Understanding the menstrual hygiene management challenges facing displaced girls and women: findings from qualitative assessments in Myanmar and Lebanon
Open accessAbstract
BACKGROUND: There is a significant gap in empirical evidence on the menstrual hygiene management (MHM) challenges faced by adolescent girls and women in emergency contexts, and on appropriate humanitarian response approaches to meet their needs in diverse emergency contexts. To begin filling the gap in the evidence, we conducted a study in two diverse contexts (Myanmar and Lebanon), exploring the MHM barriers facing girls and women, and the various relevant sectoral responses being conducted (e.g. water, sanitation and hygiene (WASH), Protection, Health, Education and Camp Management). METHODS: Two qualitative assessments were conducted: one in camps for internally displaced populations in Myanmar, and one with refugees living in informal settlements and host communities in Lebanon. Key informant interviews were conducted with emergency response staff in both sites, and focus group discussion and participatory mapping activities conducted with adolescent girls and women. RESULTS: Key findings included that there was insufficient access to safe and private facilities for MHM coupled with displacement induced shifts in menstrual practices by girls and women. Among staff, there was a narrow interpretation of what an MHM response includes, with a focus on supplies; significant interest in understanding what an improved MHM response would include and acknowledgement of limited existing MHM guidance across various sectors; and insufficient consultation with beneficiaries, related to discomfort asking about menstruation, and limited coordination between sectors. CONCLUSIONS: There is a significant need for improved guidance across all relevant sectors for improving MHM response in emergency context, along with increased evidence on effective approaches for integrating MHM into existing responses.
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With the principal focus of MHM research centered on adolescent girls in school settings, considerably less attention has been given to women's experience of MHM at other life stages.
“With the principal focus of MHM research centered on adolescent girls in school settings, considerably less attention has been given to women’s experience of MHM at other life stages, outside of a few key papers that focus on menstruation in the workplace and in emergency contexts, along with other types of vaginal bleeding [38–43].”
From ’It’s like a burden on the head’: Redefining adequate menstrual hygiene management throughout women’s varied life stages in Odisha, India. (2019) · cites this paper as [42]
In some studies, knowledge was more varied, with those who had attended secondary education or schools with more comprehensive reproductive health education having adequate knowledge.
“In some studies, knowledge was more varied, with those who had attended secondary education or schools with more comprehensive reproductive health education having adequate knowledge”
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 [83]
Girls expressed a strong desire for more practical information, including managing menses or pain relief.
“Girls expressed a strong desire for more practical information, including managing menses or pain relief”
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 [83]
In humanitarian contexts, participants expressed that material provision was inconsistent.
“Similarly, in humanitarian contexts, participants expressed that material provision was inconsistent [15, 35, 83].”
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 [83]
In humanitarian contexts, changed access to materials was salient in women's experiences as they adapted to new management practices or were unable continue their past preferred behaviours.
“In humanitarian contexts, changed access to materials was salient in women’s experiences as they adapted to new management practices or were unable continue their past preferred behaviours [40, 83].”
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 [83]
Lessons from Myanmar and Lebanon suggest that women and girls' choice of adsorbents in emergency settings depend on the availability of the materials, privacy for changing the pads and availability of private space for washing and drying the reusable towels or disposing of pads.
“Lessons from Myanmar and Lebanon suggests that, women and girls’ choice of adsorbents in emergency settings depend on the availability of the materials, privacy for changing the pads and availability of private space for washing and drying the reusable towels or disposing of pads [35].”
From Menstrual hygiene management among women and adolescent girls in the aftermath of the earthquake in Nepal (2018) · cites this paper as [35]
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“Safe disposal of sanitary pads was also a concerning issue, echoing the findings reported among displaced girls and women in Myanmar and Lebanon, where some women disposed of used pads together with household waste in dark colored plastic bags [35].”
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Self-citation
- Authors
- Schmitt, M. L., Clatworthy, D., Ratnayake, R., Klaesener-Metzner, N., Roesch, E., Wheeler, E., & Sommer, M.
- Affiliations
- Columbia University (US)
- International Rescue Committee (US)
- Corresponding author
- Sommer, Marni
- Venue
- Conflict and Health
- Published
- 2017-10-16
- Volume
- 11
- Issue
- 1
- Pages
- 19-19
- ISSN
- 1752-1505 (ISSN-L)
- PMC
- PMC5641996
- OpenAlex
- W2754468994
- Cited by
- 117
- References
- 18
- Citations by year
- 2026: 19 · 2025: 22 · 2024: 16 · 2023: 13 · 2022: 15 · 2021: 10 · 2020: 12 · 2019: 5 · 2018: 5
- FWCI
- 5.65
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Conflict and Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Columbia Academic Commons (Columbia University)
- Funders
- R2HC (Wellcome Trust and UK DFID) (12964)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Social Sciences › Gender Studies › Gender, Security, and Conflict
- Keywords
- menstrual hygiene management, humanitarian response, internally displaced persons, refugee camps, informal settlements, emergency situations, menstrual practices, sectoral coordination, Myanmar, Lebanon
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