Practice Note: Menstrual Health Management in Humanitarian Settings. Chapter 45 in the Palgrave Handbook of Critical Menstruation Studies, July 2020.
The authors are volunteers or staff with WoMena, an NGO that works to improve menstrual health and management in Uganda. Based on this experience and focusing on Uganda and Nepal, this practice note probes how the issue is approached in different contexts and at different stages—comparing urgent response after a sudden onset disaster (for example, earthquakes) to protracted crises (for example, long-term refugee settings).
The authors discuss how interventions can be made sustainable beyond the short-term ‘kit culture’ response; they highlight experiences with more developmental approaches involving policy support, community participation, capacity building, and the use of products that are economically and environmentally sustainable.
Background: There is growing attention to addressing the menstrual hygiene management (MHM) needs of the over 21 million displaced adolescent girls and women globally. Current approaches to MHM-related humanitarian programming often prioritize the provision of menstrual materials and information. However, a critical component of an MHM response includes the construction and maintenance of water, sanitation and hygiene (WASH) facilities, including more female-friendly toilets. This enables spaces for menstruating girls and women to change, dispose, wash and dry menstrual materials; all of which are integral tasks required for MHM. A global assessment identied a number of innovations focused on designing and implementing menstruation-supportive WASH facilities in the refugee camps located in Cox’s Bazar (CXB), Bangladesh. These pilot efforts strove to include the use of more participatory methodologies in the process of developing the new MHM-supportive WASH approaches.
Results: Key findings included one, the identification of new female-driven consultation methods aimed at improving female beneficiary involvement and buy-in during the design and construction phases; two, the design of new multi-purpose WASH facilities to increase female beneficiary usage; three, new menstrual waste disposal innovations being piloted in communal and institutional settings, with female users indicating at least initial acceptability; and four, novel strategies for engaging male beneficiaries in the design of female WASH facilities, including promoting dialogue to generate buy-in regarding the importance of these facilities and debate about their placement.
Conclusions: Although the identified innovative participatory methodologies and design approaches are promising, the long term viability of the facilities, including plans to expand them, may be dependent on the continued engagement of girls and women, and the availability of resources.