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. 2017 Oct 16:11:19.
doi: 10.1186/s13031-017-0121-1. eCollection 2017.

Understanding the menstrual hygiene management challenges facing displaced girls and women: findings from qualitative assessments in Myanmar and Lebanon

Margaret L Schmitt  1 , David Clatworthy  2 , Ruwan Ratnayake  2 , Nicole Klaesener-Metzner  2 , Elizabeth Roesch  2 , Erin Wheeler  2 , Marni Sommer  1
Affiliations

Understanding the menstrual hygiene management challenges facing displaced girls and women: findings from qualitative assessments in Myanmar and Lebanon

Margaret L Schmitt et al. Confl Health. .

Abstract

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.

Keywords: Humanitarian response; Lebanon; Menstrual hygiene management; Menstruation; Myanmar.

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Conflict of interest statement

Ethics approval and consent to participate

All participants provided oral informed consent before beginning data collection. All study procedures were approved by the Columbia University Institutional Review Board (IRB) and the IRC IRB, and through a facilitated and systematic process of ethical review of the protocol by two local experts in each country.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Example participatory map developed by Syrian girls living in a host community in Lebanon. Legend: Black box with +: Clinic, Green box with +: Pharmacy, Swerving lines: River, Round cylinder: communal garbage bins, Red rectangle: Supermarket, Black Rectangle and triangle roof: Home or apartment building, Green stickers: Safe or comfortable places for MHM, Red stickers: Not safe or comfortable places for MHM
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