Uncovering the challenges to menstrual hygiene management in schools in Mali
Murat Sahin | Victoria Trinies | Bethany Caruso | Assitan Sogoré | Jérémie Toubkiss | Matthew Freeman
There is limited information on girls' menstrual hygiene practices and experiences at school in francophone sub-Saharan Africa. We conducted qualitative research to determine the challenges faced by school-aged girls in Mali, a culturally diverse and largely Muslim country. Research activities were conducted in eight urban and rural schools across the Sikasso and Koulikoro regions, including in-depth interviews with 26 girls and key informant interviews with 14 teachers and school directors. Results describe girls' practices for managing menstruation at school, their support systems and information channels, and their voiced recommendations for school WASH and education improvements.Caruso, B.A. (2014) WASH in Schools Empowers Girls' Education: Tools for Assessing Menstrual Hygiene Management in Schools, New York: UNICEF.
Caruso, B.A., Fehr, A., Inden, K., Sahin, M., Ellis, A., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Freetown, Sierra Leone: An Assessment of Menstrual Hygiene Management in Schools, New York: UNICEF.
Crofts, T. and Fisher, J. (2012) ‘Menstrual hygiene in Ugandan schools: an investigation of low-cost sanitary pads’, Journal of Water, Sanitation and Hygiene for Development 2: 50-8 <http://dx.doi.org/10.2166/washdev.2012.067≯.
Dhingra, R., Kumar, A. and Kour, M. (2009) ‘Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls’, Studies on Ethno-Medicine 3: 43-8 <http://dx.doi.org/10.1080/19371918.2010.525144≯.
Gottlieb, A. (1982) ‘Sex, fertility and menstruation among the Beng of the Ivory Coast: a symbolic analysis’, Africa 52: 34-47.
Guest, G., MacQueen, K.M. and Namey, E.E. (2011) Applied Thematic Analysis, Thousand Oaks, CA: SAGE Publications.
Haver, J., Caruso, B.A., Ellis, A., Sahin, M., Villasenor, J.M., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Masbate Province and Metro Manila, Philippines: An Assessment of Menstrual Hygiene Management in School, New York: UNICEF.
Institut National de la Statistique (2011) 4ème Recensement général de la population et de l'habitat du Mali, République du Mali: Ministère de L'Économie et des Finances.
Irinoye, O.O., Ogungbemi, A. and Ojo, A.O. (2003) ‘Menstruation: knowledge, attitude and practices of students in Ile-Ife, Nigeria’, Nigerian Medical Journal 12: 43-51
Keihas, L. (2013) Menstrual Hygiene in Schools in Two Countries of Francophone West Africa: Burkina Faso and Niger, New York: UNICEF.
Lawan, U.M., Nafisa, W.Y. and Musa, A.B. (2010) ‘Menstruation and menstrual hygiene amongst adolescent school girls in Kano, Northwestern Nigeria’, African Journal of Reproductive Health 14: 201-7.
Lee, S. and Kerner, B. (2013) ‘What do menstruating girls need in schools?’, A Global Village 9: 30-3.
Levin, E. (2001) ‘The meaning of menstrual management in a high-fertility society: Guinea, West Africa’, in E. van de Walle and E.P. Renne (eds), Regulating Menstruation: Beliefs, Practices, Interpretations, Chicago, IL: University of Chicago Press.
Long, J., Caruso, B.A., Lopez, D., Vancraeynest, K., Sahin, M., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Rural Cochabamba, Bolivia: An Assessment of Menstrual Hygiene Management in School, New York: UNICEF.
McMahon, S.A., Winch, P.J., Caruso, B.A., Obure, A.F., Ogutu, E.A., Ochari, I.A. and Rheingans, R.D. (2011) ‘“The girl with her period is the one to hang her head”: reflections on menstrual management among schoolgirls in rural Kenya’, BMC International Health and Human Rights 11: 7 <http://dx.doi.org/10.1186/1472-698X-11-7≯.
Madhavan, S. and Diarra, A. (2001) ‘The blood that links: menstrual regulation among the Bamana of Mali’, in E. van de Walle and E.P. Renne (eds), Regulating Menstruation: Beliefs, Practices, Interpretations, Chicago, IL: University of Chicago Press.
Mason, L., Nyothach, E., Alexander, K., Odhiambo, F.O., Eleveld, A., Vulule, J., Rheingans, R., Laserson, K.F., Mohammed, A. and Phillips-Howard, P.A. (2013) ‘“We keep it secret so no one should know”: a qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural western Kenya’, PloS One 8: e79132 <http://dx.doi.org/10.1371/journal.pone.0079132≯.
Moawed, S. (2001) ‘Indigenous practices of Saudi girls in Riyadh during their menstrual period’, Eastern Mediterranean Health Journal 7: 197-203.
Poureslami, M. and Osati-Ashtiani, F. (2002) ‘Assessing knowledge, attitudes, and behavior of adolescent girls in Suburban districts of Tehran about dysmenorrhea and menstrual hygiene’, Journal of International Women's Studies 3: 10-11
Rasmussen, S.J. (1991) ‘Lack of prayer: ritual restrictions, social experience, and the anthropology of menstruation among the Tuareg’, American Ethnologist 18: 751-69.
Slobin, K. (1998) ‘Repairing broken rules: care-seeking narratives for menstrual problems in rural Mali’, Medical Anthropology Quarterly 12: 363-83.
Caruso, B.A. (2014) WASH in Schools Empowers Girls' Education: Tools for Assessing Menstrual Hygiene Management in Schools, New York: UNICEF.
Caruso, B.A., Fehr, A., Inden, K., Sahin, M., Ellis, A., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Freetown, Sierra Leone: An Assessment of Menstrual Hygiene Management in Schools, New York: UNICEF.
Crofts, T. and Fisher, J. (2012) ‘Menstrual hygiene in Ugandan schools: an investigation of low-cost sanitary pads’, Journal of Water, Sanitation and Hygiene for Development 2: 50-8 <http://dx.doi.org/10.2166/washdev.2012.067≯.
Dhingra, R., Kumar, A. and Kour, M. (2009) ‘Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls’, Studies on Ethno-Medicine 3: 43-8 <http://dx.doi.org/10.1080/19371918.2010.525144≯.
Gottlieb, A. (1982) ‘Sex, fertility and menstruation among the Beng of the Ivory Coast: a symbolic analysis’, Africa 52: 34-47.
Guest, G., MacQueen, K.M. and Namey, E.E. (2011) Applied Thematic Analysis, Thousand Oaks, CA: SAGE Publications.
Haver, J., Caruso, B.A., Ellis, A., Sahin, M., Villasenor, J.M., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Masbate Province and Metro Manila, Philippines: An Assessment of Menstrual Hygiene Management in School, New York: UNICEF.
Institut National de la Statistique (2011) 4ème Recensement général de la population et de l'habitat du Mali, République du Mali: Ministère de L'Économie et des Finances.
Irinoye, O.O., Ogungbemi, A. and Ojo, A.O. (2003) ‘Menstruation: knowledge, attitude and practices of students in Ile-Ife, Nigeria’, Nigerian Medical Journal 12: 43-51
Keihas, L. (2013) Menstrual Hygiene in Schools in Two Countries of Francophone West Africa: Burkina Faso and Niger, New York: UNICEF.
Lawan, U.M., Nafisa, W.Y. and Musa, A.B. (2010) ‘Menstruation and menstrual hygiene amongst adolescent school girls in Kano, Northwestern Nigeria’, African Journal of Reproductive Health 14: 201-7.
Lee, S. and Kerner, B. (2013) ‘What do menstruating girls need in schools?’, A Global Village 9: 30-3.
Levin, E. (2001) ‘The meaning of menstrual management in a high-fertility society: Guinea, West Africa’, in E. van de Walle and E.P. Renne (eds), Regulating Menstruation: Beliefs, Practices, Interpretations, Chicago, IL: University of Chicago Press.
Long, J., Caruso, B.A., Lopez, D., Vancraeynest, K., Sahin, M., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Rural Cochabamba, Bolivia: An Assessment of Menstrual Hygiene Management in School, New York: UNICEF.
McMahon, S.A., Winch, P.J., Caruso, B.A., Obure, A.F., Ogutu, E.A., Ochari, I.A. and Rheingans, R.D. (2011) ‘“The girl with her period is the one to hang her head”: reflections on menstrual management among schoolgirls in rural Kenya’, BMC International Health and Human Rights 11: 7 <http://dx.doi.org/10.1186/1472-698X-11-7≯.
Madhavan, S. and Diarra, A. (2001) ‘The blood that links: menstrual regulation among the Bamana of Mali’, in E. van de Walle and E.P. Renne (eds), Regulating Menstruation: Beliefs, Practices, Interpretations, Chicago, IL: University of Chicago Press.
Mason, L., Nyothach, E., Alexander, K., Odhiambo, F.O., Eleveld, A., Vulule, J., Rheingans, R., Laserson, K.F., Mohammed, A. and Phillips-Howard, P.A. (2013) ‘“We keep it secret so no one should know”: a qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural western Kenya’, PloS One 8: e79132 <http://dx.doi.org/10.1371/journal.pone.0079132≯.
Moawed, S. (2001) ‘Indigenous practices of Saudi girls in Riyadh during their menstrual period’, Eastern Mediterranean Health Journal 7: 197-203.
Poureslami, M. and Osati-Ashtiani, F. (2002) ‘Assessing knowledge, attitudes, and behavior of adolescent girls in Suburban districts of Tehran about dysmenorrhea and menstrual hygiene’, Journal of International Women's Studies 3: 10-11
Rasmussen, S.J. (1991) ‘Lack of prayer: ritual restrictions, social experience, and the anthropology of menstruation among the Tuareg’, American Ethnologist 18: 751-69.
Slobin, K. (1998) ‘Repairing broken rules: care-seeking narratives for menstrual problems in rural Mali’, Medical Anthropology Quarterly 12: 363-83.
Caruso, B.A. (2014) WASH in Schools Empowers Girls' Education: Tools for Assessing Menstrual Hygiene Management in Schools, New York: UNICEF.
Caruso, B.A., Fehr, A., Inden, K., Sahin, M., Ellis, A., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Freetown, Sierra Leone: An Assessment of Menstrual Hygiene Management in Schools, New York: UNICEF.
Crofts, T. and Fisher, J. (2012) ‘Menstrual hygiene in Ugandan schools: an investigation of low-cost sanitary pads’, Journal of Water, Sanitation and Hygiene for Development 2: 50-8 <http://dx.doi.org/10.2166/washdev.2012.067≯.
Dhingra, R., Kumar, A. and Kour, M. (2009) ‘Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls’, Studies on Ethno-Medicine 3: 43-8 <http://dx.doi.org/10.1080/19371918.2010.525144≯.
Gottlieb, A. (1982) ‘Sex, fertility and menstruation among the Beng of the Ivory Coast: a symbolic analysis’, Africa 52: 34-47.
Guest, G., MacQueen, K.M. and Namey, E.E. (2011) Applied Thematic Analysis, Thousand Oaks, CA: SAGE Publications.
Haver, J., Caruso, B.A., Ellis, A., Sahin, M., Villasenor, J.M., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Masbate Province and Metro Manila, Philippines: An Assessment of Menstrual Hygiene Management in School, New York: UNICEF.
Institut National de la Statistique (2011) 4ème Recensement général de la population et de l'habitat du Mali, République du Mali: Ministère de L'Économie et des Finances.
Irinoye, O.O., Ogungbemi, A. and Ojo, A.O. (2003) ‘Menstruation: knowledge, attitude and practices of students in Ile-Ife, Nigeria’, Nigerian Medical Journal 12: 43-51
Keihas, L. (2013) Menstrual Hygiene in Schools in Two Countries of Francophone West Africa: Burkina Faso and Niger, New York: UNICEF.
Lawan, U.M., Nafisa, W.Y. and Musa, A.B. (2010) ‘Menstruation and menstrual hygiene amongst adolescent school girls in Kano, Northwestern Nigeria’, African Journal of Reproductive Health 14: 201-7.
Lee, S. and Kerner, B. (2013) ‘What do menstruating girls need in schools?’, A Global Village 9: 30-3.
Levin, E. (2001) ‘The meaning of menstrual management in a high-fertility society: Guinea, West Africa’, in E. van de Walle and E.P. Renne (eds), Regulating Menstruation: Beliefs, Practices, Interpretations, Chicago, IL: University of Chicago Press.
Long, J., Caruso, B.A., Lopez, D., Vancraeynest, K., Sahin, M., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Rural Cochabamba, Bolivia: An Assessment of Menstrual Hygiene Management in School, New York: UNICEF.
McMahon, S.A., Winch, P.J., Caruso, B.A., Obure, A.F., Ogutu, E.A., Ochari, I.A. and Rheingans, R.D. (2011) ‘“The girl with her period is the one to hang her head”: reflections on menstrual management among schoolgirls in rural Kenya’, BMC International Health and Human Rights 11: 7 <http://dx.doi.org/10.1186/1472-698X-11-7≯.
Madhavan, S. and Diarra, A. (2001) ‘The blood that links: menstrual regulation among the Bamana of Mali’, in E. van de Walle and E.P. Renne (eds), Regulating Menstruation: Beliefs, Practices, Interpretations, Chicago, IL: University of Chicago Press.
Mason, L., Nyothach, E., Alexander, K., Odhiambo, F.O., Eleveld, A., Vulule, J., Rheingans, R., Laserson, K.F., Mohammed, A. and Phillips-Howard, P.A. (2013) ‘“We keep it secret so no one should know”: a qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural western Kenya’, PloS One 8: e79132 <http://dx.doi.org/10.1371/journal.pone.0079132≯.
Moawed, S. (2001) ‘Indigenous practices of Saudi girls in Riyadh during their menstrual period’, Eastern Mediterranean Health Journal 7: 197-203.
Poureslami, M. and Osati-Ashtiani, F. (2002) ‘Assessing knowledge, attitudes, and behavior of adolescent girls in Suburban districts of Tehran about dysmenorrhea and menstrual hygiene’, Journal of International Women's Studies 3: 10-11
Rasmussen, S.J. (1991) ‘Lack of prayer: ritual restrictions, social experience, and the anthropology of menstruation among the Tuareg’, American Ethnologist 18: 751-69.
Slobin, K. (1998) ‘Repairing broken rules: care-seeking narratives for menstrual problems in rural Mali’, Medical Anthropology Quarterly 12: 363-83.
Caruso, B.A. (2014) WASH in Schools Empowers Girls' Education: Tools for Assessing Menstrual Hygiene Management in Schools, New York: UNICEF.
Caruso, B.A., Fehr, A., Inden, K., Sahin, M., Ellis, A., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Freetown, Sierra Leone: An Assessment of Menstrual Hygiene Management in Schools, New York: UNICEF.
Crofts, T. and Fisher, J. (2012) ‘Menstrual hygiene in Ugandan schools: an investigation of low-cost sanitary pads’, Journal of Water, Sanitation and Hygiene for Development 2: 50-8 <http://dx.doi.org/10.2166/washdev.2012.067≯.
Dhingra, R., Kumar, A. and Kour, M. (2009) ‘Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls’, Studies on Ethno-Medicine 3: 43-8 <http://dx.doi.org/10.1080/19371918.2010.525144≯.
Gottlieb, A. (1982) ‘Sex, fertility and menstruation among the Beng of the Ivory Coast: a symbolic analysis’, Africa 52: 34-47.
Guest, G., MacQueen, K.M. and Namey, E.E. (2011) Applied Thematic Analysis, Thousand Oaks, CA: SAGE Publications.
Haver, J., Caruso, B.A., Ellis, A., Sahin, M., Villasenor, J.M., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Masbate Province and Metro Manila, Philippines: An Assessment of Menstrual Hygiene Management in School, New York: UNICEF.
Institut National de la Statistique (2011) 4ème Recensement général de la population et de l'habitat du Mali, République du Mali: Ministère de L'Économie et des Finances.
Irinoye, O.O., Ogungbemi, A. and Ojo, A.O. (2003) ‘Menstruation: knowledge, attitude and practices of students in Ile-Ife, Nigeria’, Nigerian Medical Journal 12: 43-51
Keihas, L. (2013) Menstrual Hygiene in Schools in Two Countries of Francophone West Africa: Burkina Faso and Niger, New York: UNICEF.
Lawan, U.M., Nafisa, W.Y. and Musa, A.B. (2010) ‘Menstruation and menstrual hygiene amongst adolescent school girls in Kano, Northwestern Nigeria’, African Journal of Reproductive Health 14: 201-7.
Lee, S. and Kerner, B. (2013) ‘What do menstruating girls need in schools?’, A Global Village 9: 30-3.
Levin, E. (2001) ‘The meaning of menstrual management in a high-fertility society: Guinea, West Africa’, in E. van de Walle and E.P. Renne (eds), Regulating Menstruation: Beliefs, Practices, Interpretations, Chicago, IL: University of Chicago Press.
Long, J., Caruso, B.A., Lopez, D., Vancraeynest, K., Sahin, M., Andes, K.L. and Freeman, M.C. (2013) WASH in Schools Empowers Girls' Education in Rural Cochabamba, Bolivia: An Assessment of Menstrual Hygiene Management in School, New York: UNICEF.
McMahon, S.A., Winch, P.J., Caruso, B.A., Obure, A.F., Ogutu, E.A., Ochari, I.A. and Rheingans, R.D. (2011) ‘“The girl with her period is the one to hang her head”: reflections on menstrual management among schoolgirls in rural Kenya’, BMC International Health and Human Rights 11: 7 <http://dx.doi.org/10.1186/1472-698X-11-7≯.
Madhavan, S. and Diarra, A. (2001) ‘The blood that links: menstrual regulation among the Bamana of Mali’, in E. van de Walle and E.P. Renne (eds), Regulating Menstruation: Beliefs, Practices, Interpretations, Chicago, IL: University of Chicago Press.
Mason, L., Nyothach, E., Alexander, K., Odhiambo, F.O., Eleveld, A., Vulule, J., Rheingans, R., Laserson, K.F., Mohammed, A. and Phillips-Howard, P.A. (2013) ‘“We keep it secret so no one should know”: a qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural western Kenya’, PloS One 8: e79132 <http://dx.doi.org/10.1371/journal.pone.0079132≯.
Moawed, S. (2001) ‘Indigenous practices of Saudi girls in Riyadh during their menstrual period’, Eastern Mediterranean Health Journal 7: 197-203.
Poureslami, M. and Osati-Ashtiani, F. (2002) ‘Assessing knowledge, attitudes, and behavior of adolescent girls in Suburban districts of Tehran about dysmenorrhea and menstrual hygiene’, Journal of International Women's Studies 3: 10-11
Rasmussen, S.J. (1991) ‘Lack of prayer: ritual restrictions, social experience, and the anthropology of menstruation among the Tuareg’, American Ethnologist 18: 751-69.
Slobin, K. (1998) ‘Repairing broken rules: care-seeking narratives for menstrual problems in rural Mali’, Medical Anthropology Quarterly 12: 363-83.
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Nyothach, Elizabeth
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