Cited by 125Menstrual Health and DisordersGender Studies and Social IssuesHypothalamic control of reproductive hormones

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Practice and lived experience of menstrual exiles (Chhaupadi) among adolescent girls in far-western Nepal

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Amatya, Prabisha, Ghimire, Saruna, Callahan, Karen E., Baral, Binaya Kumar, Poudel, Krishna C.·2018·PLoS ONE

DOI 10.1371/journal.pone.0208260PMC PMC6287853

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Abstract

BACKGROUND: Menstrual exile, also known as Chhaupadi, is a tradition of "untouchability" in far-western Nepal. Forbidden from touching other people and objects, women and girls are required to live away from the community, typically in a livestock shed, during menstruation. We assessed the lived experiences of Chhaupadi among Nepalese adolescent girls in the far-western Achham district of Nepal, observed the safety and sanitation of their living spaces during Chhaupadi, and assessed the perceptions of local adult stakeholders towards the practice of Chhaupadi. METHODS: We collected data from 107 adolescent girls using a self-administered survey in two local schools in Achham. We also conducted a focus group discussion with seven girls, held key informant interviews, and observed the girls' living spaces during Chhaupadi, using a checklist. Descriptive statistics of the quantitative survey and thematic analyses of qualitative interviews are presented. RESULTS: The majority of the girls (n = 77, 72%) practiced exile, or Chhaupadi, during their menstruation, including 3 (4%) exiled to traditional Chhau sheds, 63 (82%) to livestock sheds, and 11 (14%) to courtyards outside their home. The remaining girls (n = 30, 28%) stayed inside the house, yet practiced some form of menstrual taboos. Of the 77 observed living spaces where the girls stayed during exile, only 30% (n = 23) had a toilet facility. Most exiled girls (97.4%) were restricted from eating dairy products. Participants reported having various psychological problems, including lonliness and difficulty sleeping while practicing Chhaupadi. Three of the girls were physically abused; nine were bitten by a snake. Notably high proportions of the living spaces lacked ventilation/windows (n = 20, 26%), electricity (n = 29, 38%), toilets (n = 54, 70%) and a warm blanket and mattress for sleeping (n = 29, 38%). Our qualitative findings supported our quantitative results. CONCLUSIONS: Chhaupadi has been condemned by human rights organizations. While the government has banned the practice, implementation on the ban is proceeding slowly, especially in far-western Nepal. Thus, as a temporary measure, public health professionals must work towards promoting the health and safety of Nepalese women and girls still practicing Chhaupadi.

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Untitled work
(2017) · Cited by 16,036
Phenomenological research methods
Moustakas, C. (1994) · doi:10.4135/9781412995658 · Cited by 13,919
Nepal Demographic And Health Survey 2006
Mohp, P., & Nepal (2007) · Cited by 1,359
Qualitative research in healthcare: An introduction to grounded theory using thematic analysis
Chapman, A. L. N., Hadfield, M., & Chapman, C. (2015) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.4997/jrcpe.2015.305 · Cited by 658
A systematic review of the health and social effects of menstrual hygiene management
Sumpter, C., & Torondel, B. (2013) · PLoS ONE · doi:10.1371/journal.pone.0062004 · Cited by 518
Menstrual hygiene management among adolescent girls in India: a systematic review and meta-analysis
van Eijk, A. M., Sivakami, M., Thakkar, M. B., Bauman, A., Laserson, K. F., Coates, S., & Phillips-Howard, P. A. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010290 · Cited by 471
John W. Creswell, "Qualitative Inquiry and Research Design : Choosing Among Five Approaches.", SAGE, 2013
寺口, 季. (2017) · Institutional Repositories DataBase (IRDB) · doi:10.18910/60462 · Cited by 281
Nutrition and pubertal development
Soliman, A. T., Sanctis, V. D., & Elalaily, R. (2014) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.145073 · Cited by 265
Caste ethnic and regional identity in Nepal: Further analysis of the 2006 Nepal Demographic and Health Survey.
Bennett, L., Dr, D., & Govindasamy, P. (2008) · Cited by 215
Untitled work
(2012) · Cited by 189

Show all 21 references

Research works printed but not linked: 13

K Seymour, 2008, Bangladesh: Tackling menstrual hygiene taboos, UNICEF Sanitation and Hygiene, Case 10
United Nations, 2011, Field Bulletin: Chaupadi in the far-west
K Hodal, 2016, ) Nepal’s bleeding shame: menstruating women banished to cattle sheds, The Guardian
PHASE Worldwide, 2013, Chhaupadi: Giving Birth in the Cow Shed, Bristol: PHASE Worldwide
D Lama, 2015, Maternal and Child Health Care in Chhaupadi Pratha, Social seclusion of mother and child after delivery in Achham, Nepal, Public Health Research Series, 22
D Preiss, 2017, Law In Nepal Sets Penalties For Forcing A Woman Into A Menstrual Shed. National Public Radio, Law In Nepal Sets Penalties For Forcing A Woman Into A Menstrual Shed. National Public Radio
S Pokharel, 2017, Nepal outlaws menstruation huts, but what will take their place?, CNN
Bhandari R, Pandey B, Rajak M, Pantha P (2013) Chhaupadi: victimizing women of Nepal. in Jaishankar K and Ronel N (2013). Proceedings of the Second International Conference of the South Asian Society of Criminology and Victimology (SASCV), January 11–13, 2013. Tamilnadu, India.
KB Karki, 2017, Scoping Review and Preliminary Mapping Menstrual Health and Hygiene Management in Nepal
2006, Adolescent nutrition: a review of the situation in selected South-East Asian Countries
S Pokharel, 2017, Nepali 'menstruation hut' ritual claims life of teenage girl, CNN. New Delhi
D Preiss, 2016, 15-Year-Old Girl Found Dead In A Menstrual Hut In Nepal, National Public Radio.
A Gaelstel, 2013, Women in Nepal suffer monthly ostracization, The New York Times, 14

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Kawata, R., Endo, M., & Ohashi, K. (2022) · BMC Women s Health · doi:10.1186/s12905-022-01789-9 · Cited by 4
“Several studies have been conducted on the relationship between traditional practices and menstrual hygiene management (MHM) education in primary schools [10, 11, 20, 21].”
Background
Experiences of menstrual health in the Nordic countries: a scoping review of qualitative research, applying an intersectional lens
Åkerman, E., Wängborg, A., Persson, M., & Klingberg‐Allvin, M. (2024) · Sexual and Reproductive Health Matters · doi:10.1080/26410397.2024.2446081 · Cited by 6
Menstrual health needs and educational outcomes among adolescent girls living in countries in sub-Saharan Africa: systematic review protocol
Gbogbo, S., Axame, W. K., Wuresah, I., Gbogbo, E., Klutse, P., Hayibor, F., Kugbey, N., Imakando, M. M., Doku, V. C. K., Hennegan, J. M., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-094613 · Cited by 3
Navigating the patriarchal bargain: Compliance with and negotiation of menstrual customs in Kathmandu, Nepal
Karki, S., & Mix, T. L. (2023) · Women s Studies International Forum · doi:10.1016/j.wsif.2023.102767 · Cited by 3
From stigma to solutions: harnessing local wisdom to tackle harms associated with menstrual seclusion ( chhaupadi ) in Nepal
Baumann, S. E., Rabin, M. A., Hawk, M. E., Devkota, B., Upadhaya, K., Shrestha, G. R., Joseph, B., & Burke, J. G. (2024) · Culture Health & Sexuality · doi:10.1080/13691058.2024.2373793 · Cited by 5
“Nepal consider menstruating women as impure, imposing restrictions that affect women’s daily routines (Amatya et al. 2018; Baumann, Lhaki, et al. 2021b; Bennett 1983; Cameron 1998; Thakuri et al. 2021).”
Influential
Unlocking the potential for engaging men to improve reproductive, maternal, and neonatal health in Karnali Province, Nepal
Pokhrel, K. N., Thakuri, D. S., Dagadu, N. A., Balami, R., Sharma, M., & Bhandari, R. (2022) · BMC Public Health · doi:10.1186/s12889-022-14534-6 · Cited by 3
“Such belief is often harmful and women are being stigmatized that resulted in poor utilization of RMNH services [23].”
Background
Exploratory systematic review and meta-analysis on period poverty
Delanerolle, G., Yang, X., Cavalini, H. F. S., Kurmi, O., Røstvik, C. M., Shetty, A., Saraswat, L., Taylor, J., Sajid, S., Rathod, S., et al. (2023) · World Journal of Meta-Analysis · doi:10.13105/wjma.v11.i5.196 · Cited by 12
Menstrual practices, fertility intentions and decision-making regarding family planning by women belonging to various indigenous groups of Wayanad- A qualitative study
Sreedevi, A., George, L. S., Varughese, S. A., Najeeb, S. S., Aravindan, L., Anvar, R., Georgy, S., Menon, V. B., Sathish, S., & Nedungadi, P. (2023) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1799_22 · Cited by 3
“The women are restricted from performing their routine daily activities and excluded from community activities, a finding similar to a study on tribals in Nepal by Amatya et al.[18] Though some younger women voiced discomfort in carrying out these rituals, the older women were happy to abide by the age‐old traditions.”
Result
Diaspora Diplomacy: Emerging Priority of Nepal’s Foreign Policy
Sharma, P. (2021) · Journal of Political Science · doi:10.3126/jps.v21i0.35267 · Cited by 3
Exploring Coastal Male Knowledge, Perception, and Prioritization of Female Menstrual Health in Southern Bangladesh
Yasmin, F., Meem, J. J., Saha, S. K., & Khanam, D. (2026) · Health Science Reports · doi:10.1002/hsr2.71783 · Cited by 2
Socio-Demographic and Health Status of Women in Nepal
Khanal, P. (2022) · Journal of Population and Development · doi:10.3126/jpd.v3i1.48809 · Cited by 2
“In the discussion series on India, Germain (2003) said that people living with HIV/AIDS in India are more likely to be close to 10 million, and already 40 percent of these are female. Most of them are girls and young women. According to a study conducted by Amatya et al (2018), women are still dying as a result of tra…”
BackgroundMethodInfluential
Menstruation and Gender-Based Violence
Whitecross, R. W. (2023) · Springer eBooks · doi:10.1007/978-3-031-05640-6_23 · Cited by 2
Socio-cultural practices and experiences of menstruation among adolescents and women of Kurichiya tribe of Wayanad: an ethnographic study
Shibu, A., & Amaresha, A. C. (2023) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20233761 · Cited by 2
The Interplay Between Social Media, Moral Perceptions, and the Proliferation of Mimetic Desires Among Youth in South Asia
Udayanga, S. (2023) · Springer eBooks · doi:10.1007/978-3-030-87624-1_403-1 · Cited by 2
Cultural taboos and menstrual health: analysing practices in Gadchiroli’s Kurma Ghar (period huts) in Maharashtra
Siddiqui, S., & Nidhi, K. (2025) · Discover Public Health · doi:10.1186/s12982-025-00544-3 · Cited by 2
“These period huts are typically unsanitary and lack basic amenities, further stigmatizing the natural biological process [4].”
Gender, Populism and Collective Identity: a Feminist Analysis of the Maoist Movement in Nepal
Riley, H., Ketola, H., & Yadav, P. K. (2022) · Journal of Human Security · doi:10.12924/johs2022.18020035 · Cited by 2
“A crucial theme in the literature is the prevalent threat of a post-conﬂict ‘backlash’, a dynamic that involves a violent rein-stating of regulatory gender norms (E.g. [66,67]).”
Educating for equity, navigating reality: community health nurses implementing interventions to eradicate Chhaupadi in Karnali, Nepal
Ghimire, A., & Neupane, M. S. (2025) · BMC Nursing · doi:10.1186/s12912-025-04012-w · Cited by 1
“This study’s finding contrasts with previous studies that have focused primarily on FCHV activities [1, 4, 23, 50, 51], failing to highlight the often-invisible intellectual and creative labor that CHRNs invest in equip-ping these frontline volunteers.”
Unpacking the water-wealth-gender nexus: an integrated vulnerability approach
Oluwasanya, G., Omoniyi, A., Matin, M. A., Bankole, A. R., Qadir, M., & Madani, K. (2026) · Sustainability Nexus Forum · doi:10.1007/s00550-026-00586-4 · Cited by 1
“…a deeply rooted religious-cultural practice in which menstruating girls/women are considered untouchable and forced to live in separate huts (sometimes in livestock sheds) away from home with inadequate access to WASH services (Robinson 2015 ; Amatya et al. 2018 ; Thakuri et al. 2021; Joshi 2022).”
Strengthening Actions for Menstrual Health and Hygiene Interventions for Promotion of Women’s Health in Nepal (SAMIP): Protocol for a Participatory Intervention Development Study Using Realist Synthesis, Human-Centered Design, Intervention Mapping, and Arts-Based Methods
Baumann, S. E., Schwarz, H., Agarwal, A., Devkota, B., Miller, E. P., Youk, A. O., Parker, S., Murthy, S., Sharma, N., Shrestha, A., et al. (2026) · JMIR Research Protocols · doi:10.2196/89117 · Cited by 1
“Local officials have acknowledged that women have rebuilt sheds out of fear, suggesting that physical demolition without attitude change does not constitute a meaningful victory [23,39].”
Product Innovation and Consumer Preference for Feminine Hygiene Products: A Moderated Model with Product Deprivation
Gautam, P. K., & Khadka, S. (2022) · Management Dynamics · doi:10.3126/md.v25i1.53287 · Cited by 1
Wearing: Art, the Body, and Distance
Yodanis, C. L. (2024) · Fashion Theory · doi:10.1080/1362704x.2024.2391172 · Cited by 1
“To not control the impure body, it is believed, is to risk contamination of the pure, including food, religious symbols, animals, plants, water, and men and their hunting gear (Amatya et al. 2018; Buckley and Gottlieb 1998).”
Menstruation and Menstrual Hygiene: Analyzing the Gaps in Knowledge, Perception and Practices in a Rural Area of North East India
Khound, M., Bhattacharyya, H., & Ghosh, S. (2025) · Indian Journal of Community Medicine · doi:10.4103/ijcm.ijcm_513_24 · Cited by 2
“[2] from Nepal, indicating that dysmenorrhea is a widespread issue affecting the majority of adolescent girls.”
Influential
Women in Newar Cultural Practices of Bhaktapur Municipality: Representation, Empowerment and Change
Phelu, R. (2025) · Bagiswori Journal · doi:10.3126/bagisworij.v4i1.78072 · Cited by 1
“In remote areas of far-western and Karnali Province of rural Nepal, the menstruating girls and women should make a distance from both community people and their daily normal activities (Amatya et al., 2018).”
An African Feminist Analysis of the Impact of Menstrual Taboos in Abrahamic Religions on Women and Girls in Africa
Olaitan, Z. M. (2025) · Human rights interventions. · doi:10.1007/978-3-031-90333-5_11 · Cited by 1
Menstrual Experiences of Totally Blind Menstruators in Kathmandu
Pant, P. (2022) · Journal of Education and Research · doi:10.51474/jer.v11i2.560
“This isolation, known as the “Chhaupadi” tradition in some remote areas in the Far and Mid-western parts of the country, is so harsh that the menstruators are kept in the livestock shed or makeshift huts during their menstruation (Amatya et al., 2018).”
Background
Menstruation Hygiene Management among Secondary School Students of Chitwan, Nepal- Pre-Post Study DesignPreprint
Khanal, G., Shrestha, N., Adhikari, K., & Ghimire, U. (2022) · medRxiv · doi:10.1101/2022.12.05.22283126 · Cited by 1
Breaking Barriers: A cross-sectional study on Menstrual Restrictions and Perceived Stress among adolescent girls in Kailali, NepalPreprint
Dahal, A., Sapkota, K. P., Bhatta, D. K., & Acharya, A. (2023) · medRxiv · doi:10.1101/2023.03.31.23287836 · Cited by 1
“(20) When looking at the relationship of menstrual restrictions with perceived stress”
BackgroundInfluential
Menstruation stigma: A qualitative exploratory study of the lived experiences of Nepali women.
Gurung, I. (2023) · ThinkIR: The University of Louisville's Institutional Repository (University of Louisville) · doi:10.18297/etd/4105 · Cited by 4
New laws have not stopped women and girls being exiled during their periods in Nepal
Channon, M. D., Thomson, J., & Amery, F. (2019) · doi:10.64628/ab.q4pxupsqa
SOCIO-DEMOGRAPHIC FACTORS ASSOCIATED WITH CHHAUPADI PRACTICE AMONG ADOLESCENCE GIRLS OF MANGALSEN MUNICIPALITY, ACCHAM NEPAL
Thapa, R. K., Chhetri, M., Paudel, A., Koirala, S., Poudel, E. N., & Adhikari, K. (2021) · Journal of Chitwan Medical College · doi:10.54530/jcmc.398
Family Context Matters: Exploring Family Environmental Factors That Influence the Development and Performance of Religio-Cultural Menstrual Practices in Far-West Nepal
Park, J. S. (2022) · Journal of International Development Cooperation · doi:10.34225/jidc.2022.17.2.31 · Cited by 1
Social Psychiatry
Stotland, N. L., & Shrestha, A. (2023) · doi:10.1093/med/9780197521359.003.0012
Experiences of menstrual exiles (Chaupadi) and its consequences among women in Nepal
Lama, S. M. (2019) · doi:10.58837/chula.the.2019.469
Spatial heterogeneity of menstrual discriminatory practices against Nepalese women: a population-based study using the 2022 Demographic and Health SurveyPreprint
Barini, G. O., Amima, S., Mulwa, D. F., & Mogeni, P. (2024) · medRxiv · doi:10.1101/2024.04.04.24305345
“…the infamous Chhaupadi —the severest form of menstrual exclusion—that designates women as impure and untouchable during menstruation or postpartum period banishing them to a separate house, cowshed or menstrual hut (ActionAid, 2024; Amatya et al., 2018; Amery et al., 2023; Thakuri et al., 2021).”
Suicide in Nepal
Wenzel, T., & Risal, A. (2024) · Oxford University Press eBooks · doi:10.1093/med/9780198843405.003.0014
Time will Tell: Exploring Impacts of a Collaborative Filmmaking Menstruation Research Study on Adolescent Participants One Year Later
BAUMANN, B., PARKER, S., Lhaki, P., & Burke, J. G. (2024) · doi:10.5871/bacad/9780197267578.003.0014
Navigating Menstrual Taboos in Rural Ghana
Wohoyie, H. S. (2025) · Girlhood Studies · doi:10.3167/ghs.2025.180103
Ubóstwo menstruacyjne w świetle badań i opracowań naukowych z lat 2013–2023
Buczak, A. (2024) · Nierówności społeczne a wzrost gospodarczy · doi:10.15584/nsawg.2024.4.6
The effect of traditional menstrual practices on violence against women: A feminist-inspired structural violence perspective from the Far-Western Nepal
Chalise, B., Clark, C. J., Bhattarai, S., & Thapa, S. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.118416
Neutral-bodied female students?: schools and the menstrual mandate of shame, secrecy, and silence in Nepal
Karki, S., & Mix, T. L. (2025) · Gender and Education · doi:10.1080/09540253.2025.2568413
“Menstrual customs in Nepal have been the topic of frequent study, with media coverage focusing on stringent menstrual customs called Chhaupadi, practiced in the nation’s mid – and far-western regions (Amatya et al. 2018; Upadhyay 2018).”
Menstrual Hygiene Management Practices among Girls and Women after the Chhaugoth Demolition Campaign in Chaurpati Rural Municipality, Achham, NepalPreprint
Jnawali, K., Tiwari, P., Ghale, A., Upadhyay, J. P., Sigdel, A., Thapa, S., Shrestha, A., Kiran, K. C., Pahari, S. P., & Paneru, D. P. (2025) · medRxiv · doi:10.1101/2025.10.28.25339015
Strengthening Actions for Menstrual Health and Hygiene Interventions for Promotion of Women's Health in Nepal (SAMIP): Protocol for a Participatory Intervention Development Study Using Realist Synthesis, Human-centered Design, Intervention Mapping and Arts-based Methods (Preprint)Preprint
Baumann, S. E., Schwarz, H., Agarwal, A., Devkota, B., Miller, E., Youk, A. O., Parker, S., Murthy, S., Sharma, N., Shrestha, A., et al. (2025) · doi:10.2196/preprints.89117
Additional file 1 of Qualitative study exploring the barriers to menstrual hygiene management faced by adolescents and young people with a disability, and their carers in the Kavrepalanchok district, Nepal
Wilbur, J., Kayastha, S., Mahon, T., Torondel, B., Hameed, S., Sigdel, A., Gyawali, A., & Kuper, H. (2021) · Figshare · doi:10.6084/m9.figshare.14196714
Additional file 2 of Qualitative study exploring the barriers to menstrual hygiene management faced by adolescents and young people with a disability, and their carers in the Kavrepalanchok district, Nepal
Wilbur, J., Kayastha, S., Mahon, T., Torondel, B., Hameed, S., Sigdel, A., Gyawali, A., & Kuper, H. (2021) · Figshare · doi:10.6084/m9.figshare.14196720
Additional file 2 of Are Nepal’s water, sanitation and hygiene and menstrual hygiene policies and supporting documents inclusive of disability? A policy analysis
Wilbur, J., Scherer, N., Mactaggart, I., Shrestha, G., Mahon, T., Torondel, B., Hameed, S., & Kuper, H. (2021) · Figshare · doi:10.6084/m9.figshare.14936599
Additional file 1 of Exploring comprehensive sexuality education experiences and barriers among students, teachers and principals in Nepal: a qualitative study
Rivenes Lafontan, S., Jones, F., & Lama, N. (2024) · Figshare · doi:10.6084/m9.figshare.26982112
Additional file 1 of Menstruation hygiene management among secondary school students of Chitwan, Nepal:a cross-sectional study
Khanal, G., Shrestha, N., Adhikari, K., & Ghimire, U. (2024) · Figshare · doi:10.6084/m9.figshare.26606848

Authors: Amatya, P., Ghimire, S., Callahan, K. E., Baral, B. K., & Poudel, K. C.
Affiliations: Pokhara University (NP)
University of Nevada, Las Vegas (US)
Nepal Medical College Teaching Hospital (NP)
University of Massachusetts Amherst (US)
Corresponding author: Ghimire, Saruna
ORCID: Ghimire, Saruna
Callahan, Karen E.
Poudel, Krishna C.
Venue: PLoS ONE
Publisher: Public Library of Science (PLoS)
Published: 2018-12-10
Volume: 13
Issue: 12
Pages: e0208260
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0208260
PMC: PMC6287853
OpenAlex: W2904190350
Cited by: 125
References: 21
Citations by year: 2026: 19 · 2025: 20 · 2024: 17 · 2023: 14 · 2022: 21 · 2021: 25 · 2020: 5 · 2019: 4
FWCI: 8.09
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS ONE (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Digital Scholarship - UNLV (University of Nevada Reno) (submittedVersion, cc-by)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Figshare (submittedVersion, cc-by)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
Social Sciences › Gender Studies › Gender Studies and Social Issues
Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords: menstrual taboos, adolescent girls, Far Western Nepal, sanitation, living conditions, physical abuse, psychological distress, menstrual health
MeSH terms: Adolescent, Child, Female, Humans, Hygiene, Menstruation, Nepal, Sanitation, Focus Groups, Young Adult

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Practice and lived experience of menstrual exiles (Chhaupadi) among adolescent girls in far-western Nepal

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