What can existing data on water and sanitation tell us about menstrual hygiene management?
Abstract
Half of the global population menstruate as part of their life cycle. This involves water, sanitation, and hygiene (WASH) needs that are often overlooked. Experience from the Millennium Development Goals shows that states focus on targets that are measured globally. Data and indicators on menstrual hygiene management (MHM) for women and girls can have a positive impact on raising awareness, national policy making, and in finding sustainable WASH sector solutions. With this paper, we explore the possible use of Joint Monitoring Programme for Water Supply and Sanitation estimates for representing women and girls’ unique WASH experience, through a focus on MHM. We reviewed definitions of MHM alongside indicators monitored by the JMP and calculated estimates for 18 case-study low- and middle-income countries. Consultation with a broad range of experts identified open defecation and handwashing indicators as the best proxy indicators for inadequate MHM. Globally around half a billion women (13 per cent) defecate in the open and likely lack privacy for MHM. Data on handwashing suggest that a lack of cleansing materials is a particular challenge for MHM. In six of 10 study countries with data, over three-quarters of women lacked handwashing facilities with water and soap. Further research is needed to establish the validity of various aspects of these proxies and to gain greater understanding of the principal WASH-related challenges and barriers faced by women. Nevertheless, it seems clear that interventions among communities with highest open defecation rates and lowest handwashing levels are needed to address barriers to MHM.
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Loughnan and colleagues proposed applying existing WASH indicators as proxies for measuring inadequate menstrual hygiene.
“As such, Loughnan and colleagues proposed applying existing WASH indicators as proxies for measuring inadequate menstrual hygiene [23].”
From The relationship between household sanitation and women’s experience of menstrual hygiene: Findings from a cross-sectional survey in Kaduna State, Nigeria. (2018) · cites this paper as [23]
The use of open defecation at the household level is inadequate to capture women's access to a location for menstrual management.
“This has significant implications for the use of open defecation at the household level to capture women’s access to a location for menstrual management as proposed by Loughnan and colleagues [23].”
From The relationship between household sanitation and women’s experience of menstrual hygiene: Findings from a cross-sectional survey in Kaduna State, Nigeria. (2018) · cites this paper as [23]
Loughnan et al. suggest unimproved sanitation and open defecation as indicative of inadequate access to menstrual hygiene.
“In their study of proxies for large-scale assessment of menstrual hygiene, Loughnan et al. [23] suggest unimproved sanitation and open defecation as indicative of inadequate access to menstrual hygiene.”
From The relationship between household sanitation and women’s experience of menstrual hygiene: Findings from a cross-sectional survey in Kaduna State, Nigeria. (2018) · cites this paper as [23]
Limited items were available to appraise the adequacy of other menstrual hygiene proxies in current WASH monitoring.
“Limited items were available to appraise the adequacy of other menstrual hygiene proxies in current WASH monitoring [23].”
From The relationship between household sanitation and women’s experience of menstrual hygiene: Findings from a cross-sectional survey in Kaduna State, Nigeria. (2018) · cites this paper as [23]
Structural challenges to MHM include inadequate provision of clean water and soap, sanitation infrastructure, private places to clean and change, and disposal facilities.
“Structural challenges include inadequate provision of clean water and soap, sanitation infrastructure, private places to clean and change, and disposal facilities [7, 8, 11–22].”
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 [14]
The findings demonstrate the need for access to "female-friendly toilets" with disposal bins inside.
“Our findings contribute detailed accounts of disposal practices and further demonstrate the need for access to “female-friendly toilets” with disposal bins inside [8, 14, 21, 62].”
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 [14]
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- Authors
- Libbet C. Loughnan, L. C. L., Rob Bain, R. B., Rosemary Rop, R. R., Marni Sommer, M. S., & Tom Slaymaker, T. S.
- Venue
- Waterlines
- Publisher
- Practical Action Publishing
- Published
- 2016-07-01
- Volume
- 35
- Issue
- 3
- Pages
- 228-244
- ISSN
- 0262-8104 (ISSN-L)
- 1756-3488
- OpenAlex
- W2505199207
- Cited by
- 19
- References
- 21
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 4
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Waterlines (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Social Sciences › Gender Studies › Gender Studies and Social Issues
- Keywords
- menstrual hygiene management, women and girls, open defecation, hand washing, Joint Monitoring Programme, proxy indicators, low- and middle-income countries, sanitation, water supply, menstrual health
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