Emotional and Psychosocial Aspects of Menstrual Poverty in Resource-Poor Settings: A Qualitative Study of the Experiences of Adolescent Girls in an Informal Settlement in Nairobi
Abstract
We introduce the concept of "menstrual poverty" to categorize the multiple deprivations relating to menstruation in resource-poor settings across the Global South, and we examine how this affects the psychological well-being of adolescent girls in an urban informal settlement in Kenya. We use qualitative data collected through 34 in-depth interviews and 18 focus group discussions with girls, women, and key informants. Menstrual poverty involved practical and psychosocial challenges affecting girls at home and at school. Its emotional impacts included anxiety, embarrassment, fear of stigma, and low mood. Further research is needed on how menstrual poverty affects girls' psychological and educational outcomes.
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Girls' experiences of menstruation in informal settlements of Nairobi are worse than the rest of the city.
“Evidence suggests that girls’ experiences of menstruation in informal settlements of Nairobi are worse than the rest of the city [27].”
From Physical, social, and political inequities constraining girls’ menstrual management at schools in informal settlements of Nairobi, Kenya. (2017) · cites this paper as [27]
In some studies, girls' post menarche and older women had lingering questions whether menstruation was needed to rid the body of 'dirty blood'.
“or whether it was needed to rid the body of ‘dirty blood’”
From Women’s and girls’ experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis (2019) · cites this paper as [10]
In many settings, menstrual blood-and by extension, menstruating women-were considered ritually impure or polluting.
“In many settings, menstrual blood—and by extension, menstruating women—were considered ritually impure or polluting”
From Women’s and girls’ experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis (2019) · cites this paper as [10]
Adolescent girls in poor households noted that requesting money for menstrual needs could cause friction in the household.
“Adolescent girls in poor households noted that requesting money for menstrual needs could cause friction in the household [10, 11].”
From Women’s and girls’ experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis (2019) · cites this paper as [10]
Many women and girls struggled to afford their choice of material, some studies noting that the household frequently lacked money for basic necessities and that commercial sanitary pads were considered an unaffordable luxury.
“Many women and girls struggled to afford their choice of material, some studies noting that the household frequently lacked money for basic necessities and that commercial sanitary pads were considered an unaffordable luxury [5, 10, 15, 41, 43, 51, 64, 68].”
From Women’s and girls’ experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis (2019) · cites this paper as [10]
Women and girls reported genital discomfort, irritation, rashes, and bruising during menses stemming from the properties of menstrual materials or inadequate frequency of change.
“Women and girls reported genital discomfort, irritation, rashes, and bruising during menses stemming from the properties of menstrual materials or inadequate frequency of change [9–11, 15, 37, 41, 44, 51, 56, 57, 68, 69, 72, 75].”
From Women’s and girls’ experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis (2019) · cites this paper as [10]
Reading across studies, authors consistently noted improved confidence to manage menstruation when participants had access to preferred materials and environments, greater knowledge, and access to social support.
“Reading across studies, authors consistently noted improved confidence to manage menstruation when participants had access to preferred materials and environments, greater knowledge, and access to social support [10, 15, 34, 38, 41, 51, 56, 58, 64, 70, 72, 75, 79, 84, 95, 103, 104].”
From Women’s and girls’ experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis (2019) · cites this paper as [10]
Studies noted the potential for negative menstrual experiences to have broader psychological impacts.
“Studies noted the potential for negative menstrual experiences to have broader psychological impacts [9, 10, 43, 44, 47, 68, 89, 93, 107].”
From Women’s and girls’ experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis (2019) · cites this paper as [10]
Many studies that focused on girls of school age reported consequences for education.
“Many studies that focused on girls of school age reported consequences for education [3–5, 8–11, 15, 37, 39, 41, 44, 51, 56–59, 62–64, 67–70, 72, 75, 77, 79, 85, 87–89, 91, 93, 94, 100, 101, 104, 106, 107].”
From Women’s and girls’ experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis (2019) · cites this paper as [10]
Qualitative research has documented challenges girls face in managing their menses and indicated health, education and psychosocial well-being consequences of poor management.
“Qualitative research has documented challenges girls face in managing their menses and indicated health, education and psychosocial well-being consequences of poor management.1–4”
From Measuring the prevalence and impact of poor menstrual hygiene management: A quantitative survey of schoolgirls in rural Uganda (2016) · cites this paper as [2]
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“13 Psychosocial consequences including shame, insecurity, anxiety and fear of stigma are well-documented correlates of menstruation in qualitative studies.(2) 4 Such negative psychosocial outcomes have been hypothesised to arise from poor MHM such as inadequate absorbent use.”
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- Authors
- Crichton, J., Okal, J., Kabiru, C. W., & Zulu, E. M.
- Affiliations
- University of Bristol (GB)
- Population Council (IN)
- African Population and Health Research Center (KE)
- African Institute for Development Policy (KE)
- Venue
- Health Care for Women International
- Publisher
- Informa UK Limited
- Published
- 2013-04-09
- Volume
- 34
- Issue
- 10
- Pages
- 891-916
- ISSN
- 0739-9332 (ISSN-L)
- 1096-4665
- OpenAlex
- W2039343977
- Cited by
- 147
- References
- 55
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 25 · 2023: 23 · 2022: 18 · 2021: 20 · 2020: 16 · 2019: 6 · 2018: 4 · 2017: 8 · 2016: 3 · 2014: 1 · 2013: 1
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Care For Women International (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- menstrual poverty, adolescent girls, menstrual health, psychosocial impact, stigma, anxiety, emotional well-being, informal settlements, resource-limited settings, school absenteeism
- MeSH terms
- Adaptation, Physiological, Adolescent, Adult, Child, Cross-Sectional Studies, Emotions, Female, Humans, Interviews as Topic, Kenya, Health Knowledge, Attitudes, Practice, Menstruation, Poverty, Social Environment, Social Support, Urban Population, Focus Groups, Qualitative Research, Young Adult
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