance of addressing girls' and women's MHM-related needs in post-disaster and post-conflict settings. However consensus on the most effective and culturally appropriate responses to provide for girls and women remains insufficiently documented for widespread sharing of lessons learned. This article is an effort to begin to document the recommendation of key multi-disciplinary experts working in humanitarian response on effective approaches to MHM in emergency contexts, along with a summarizing of the existing literature, and the identification of remaining gaps in MHM practice, research and policy in humanitarian contexts.
Half of the global population menstruate as part of their life cycle. This involves water, sanitation, and hygiene (WASH) needs that are often overlooked. Experience from the Millennium Development Goals shows that states focus on targets that are measured globally. Data and indicators on menstrual hygiene management (MHM) for women and girls can have a positive impact on raising awareness, national policy making, and in finding sustainable WASH sector solutions. With this paper, we explore the possible use of Joint Monitoring Programme for Water Supply and Sanitation estimates for representing women and girls’ unique WASH experience, through a focus on MHM. We reviewed definitions of MHM alongside indicators monitored by the JMP and calculated estimates for 18 case-study low- and middle-income countries. Consultation with a broad range of experts identified open defecation and handwashing indicators as the best proxy indicators for inadequate MHM. Globally around half a billion women (13 per cent) defecate in the open and likely lack privacy for MHM. Data on handwashing suggest that a lack of cleansing materials is a particular challenge for MHM. In six of 10 study countries with data, over three-quarters of women lacked handwashing facilities with water and soap. Further research is needed to establish the validity of various aspects of these proxies and to gain greater understanding of the principal WASH-related challenges and barriers faced by women. Nevertheless, it seems clear that interventions among communities with highest open defecation rates and lowest handwashing levels are needed to address barriers to MHM.
What is the scope for addressing menstrual hygiene management in complex humanitarian emergencies? A global review
Global attention on improving the integration of menstrual hygiene management (MHM) into humanitarian response is growing. However, there continues to be a lack of consensus on how best to approach MHM inclusion within response activities. This global review assessed the landscape of MHM practice, policy, and research within the field of humanitarian response. This included an analysis of the limited existing documentation and research on MHM in emergencies and global key informant interviews (n=29) conducted with humanitarian actors from relevant sectors (water, sanitation, and hygiene; women’s protection; child protection; health; education; non-food items; camp management). The findings indicate that despite a growing dialogue around MHM in emergencies, there remains a lack of clarity on the key components for a complete MHM response, the responsible sectoral actors to implement MHM activities, and the most effective interventions to adapt in emergency contexts, and insufficient guidance on monitoring and evaluation. There is a critical need for improved technical guidance and documentation on how to integrate MHM into existing programming and monitoring systems and to ensure adequate coordination and communication about MHM across relevant sectors. There is also a need for improved evidence on effective MHM approaches, the development of MHM-specific indicators, improved consultation with girls and women in crisis-afflicted areas, and the documentation of practical learning. It is only through improving the resources available and enhancing this evidence base that MHM can be perceived as an integral and routine component of any humanitarian response.