Menstrual hygiene: a ‘silent’ need during disaster recovery
Abstract
Post-disaster relief and recovery operations seldom focus on women’s priorities regarding menstrual hygiene. There is an increasing awareness to incorporate inclusive, participatory, and gender-sensitive strategies for implementation of response programmes. This article presents empirical findings related to menstrual hygiene management (MHM), demonstrating it is integral to women’s privacy and safety during recovery. Using case studies from India, the 2012 Assam floods and 2013 Cyclone Phailin in Odisha, this article explores menstrual hygiene practices in a post-disaster context. The data were collected through participatory learning and action tools such as focus group discussions, household interviews, priority ranking, and observations. It emerged that menstrual hygiene was overlooked at the household level during recovery; women and adolescent girls faced seclusion and isolation, exacerbating privacy and security concerns post-disasters. Some humanitarian agencies have an ad hoc approach towards MHM, which is limited to distribution of sanitary pads and does not address the socio-cultural practices around MHM. There is a need for strategic planning to address MHM with a gender-sensitive and inclusive approach. This article draws practical and policy inferences from the research for stronger approaches towards initiating behaviour change in MHM, and addressing attitudes and knowledge regarding menstrual hygiene.
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Written from the paper’s full text.
TL;DR
Post-disaster recovery in Assam and Odisha overlooked menstrual hygiene at the household level, forcing women and girls into seclusion, privacy and security risks, and ad hoc aid limited largely to sanitary pad distribution. The paper argues that menstrual hygiene management must be integrated into gender-sensitive WASH recovery planning, assessment, and policy.
Key findings
- In the 2012 Assam floods, 70% of women and girl participants reported open defecation and managing menstruation while defecating or bathing; 100% reported restrictions during menstruation, including being prohibited from kitchen and prayer rooms; at least 50% found it difficult to use a separate soap or detergent for menstrual linen post-floods; women travelled 3–5 km in the dark for personal needs, posing a security risk.
- In Odisha after 2013 Cyclone Phailin, 100% of girls were unaware of disposal mechanisms for sanitary pads; in villages with market access, 70% of adolescent girls preferred sanitary pads and 30% studied in Puri; in remote fishing households, 100% of female participants used old sarees as menstrual linen; 60% across Odisha used a separate soap for washing menstrual cloth.
- Humanitarian response included hygiene kits with sanitary cloth, string, bag, and detergent soap, privacy screens, female facilitators, and a staff checklist, but MHM was often ad hoc, limited to distribution of sanitary pads, and did not address socio-cultural practices around MHM.
- Analysis of the Disaster Management Act 2005, Swachh Bharat Abhiyan 2013, Odisha Relief Code, Assam Relief Manual, and state disaster management plans revealed no mention of strategies or explicit guidelines on incorporating MHM in post-disaster interventions.
Methods
- Qualitative case studies in Eastern India: the 2012 Assam floods and erosion, and 2013 Cyclone Phailin and floods in Odisha. Fieldwork included visits from June 2012, a scoping study in January–February 2013, an extensive study in Solmari (Sonitpur) and Boramari (Morigaon) between August and October 2013, and a six-month Odisha study from October 2013 to March 2014 in Puri and Balasore districts.
- Data were collected through semi-structured and unstructured interviews and participatory learning and action tools: seven FGDs each in Assam and Odisha with rural women aged 19–35; unstructured interviews with women-headed households (six in Assam, 10 in Odisha); 39 semi-structured interviews with NGO staff, experts, and humanitarian and government officials in Assam; plus transect walks, priority ranking, and observations.
- Data were manually coded and thematically analysed. Ethical procedures included doing no harm, informed consent, privacy, UCL ethical guidelines, and compliance with the Data Protection Act 1998, Part II.
Limitations
- Stated: because participants were disaster-affected and in despair, they were not probed for further information if they did not wish to discuss private and sensitive issues; the article anonymizes data from the two cases; practical challenges affected ethical considerations.
- Evident from the text: the findings come from two qualitative case studies in Assam and Odisha, so they are not statistically generalizable; the paper reports participant-reported percentages but no broader prevalence estimates.
- Evident from the text: reliance on self-reported practices and recall may affect data quality, especially as adolescent girls were initially shy and reluctant to discuss menstrual hygiene; the 39 semi-structured interviews with officials were undertaken in Assam only, not Odisha.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
0 of 4 cited sources checked · 0 supported · 0 flagged
- Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
After washing, the women and girls dried the cloth inside their homes in dark corners, instead of drying in the open, to prevent others from seeing or accidentally touching them.
“After washing, the women and girls dried the cloth inside their homes in dark corners, instead of drying in the open, to prevent others from seeing or accidentally touching them.”
Quote in the paperSubstantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
In the fishing households located in remote villages in Odisha, access to markets in the main towns was a challenge.
“The research found that in the fishing households, located in remote villages, the access to markets in the main towns was a challenge.”
Quote in the paperNot a substantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 7
Menstrual hygiene requirements, especially of girls, young women, and single-women headed households, were often overlooked.
“Menstrual hygiene requirements, especially of the girls, young women, and single-women headed households, were often overlooked.”
Quote in the paperSubstantial claim - Findingown data§ Assam floods, 2012 · p. 5
In Assam, all female participants reported that menstrual hygiene was overlooked while preparing rescue kits.
“All the female participants reported that menstrual hygiene was overlooked while preparing these kits.”
Quote in the paperSubstantial claim - Findingnone given§ Box 1 Checklist used by humanitarian agency, Odisha, for sensitizing programme staff towards MHM · p. 8
The formation of separate adolescent girls' committees as well as school committees for water, sanitation, and personal hygiene provided a space to impart knowledge on menstrual hygiene to young girls and adolescents post-disasters.
“The formation of separate adolescent girls' committees as well as school committees for water, sanitation, and personal hygiene provided a space to impart knowledge on menstrual hygiene to young girls and adolescents post-disasters.”
Quote in the paperNot a substantial claim
- Findingown data§ Assam floods, 2012 · p. 5
In Assam, at least 50 per cent of participants reported that it was difficult to follow the general practice of using a separate soap or detergent powder to wash their menstrual linen post-floods.
“The general practice was to use a separate soap or detergent powder to wash their menstrual linen, which was difficult to follow post-floods, as reported by at least 50 per cent of the participants.”
Quote in the paperNot a substantial claim - Findingown data§ Assam floods, 2012 · p. 5
The humanitarian response in Assam incorporated MHM through distribution and WASH interventions.
“The humanitarian response in Assam incorporated MHM through distribution and WASH interventions.”
Quote in the paperSubstantial claim - Findingown data§ Assam floods, 2012 · p. 5
Young girls reported that they always went to water sources accompanied by elderly female family members.
“The young girls reported that they always went to the water sources accompanied by elderly female family members.”
- Also stated in: § Cyclone Phailin, Odisha, 2013 · p. 6 · plain
“The young girls reported that they always went to the water sources accompanied by elderly female family members.”
Quote in the paperNot a substantial claim - Also stated in: § Cyclone Phailin, Odisha, 2013 · p. 6 · plain
- Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
In the post-disaster context in relief camps in Odisha, there was no privacy for women to maintain personal hygiene due to lack of space.
“In the post-disaster context in relief camps, there was no privacy for women to maintain personal hygiene due to lack of space.”
Quote in the paperSubstantial claim - Findingnone given§ Facilities and materials · p. 8
Those who preferred using sanitary napkins lacked the financial means to afford the pads in the local markets.
“Those who preferred using sanitary napkins lacked the financial means to afford the pads in the local markets.”
Quote in the paperNot a substantial claim - Findingreasoning§ Cyclone Phailin, Odisha, 2013 · p. 6
This soap was kept separate from other members of the household.
“This soap was kept separate from other members of the household.”
Quote in the paperNot a substantial claim - Findingown data§ Assam floods, 2012 · p. 5
During floods in Assam, access to water points was difficult due to water inundation.
“During floods, access to water points was difficult due to water inundation.”
Quote in the paperSubstantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
The common practice was to change in the dark while going for open defecation or while bathing near waterbodies, fields, or bushes.
“The common practice was to change in the dark, while they went for open defecation or while bathing near waterbodies, fields, or bushes.”
Quote in the paperSubstantial claim - Findingown data§ Discussion · p. 8
Based on thematic analysis of the empirical data, in Assam and Odisha the menstrual practices differed according to the cultural context, mobility, and age of the research participants.
“Based on thematic analysis of the empirical data, it emerged that in Assam and Odisha the menstrual practices differed according to the cultural context, mobility, and age of the research participants.”
Quote in the paperSubstantial claim - Findingown data§ Assam floods, 2012 · p. 5
The practice of cultural seclusion was believed to be undertaken to restrict menstruating females who were considered impure from polluting the household.
“This practice of cultural seclusion was believed to be undertaken to restrict the menstruating females who were considered impure from polluting the household.”
Quote in the paperNot a substantial claim - Findingnone given§ Cyclone Phailin, Odisha, 2013 · p. 6
It was reported that the pads were burnt along with the garbage in their backyards.
“It was reported that the pads were burnt along with the garbage in their backyards.”
Quote in the paperNot a substantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
Findings from Odisha indicate differences in MHM preferences and practices based on geographical locations, household income, and livelihoods.
“The findings from Odisha indicate differences in MHM preferences and practices based on geographical locations, household income, and livelihoods.”
Quote in the paperSubstantial claim - Findingnone given§ Facilities and materials · p. 8
Within households that had more than one female member of menstruating age there were difficulties in sharing the limited resources for sanitary materials.
“Within households that had more than one female member of menstruating age there were difficulties in sharing the limited resources for sanitary materials.”
Quote in the paperNot a substantial claim - Findingreasoning§ Assam floods, 2012 · p. 5
As a result, women travelled distances of 3-5 km in the dark (before sunrise or late at night) to cater to personal needs such as open defecation, changing menstrual cloths, and washing linen.
“As a result women travelled distances of 3-5 km in the dark (before sunrise or late in the night) to cater to their personal needs, such as open defecation, changing menstrual cloths, and washing linen.”
Quote in the paperSubstantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
In order to avoid being seen, women would venture out in the early hours of the morning before sunrise or after dark.
“In order to avoid being seen, women would venture out in the early hours of the morning before sunrise or after the dark.”
Quote in the paperNot a substantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
In Odisha, in villages with easy access to local markets and township, 70 per cent of adolescent girls preferred using sanitary pads for the comfort they provided.
“In Odisha, in the villages with easy access to the local markets and township, 70 per cent of the adolescent girls preferred using sanitary pads for the comfort they provided.”
Quote in the paperNot a substantial claim - Findingnone given§ Assam floods, 2012 · p. 5
Humanitarian agencies installed privacy screens using tarpaulin sheets near the embankments for displaced households immediately after the 2012 floods in Assam.
“Humanitarian agencies installed privacy screens using tarpaulin sheets near the embankments for displaced households immediately after the floods in 2012.”
Quote in the paperNot a substantial claim - Findingnone given§ Assam floods, 2012 · p. 5
The cultural practices and seclusion of women and girls during menstruation were reported to have affected attendance in school.
“The cultural practices and seclusion of women and girls during menstruation was reported to have affected attendance in school.”
Quote in the paperNot a substantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
In these fishing households, 100 per cent of the female participants used old sarees as menstrual linen.
“Here, 100 per cent of the female participants used old sarees as menstrual linen.”
Quote in the paperNot a substantial claim - Findingnone given§ Assam floods, 2012 · p. 5
Affected families in Sonitpur and Morigaon received household hygiene kits including sanitary cloth, a string for tying, and a cloth bag for storage.
“The affected families in Sonitpur and Morigaon received household hygiene kits including sanitary cloth, a string (for tying), and a cloth bag for storage.”
Quote in the paperNot a substantial claim - Findingnone given§ Privacy for changing · p. 8
The data show that menstrual health is overlooked post-disasters at the household level.
“The data show that menstrual health is overlooked post-disasters at the household level”
Quote in the paperNot a substantial claim - Findingown data§ Assam floods, 2012 · p. 5
In Assam, the menstrual cloth was washed, dried, and reused each time.
“The study found that the menstrual cloth was washed, dried, and reused each time.”
Quote in the paperNot a substantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
The remaining participants, girls and women, used an old piece of cloth made using sarees or cotton linen.
“The remaining participants - girls and women - used an old piece of cloth, which was made using sarees or cotton linen.”
Quote in the paperNot a substantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
When not in use, the menstrual cloths and washing soap were hidden separately under the roof tile to prevent other household members from seeing or accidentally touching them.
“When not in use the menstrual cloths and washing soap were hidden separately under the roof tile, again to prevent other household members from seeing or accidently touching them.”
Quote in the paperNot a substantial claim - Findingown data§ Assam floods, 2012 · p. 5
Primary observation data show that there were no provisions or separate toilets for girls in schools.
“The primary observation data show that there were no provisions or separate toilets for girls in schools.”
Quote in the paperSubstantial claim - Findingnone given§ Facilities and materials · p. 8
The lack of sanitation facilities and bathing spaces post-disasters affected women's comfort to change their menstrual cloths.
“The lack of sanitation facilities and bathing spaces post-disasters affected women's comfort to change their menstrual cloths.”
Quote in the paperSubstantial claim - Findingnone given§ Cyclone Phailin, Odisha, 2013 · p. 7
Humanitarian Agency A followed a similar standardized approach to menstrual hygiene in Odisha, including distribution of emergency hygiene kits to affected households containing sanitary cloth, string, bag, and detergent soap.
“The humanitarian Agency A followed a similar standardized approach to menstrual hygiene in Odisha. This included distribution of emergency hygiene kits to affected households, including sanitary cloth, string, bag, and detergent soap.”
Quote in the paperNot a substantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
As per local custom, 60 per cent of the female participants across Odisha used a separate soap for washing their menstrual cloth.
“As per local custom, 60 per cent of the female participants across Odisha used a separate soap for washing their menstrual cloth.”
Quote in the paperNot a substantial claim - Findingnone given§ Cyclone Phailin, Odisha, 2013 · p. 6
100 per cent of the girls in Odisha were unaware of the disposal mechanisms for sanitary pads.
“100 per cent of the girls in Odisha were unaware of the disposal mechanisms for sanitary pads.”
Quote in the paperNot a substantial claim - Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6
The participants reported they had never used sanitary napkins, as they were expensive and unaffordable.
“The participants reported they had never used sanitary napkins, as they were expensive and unaffordable.”
Quote in the paperSubstantial claim - Findingown data§ Assam floods, 2012 · p. 5
In Assam, a piece of saree or any other cloth was used during menstruation.
“A piece of saree or any other cloth was used during menstruation.”
Quote in the paperNot a substantial claim - Findingown data§ Assam floods, 2012 · p. 5
In relief camps in Assam, women found it difficult to attend to their menstrual hygiene needs because of the lack of private spaces for women to wash, dry, and change their menstrual cloths.
“While living in the relief camps women found it difficult to attend to their menstrual hygiene needs because of the lack of private spaces for women to wash, dry, and change their menstrual cloths.”
Quote in the paperSubstantial claim - Findingnone given§ Gendered recovery processes · p. 9
The lack of accessible and safe WASH facilities during disasters and recovery posed further challenges for women to fulfil household and personal WASH needs.
“The lack of accessible and safe WASH facilities during disasters and recovery posed further challenges for women to fulfil household and personal WASH needs.”
Quote in the paperSubstantial claim - Findingnone given§ Cultural practices · p. 9
Cultural practices influenced the preference of using sanitary pads, napkins, or cloth.
“Cultural practices also influenced the preference of using sanitary pads, napkins, or cloth.”
Quote in the paperNot a substantial claim - Findingnone given§ Cultural practices · p. 9
Due to lack of awareness and knowledge regarding menstrual hygiene management, the adolescent girls relied on elderly wisdom and adopted cultural norms and practices.
“Due to lack of awareness and knowledge regarding menstrual hygiene management, the adolescent girls relied on elderly wisdom and adopted cultural norms and practices.”
Quote in the paperNot a substantial claim - Findingreasoning§ Facilities and materials · p. 8
With limited household income and increased poverty and food insecurity post-disasters, MHM was least prioritized at the household level.
“With limited household income and increased poverty and food insecurity post-disasters, MHM was least prioritized at the household level.”
Quote in the paperSubstantial claim - Findingnone given§ Gendered recovery processes · p. 9
In Assam and Odisha, female members had limited control, and sometimes no control, over household finances.
“In Assam and Odisha, female members had limited control, and sometimes no control, over household finances.”
Quote in the paperSubstantial claim - Findingnone given§ Cultural practices · p. 9
This varied across the two case studies in Assam and Odisha according to age, caste, and livelihoods of the female participants and their access to the local markets and affordability of sanitary pads.
“This varied across the two case studies in Assam and Odisha according to age, caste, and livelihoods of the female participants and their access to the local markets and affordability of sanitary pads.”
Quote in the paperNot a substantial claim - Findingcitation§ Gendered recovery processes · p. 9
These gender aspects in WASH during recovery were overlooked by the government and humanitarian actions.
“These gender aspects in WASH during recovery were overlooked by the government and humanitarian actions, an aspect noted in other research (O'Reilly, 2010; Sommer, 2012).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites O'Reilly, 2010
Not checked in the free run.
- cites Sommer, 2012
Not checked in the free run.
- Findingnone given§ Recommendations and conclusions · p. 10
This research demonstrated that MHM needs and experiences varied depending on the women's mobility, literacy levels, exposure or disabilities (if any), cultural practices, and post-disaster experiences in schools, homes or public places.
“This research demonstrated that MHM needs and experiences varied depending on the women's mobility, literacy levels, exposure or disabilities (if any), cultural practices, and post-disaster experiences in schools, homes or public places.”
Quote in the paperSubstantial claim - Findingnone given§ Cultural practices · p. 9
The cultural practices of secluding women and girls during menstruation affected their daily activities and social performance.
“The cultural practices of secluding women and girls during menstruation affected their daily activities and social performance.”
Quote in the paperNot a substantial claim - Findingreasoning§ Gendered recovery processes · p. 9
Due to recurring disasters and damage to livelihoods and other pressing needs during recovery, the women-headed households did not use sanitary pads.
“However, due to recurring disasters and damage to livelihoods and other pressing needs during recovery, the women-headed households did not use sanitary pads.”
Quote in the paperSubstantial claim - Premisecitation§ Menstrual hygiene: a 'silent' need during disaster recovery · p. 1
Post-disaster relief and recovery operations seldom focus on women's priorities regarding menstrual hygiene.
“Post-disaster relief and recovery operations seldom focus on women's priorities regarding menstrual hygiene.”
- Also stated in: § Menstrual hygiene: a 'silent' need during disaster recovery · p. 1 · plain
“Addressing menstrual hygiene needs remains a critical gap in recovery programming, however.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Brown et al., 2012
Not checked in the free run.
- cites Sommer, 2012
Not checked in the free run.
- Also stated in: § Menstrual hygiene: a 'silent' need during disaster recovery · p. 1 · plain
- Interpretationreasoning§ Facilities and materials · p. 8
Since a separate washing soap was used for cleaning menstrual linen, a fall in household income post-disasters adversely affected women's ability to maintain cleanliness and hygiene standards during menstruation.
“Since a separate washing soap was used for cleaning menstrual linen, a fall in household income post-disasters adversely affected women's ability to maintain cleanliness and hygiene standards during menstruation.”
Quote in the paperSubstantial claim - Interpretationreasoning§ Assam floods, 2012 · p. 5
The need for women to travel distances in the dark to attend to personal needs posed a security risk for female household members.
“This posed a security risk for female household members.”
Quote in the paperSubstantial claim - Interpretationreasoning§ Assam floods, 2012 · p. 5
The installation of privacy screens enabled female community members to address their personal needs and privacy to wash their menstrual linen.
“This enabled the female community members to address their personal needs and privacy to wash their menstrual linen.”
Quote in the paperSubstantial claim - Interpretationown data§ Menstrual hygiene: a 'silent' need during disaster recovery · p. 1
Menstrual hygiene management is integral to women's privacy and safety during recovery.
“This article presents empirical findings related to menstrual hygiene management (MHM), demonstrating it is integral to women's privacy and safety during recovery.”
Quote in the paperSubstantial claim - Interpretationreasoning§ Gendered recovery processes · p. 9
This limited control over household finances influenced women's ability to purchase sanitary materials, even when these were available in the markets.
“This influenced their ability to purchase sanitary materials, even when these were available in the markets.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 13
- May combine two claims. 19
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingnone given§ Cyclone Phailin, Odisha, 2013 · p. 7The checklist was developed by the gender assessment team for integration of MHM for effective WASH recovery programmes.
“The checklist was developed by the gender assessment team for integration of MHM for effective WASH recovery programmes.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6Women claimed that due to poverty and a decrease in household income they had to prioritize other household needs and did not prefer to spend their limited income on purchasing sanitary pads.
“The women claimed that due to poverty and a decrease in the household income they had to prioritize other household needs and did not prefer to spend their limited income on purchasing sanitary pads.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 7In Odisha, women were responsible for household duties such as cooking, collecting water, washing and cleaning, and caring for the elderly and children.
“In Odisha, women were responsible for household duties such as cooking, collecting water, washing and cleaning, and caring for the elderly and children.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 7During household interviews, 100 per cent of the respondents were concerned about food and water supplies after the disaster.
“During household interviews, it emerged that 100 per cent of the respondents were concerned about food and water supplies after the disaster.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingnone given§ Box 1 Checklist used by humanitarian agency, Odisha, for sensitizing programme staff towards MHM · p. 8During distribution of emergency hygiene kits, female hygiene facilitators explained the use of menstrual hygiene materials in the kits in the local language.
“During distribution of emergency hygiene kits, female hygiene facilitators explained the use of menstrual hygiene materials in the kits in the local language.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 7The assessment showed that since MHM issues were not discussed openly among household members, adolescent girls confided in female elders and followed their traditional knowledge and solutions to address rashes and cramps during menstruation.
“The assessment showed that since MHM issues were not discussed openly among the household members, adolescent girls confided in the female elders in the house and followed their traditional knowledge and solutions to address rashes and cramps during menstruation.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6These girls preferred using sanitary napkins but were concerned about the affordability of sanitary pads due to their meagre household income.
“These girls preferred using sanitary napkins but were concerned about the affordability of sanitary pads due to their meagre household income.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingnone given§ Cyclone Phailin, Odisha, 2013 · p. 7Gender assessments undertaken by gender experts in the humanitarian agency considered that improper menstrual care and lack of adequate facilities for women to address MHM posed risks for fungal infections and rashes for menstruating girls and women.
“The gender assessments undertaken by gender experts in the humanitarian agency considered that improper menstrual care and lack of adequate facilities for women to address MHM posed risks for fungal infections and rashes for menstruating girls and women.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Assam floods, 2012 · p. 5In Assam, 70 per cent of the women and girl participants reported that they went for open defecation and tended to their menstrual needs while defecating or bathing.
“In Assam 70 per cent of the women and girl participants reported that they went for open defecation, and tended to their menstrual needs while defecating or bathing.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingnone given§ Box 1 Checklist used by humanitarian agency, Odisha, for sensitizing programme staff towards MHM · p. 8Community facilitators monitored the use of hygiene kit items during household visits, when female members discussed in private issues and concerns regarding menstrual hygiene.
“The community facilitators monitored the use of hygiene kit items during household visits, when the female members discussed in private issues and concerns regarding menstrual hygiene.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingnone given§ Assam floods, 2012 · p. 5The agency determined the location for privacy screens after consultations with women community members.
“The agency determined the location for privacy screens after consultations with women community members.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6These villages had fair access to local markets post-disasters; 30 per cent of the girls reported that they studied in Puri where they had exposure to other women who used sanitary pads.
“These villages had fair access to local markets post-disasters; 30 per cent of the girls reported that they studied in the town of Puri where they had exposure to other women who used sanitary pads.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Assam floods, 2012 · p. 5Water inundation impacted all female participants responsible for water collection and restricted their privacy to wash menstrual linen near water sources because blood washed into open drains was visible to others.
“This impacted all the female participants, who were responsible for water collection for household purposes, and also restricted their privacy to wash their menstrual linen near the water sources, as the blood washed into the open drains was visible to others.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6In Odisha, girls who participated in the FGDs preferred using sanitary napkins, but their families could not afford them.
“In Odisha, girls who participated in the FGDs preferred using sanitary napkins, but their families could not afford them”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 6The girls did not have adequate information on how frequently they should change their pads and were unaware of safe disposal mechanisms of the used pads.
“However, the girls did not have adequate information on how frequently they should change their pads and were unaware of safe disposal mechanisms of the used pads.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 7Women hardly could attend to their personal hygiene, which was not prioritized during emergencies.
“They hardly could attend to their personal hygiene, which was not prioritized during emergencies.”
Quote in the paperSubstantial claimMay combine two claims.
Findingreasoning§ Cyclone Phailin, Odisha, 2013 · p. 6Women preferred using cloth, which was cheaper and could be reused; these were changed only once every day during the cycle.
“Therefore, women preferred using cloth, which was cheaper and could be reused; these were changed only once every day during the cycle.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingnone given§ Cyclone Phailin, Odisha, 2013 · p. 7Post-distribution, separate display stalls were installed where the use of kit items was explained to women by female community mobilizers and health promotion volunteers, covering use of sanitary cloth, maintenance of menstrual hygiene, and personal care in small groups of women.
“Post-distribution, the separate display stalls were installed, where the use of the kit items was explained to women by female community mobilizers and health promotion volunteers, covering the use of sanitary cloth, maintenance of menstrual hygiene, and personal care in small groups of women.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Assam floods, 2012 · p. 5In Assam, all (100 per cent) female participants reported that they were restricted during menstruation and were prohibited from entering the main sections of the house, including the kitchen and prayer rooms.
“All (100 per cent) of the female participants reported that they were restricted during 'those' days; during menstruation they were prohibited from entering the main sections of the house - kitchen and prayer rooms.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data§ Cyclone Phailin, Odisha, 2013 · p. 7Humanitarian agencies undertook staff training for both male and female staff members and provided participants with a checklist.
“Humanitarian agencies undertook staff training to both male and female staff members, and provided participants with a checklist (Box 1).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingnone given§ Gendered recovery processes · p. 9In Assam, women were in charge of house rebuilding and daily expenses as men had migrated for work.
“In Assam, it emerged that women were in charge of house rebuilding and daily expenses as men had migrated for work.”
Quote in the paperSubstantial claimMay combine two claims.
Findingnone given§ Cultural practices · p. 9In Assam and Odisha the practice of seclusion during menstruation led to reduced mobility within the household and society as well as dietary restrictions for women.
“In Assam and Odisha the practice of seclusion during menstruation led to reduced mobility within the household and society as well as dietary restrictions for women.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S4 (based).
Findingreasoning§ Recommendations and conclusions · p. 10Organizational understanding and learning of menstrual hygiene management remains tacit among the professionals engaged as hygiene promotion experts.
“Hence, organizational understanding and learning of menstrual hygiene management remains tacit among the professionals engaged as hygiene promotion experts.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
Findingnone given§ Recommendations and conclusions · p. 10Since menstrual hygiene is still considered taboo and discussed behind closed doors, it features very low on household recovery priorities, and often does not even get mentioned.
“Since menstrual hygiene is still considered taboo and discussed behind closed doors, it features very low on household recovery priorities, and often does not even get mentioned.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Awareness of safe menstrual practices · p. 9The data highlight that there is a lack of awareness and knowledge about how frequently sanitary pads/cloths should be changed in a day during menstruation; appropriate disposal mechanisms; necessity of regular washing and cleanliness of private body parts; and appropriate measures for washing and drying menstrual linen.
“The data highlight that there is a lack of awareness and knowledge about the following issues related to MHM: how frequently sanitary pads/cloths should be changed in a day during menstruation; appropriate disposal mechanisms; necessity of regular washing and cleanliness of private body parts; and appropriate measures for washing and drying menstrual linen.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Interpretationnone given§ Box 1 Checklist used by humanitarian agency, Odisha, for sensitizing programme staff towards MHM · p. 8General practices of hand washing and promotion of sanitation facilities were important in ensuring privacy and better environments for women to address urgent and private needs related to their menstrual health.
“General practices of hand washing and promotion of sanitation facilities were important in ensuring privacy and better environments for women to address urgent and private needs related to their menstrual health.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S4 (based).
Interpretationown data§ Privacy for changing · p. 8Menstrual health is essential to the dignity and privacy of women.
“but is essential to the dignity and privacy of women.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationreasoning§ Assam floods, 2012 · p. 5Provision of handwashing facilities near latrines, separate spaces in bathing units for women to wash menstrual linen with privacy, and closed drains were useful because running wastewater did not display menstrual blood.
“Provision of handwashing facilities near the latrines, separate spaces in bathing units for women to wash their menstrual linen with privacy, and closed drains were useful as the running wastewater did not display the menstrual blood.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable), S4 (based).
Interpretationnone given§ Recommendations and conclusions · p. 10Post-disaster recovery provided a unique opportunity to generate awareness and build local knowledge and understanding of male and female members of the communities on menstrual hygiene management.
“Moreover, post-disaster recovery provided a unique opportunity to generate awareness and build local knowledge and understanding of male and female members of the communities on menstrual hygiene management.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
The findings from the two case studies in Assam and Odisha are sufficiently representative to inform humanitarian agencies' MHM approaches in other post-disaster contexts.
“Based on the empirical evidence, this research offers a practical suggestion to humanitarian agencies to enhance MHM in WASH interventions during recovery.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Menstrual hygiene management is often overlooked in post-disaster responses.
“Despite being an important issue concerning women and girls in the menstruating age group MHM is often overlooked in post-disaster responses.”
From Menstrual hygiene management among women and adolescent girls in the aftermath of the earthquake in Nepal (2018) · cites this paper as [28]
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- Bosher, L. and Dainty, A. (2011) ‘Disaster risk reduction and “built-in” resilience: towards overarching principles for construction practice’, Disasters 35(1): 1–18 <http://dx.doi.org/10.1111/j.1467-7717.2010.01189.x>. · DOI
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- Muralidharan, A., Patil, H. and Patnaik, S. (2015) ‘Unpacking the policy landscape for menstrual hygiene management: implications for school WASH programmes in India’, Waterlines 34(1): 79–91 <http://dx.doi.org/10.3362/1756-3488.2015.008>. · DOI
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- O’Reilly, K., 2010. Combining sanitation and women’s participation in water supply: an example from Rajasthan. Development in Practice, 20(1), pp. 45–56. <http://dx.doi.org/10.1080/09614520903436976> · DOI · Paper page
- Parker, A.H., Smith, J.A., Verdemato, T., Cooke, J., Webster, J. and Carter, R.C. (2014) ‘Menstrual management: a neglected aspect of hygiene interventions’, Disaster Prevention and Management 23(4): 437–54 <http://dx.doi.org/10.1108/DPM-04-2013-0070>. · DOI · Paper page
- Parkinson, J. (2009) A Review of the Evidence Base for WASH Interventions in Emergency Responses, Atkins/UNICEF WASH Steering Group.
- Sommer, M. (2012) ‘Menstrual hygiene management in humanitarian emergencies: gaps and recommendations’, Waterlines 31(1–2): 83–104 <http://dx.doi.org/10.3362/1756-3488.2012.008>. · DOI · Paper page
- Sommer, M., Caruso, B.A., Sahin, M., Calderon, T., Cavill, S., Mahon, T. and Phillips-Howard, P.A. (2016) ‘A time for global action: addressing girls’ menstrual hygiene management needs in schools’, PLOS Medicine 13(2): p. e1001962 <http://dx.doi.org/10.1371/journal.pmed.1001962>. · DOI · Paper page
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- Bosher, L. and Dainty, A. (2011) ‘Disaster risk reduction and “built-in” resilience: towards overarching principles for construction practice’, Disasters 35(1): 1–18 <http://dx.doi.org/10.1111/j.1467-7717.2010.01189.x>. · DOI
- Brown, J., Cavill, S., Cumming, O. and Jeandron, A. (2012) ‘Water, sanitation, and hygiene in emergencies: summary review and recommendations for further research’, Waterlines 31(1): 11–29 <http://dx.doi.org/10.3362/1756-3488.2012.004>. · DOI
- Bryman, A. (2008) Social Research Methods, 3rd edn, Oxford: Oxford University Press.
- Connolly, M., Gayer, M., Ryan, M.J., Spiegel, P., Salama, P. and Heymann, D.L. (2004) ‘Communicable diseases in complex emergencies: impact and challenges’, Lancet 364(9449): 1974–83 <http://dx.doi.org/10.1016/S0140-6736(04)17481-3>. · DOI
- Few, R., McAvoy, D., Tarazona, M. and Walden, V.M. (2013) Contribution to Change: An Approach to Evaluating the Role of Intervention in Disaster Recovery, Rugby, UK: Practical Action Publishing. · DOI
- King, K., Bosher, L.S. and Kayaga, S. (2013) ‘Resilience in the humanitarian sphere: stimulating resilience for recovery’, in R. Shaw (ed.), Proceedings of the 36th WEDC International Conference: Delivering Water, Sanitation and Hygiene Services in an Uncertain Environment, pp. 1–6, Loughborough: Water, Engineering and Development Centre, Loughborough University.
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- Muralidharan, A., Patil, H. and Patnaik, S. (2015) ‘Unpacking the policy landscape for menstrual hygiene management: implications for school WASH programmes in India’, Waterlines 34(1): 79–91 <http://dx.doi.org/10.3362/1756-3488.2015.008>. · DOI
- Nawaz, J., Lal, S., Raza, S. and House, S. (2010) ‘Oxfam experience of providing screened toilet, bathing and menstruation units in its earthquake response in Pakistan’, Gender & Development 18: 81–9 <http://dx.doi.org/10.1080/13552071003600067>. · DOI
- O’Reilly, K., 2010. Combining sanitation and women’s participation in water supply: an example from Rajasthan. Development in Practice, 20(1), pp. 45–56. <http://dx.doi.org/10.1080/09614520903436976> · DOI · Paper page
- Parker, A.H., Smith, J.A., Verdemato, T., Cooke, J., Webster, J. and Carter, R.C. (2014) ‘Menstrual management: a neglected aspect of hygiene interventions’, Disaster Prevention and Management 23(4): 437–54 <http://dx.doi.org/10.1108/DPM-04-2013-0070>. · DOI · Paper page
- Parkinson, J. (2009) A Review of the Evidence Base for WASH Interventions in Emergency Responses, Atkins/UNICEF WASH Steering Group.
- Sommer, M. (2012) ‘Menstrual hygiene management in humanitarian emergencies: gaps and recommendations’, Waterlines 31(1–2): 83–104 <http://dx.doi.org/10.3362/1756-3488.2012.008>. · DOI · Paper page
- Sommer, M., Caruso, B.A., Sahin, M., Calderon, T., Cavill, S., Mahon, T. and Phillips-Howard, P.A. (2016) ‘A time for global action: addressing girls’ menstrual hygiene management needs in schools’, PLOS Medicine 13(2): p. e1001962 <http://dx.doi.org/10.1371/journal.pmed.1001962>. · DOI · Paper page
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“…McMahon 2011 [5]; Nechitilo 2016 [77]; Parker 2014 [15]; Pillitteri 2011 [79]; Tegegne 2014 [93]; Trinies 2015 [95] (n = 7) Al-Shurbji 2017 [35]; Krishnan 2016 [66]; Person 2014 [80]; Sanduvac 2017 [82]; Tamiru 2015 [91]; UN Women 2017 [98]; WSSCC 2014 [102] Perceptions of practices (n = 13)…”
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“Although increasingly considered, menstrual hygiene continues to be overlooked during disasters, even in community level responses [22, 28, 29].”
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“Globally, as the number of displaced people is increasing, menstrual hygiene still remains a neglected aspect of hygiene interventions in emergency situations [55].”
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“…households they were also prohibited from entering the main sections of the house – kitchen, prayer rooms – as they were considered impure while menstruating, so when they are living in camps, practicing seclusion becomes more challenging and exposes women at risk (see Krishnan & Twigg, 2016).”
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“In such emergencies, moreover, the security, privacy, and health needs of women and girls including menstrual health are often overlooked [18, 20, 21] This study depicts the criticality of lack of menstrual hygiene materials and supplies which is in line with other studies [9, 22–24].”
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İnal, C. G., TAŞKIN, Ş., & Taşhan, Ş. T. (2025) · Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi · doi:10.37989/gumussagbil.1727626
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Gilmer, A., Holding, S., Omar, S., Mambwe, C., Mohamed, B. A., Elmi, M. H., Ali, I. M., Ibrahim, M., & D’Mello-Guyett, L. (2026) · Research Square · doi:10.21203/rs.3.rs-8967777/v1
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- Authors
- Sneha Krishnan, S. K., & John Twigg, J. T.
- Venue
- Waterlines
- Publisher
- Practical Action Publishing
- Published
- 2016-07-01
- Volume
- 35
- Issue
- 3
- Pages
- 265-276
- ISSN
- 0262-8104 (ISSN-L)
- 1756-3488
- OpenAlex
- W2498158905
- Cited by
- 39
- References
- 15
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 4 · 2023: 5 · 2022: 10 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 1
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Waterlines (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Social Sciences › Sociology and Political Science › Disaster Management and Resilience
- Social Sciences › Gender Studies › Gender Studies and Social Issues
- Keywords
- menstrual hygiene management, disaster recovery, post-disaster relief, women's privacy, women's safety, adolescent girls, Cyclone Phailin, Odisha, sanitary pads, sociocultural practices, behavior change
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