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Hirani SAA. Barriers to Women's Menstrual Hygiene Practices during Recurrent Disasters and Displacement: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:153. [PMID: 38397644 PMCID: PMC10888390 DOI: 10.3390/ijerph21020153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
Disasters that involve displacement are particularly challenging for managing personal and menstrual hygiene, which can increase the risk of toxic shock syndrome, infections and other health conditions that can endanger women's lives. This study aimed to examine the menstrual hygiene challenges experienced by internally displaced women affected by recurrent natural disasters and subsequent displacement in the context of a low-middle-income country, i.e., Pakistan. A critical ethnographic study was undertaken in disaster-relief camps in the northern region of Pakistan. Data were collected using multiple methods, including field observations, review of media reports and in-depth interviews with 18 women. The findings suggested that the key barriers to the personal and menstrual hygiene of women during recurrent disasters and displacement in the mountainous rural region of Pakistan include inadequate housing, lack of infrastructure and humanitarian aid, no waste disposal system and lack of women-friendly spaces in disaster-relief camps. Community-based collaboration is necessary for the implementation of effective interventions. A comprehensive menstrual response to promote the health and well-being of women during disasters must include menstruation supplies, supportive facilities (mainly toilets and bathing facilities), supplementary supplies for storing, washing and drying, disposal/waste management facilities, education and culturally appropriate spaces and supplies.
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Affiliation(s)
- Shela Akbar Ali Hirani
- Faculty of Nursing, University of Regina, 516 RIC, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
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Tapp K, Henson A. "For men, by men": Menstrual victimization and the weaponization of period products in carceral settings. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241240931. [PMID: 38554068 PMCID: PMC10981853 DOI: 10.1177/17455057241240931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/20/2024] [Accepted: 03/01/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND The literature on menstruation defines period poverty as the inability to access sufficient period products, education, and sanitary facilities needed to manage menstruation healthily and effectively. While research has identified shortcomings of healthcare in the carceral setting, period poverty behind bars has remained largely absent from criminal legal discourse. OBJECTIVES The current study examines the interplay of period poverty and carceral control to introduce the novel concept of menstrual victimization, defined as the physical, emotional, and financial victimization that results from period poverty perpetuated through carceral control. METHODS The study uses qualitative content analysis to systematically gather and code journalistic accounts pertaining to the menstrual experiences of incarcerated and previously incarcerated females, criminal justice practitioners, and journalists. The analysis uses literary pieces (n = 99), which were coded deductively and guided by concepts related to structural violence and radical feminist criminology. RESULTS The findings shed light on the unique structural harms incarcerated menstruators face and reveal the dearth of needed empirical research on period poverty in carceral spaces. The narratives in the sample revealed how manufactured scarcity of period products within carceral spaces is used as a means of oppression by institutional agents. The emergent themes highlight how the intersection of period poverty and carceral control led to menstrual victimization characterized through shame, humiliation, control, and coercion. CONCLUSION Potential outcomes associated with understanding menstrual victimization in the carceral setting are discussed, including reducing menstrual stigma, disseminating health education, minimizing health disparities, and ultimately, shifting modes of holding accountability away from oppressive, retributive, and controlling tactics.
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Affiliation(s)
- Kathryn Tapp
- School of Criminology and Criminal Justice, Arizona State University, Phoenix, AZ, USA
| | - Abigail Henson
- School of Criminology and Criminal Justice, Arizona State University, Phoenix, AZ, USA
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Plesons M, Torondel B, Caruso BA, Hennegan J, Sommer M, Haver J, Keiser D, van Eijk AM, Zulaika G, Mason L, Phillips-Howard PA. Research priorities for improving menstrual health across the life-course in low- and middle-income countries. Glob Health Action 2023; 16:2279396. [PMID: 38010372 PMCID: PMC10795652 DOI: 10.1080/16549716.2023.2279396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Research on menstrual health is required to understand menstrual needs and generate solutions to improve health, wellbeing, and productivity. The identification of research priorities will help inform where to invest efforts and resources. OBJECTIVES To identify research priorities for menstrual health across the life-course, in consultation with a range of stakeholder groups from a variety of geographic regions, and to identify if menstrual health research priorities varied by expertise. METHODS A modified version of the Child Health and Nutrition Research Initiative approach was utilized to reach consensus on a set of research priorities. Multisector stakeholders with menstrual health expertise, identified through networks and the literature, were invited to submit research questions through an online survey. Responses were consolidated, and individuals were invited to rank these questions based on novelty, potential for intervention, and importance/impact. Research priority scores were calculated and evaluated by participants' characteristics. RESULTS Eighty-two participants proposed 1135 research questions, which were consolidated into 94 unique research questions. The mean number of questions did not differ between low- and middle-income country (LMIC) and high-income country (HIC) participants, but significantly more questions were raised by participants with expertise in mental health and WASH. Sixty-six participants then ranked these questions. The top ten-ranked research questions included four on 'understanding the problem', four on 'designing and implementing interventions', one on 'integrating and scaling up', and one on 'measurement'. Indicators for the measurement of adequate menstrual health over time was ranked the highest priority by all stakeholders. Top ten-ranked research questions differed between academics and non-academics, and between participants from HICs and LMICs, reflecting differences in needs and knowledge gaps. CONCLUSIONS A list of ranked research priorities was generated through a consultative process with stakeholders across LMICs and HICs which can inform where to invest efforts and resources.
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Affiliation(s)
- Marina Plesons
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Belen Torondel
- Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Bethany A. Caruso
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Julie Hennegan
- Maternal, Child, and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Marni Sommer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jacquelyn Haver
- School Health and Nutrition, Department of Education and Children Protection, Save the Children US, Washington, DC, USA
| | | | - Anna M. van Eijk
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Garazi Zulaika
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Linda Mason
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Pooseesod K, Umezaki M, Phetrak A, Phuanukoonnon S. Handwashing among caregivers of young children in a protracted and complex refugee and immigration context: a mixed methods study on the Thai-Myanmar border. Front Public Health 2023; 11:1099831. [PMID: 37583886 PMCID: PMC10423810 DOI: 10.3389/fpubh.2023.1099831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/10/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction Protracted refugee situations create complex contexts that present significant health risks for young children. Effective hand hygiene practices by caregivers can reduce respiratory infections and diarrhoeal disease, the two largest contributors to mortality among children between 1 month and 5 years of age. This study documented handwashing patterns and access to water, sanitation and hygiene (WASH) infrastructure among caregivers of young children living along the Thai-Myanmar border, one of the world's most protracted and complex refugee and immigration contexts. It also examined the association between handwashing and socio-demographic variables and captured participants' explanations for when and how hands are washed. The study broadened the scope of previous research by also including the large number of caregivers living outside formal camps. Methods Caregivers of children attending 11 preschools in Tak province, Thailand participated in a mixed-methods cross-sectional study. Quantitative questionnaire data (n = 384) were supplemented by a thematic analysis of data from in-depth interviews (n = 9). Results Fewer than half the caregivers reported routinely washing their hands before preparing meals or after using the latrine/toilet. Fewer than one-in-five routinely used soap in these situations. Interviewees explained that handwashing was only necessary when a substance could be felt or seen, in which case wiping with a cloth or a rinsing with water were sufficient to clean hands. However, their explanations also suggested some potential avenues for culturally appropriate and feasible interventions to improve hand hygiene. Conclusion The results confirmed previous research on the multi-dimensional barriers to good hand hygiene in protracted refugee situations and other low-resource settings. Additional investment to overcome shortages in the infrastructure necessary to support good hand hygiene and creative means of drawing on and developing human capital will be necessary to realize the potential hand hygiene holds for reducing ill-health and mortality among young children living in these contexts.
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Affiliation(s)
- Kasama Pooseesod
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Thailand
| | - Masahiro Umezaki
- Faculty of Public Health, Thammasat University, Bangkok, Thailand
| | - Athit Phetrak
- Department of Human Ecology, Graduate School of Medical Sciences, University of Tokyo, Tokyo, Japan
| | - Suparat Phuanukoonnon
- Department of Human Ecology, Graduate School of Medical Sciences, University of Tokyo, Tokyo, Japan
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Beeman A, Kwesiga J, Ippoliti N, Bhandari T, Pandya G, Acam FA, Lee S, Hope R, Gibbs T, Levine J. Using human-centered design to co-design dedicated menstrual health spaces with people who menstruate in Bidi Bidi refugee settlement, Uganda: Learnings for further adaptation and scale in humanitarian settings. BMC Womens Health 2023; 23:319. [PMID: 37340385 DOI: 10.1186/s12905-023-02421-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/09/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Many people who menstruate in low- and middle-income countries struggle to manage their menstruation safely, hygienically, and with dignity. This is exacerbated in humanitarian settings with limited access to menstrual products and safe, private spaces for changing, washing, and disposing of menstrual products. To address these challenges, Youth Development Labs (YLabs) used a human-centered design approach to co-design the Cocoon Mini, a safe, physical structure for managing menstruation in the Bidi Bidi Refugee Settlement in Uganda. METHODS The study comprised five phases, including background research, design research, rough prototyping, live prototyping, and a pilot study. A total of 340 people, including people who menstruate, male community members, and community stakeholders, participated in interviews, focus groups, and co-design sessions. Solution prototypes were created, evaluated, and iterated upon in each successive project phase. The final intervention design, the Cocoon Mini, was evaluated qualitatively for feasibility and acceptability during a three-month pilot using structured interviews with 109 people who menstruate utilizing Cocoon Mini structures, 64 other community members, and 20 Cocoon Mini supervisors. RESULTS Results showed widespread desirability and acceptability of the Cocoon Mini among people who menstruate and other community members. Overall, 95% (104/109) of people who menstruate stated the space had made menstrual health management easier, primarily by providing designated waste bins, solar lights, and additional water sources. The Cocoon Mini provided an increased sense of physical and psychological safety in knowing where to privately manage menstruation. Furthermore, the Cocoon Mini demonstrated that an intervention could be run and maintained sustainably at the household level in humanitarian contexts, without continued external stakeholder intervention. Each Cocoon Mini structure costs approximately $360 USD to build and maintain and serves 15-20 people who menstruate, leading to a cost per person of $18-$24. Furthermore, attaching an incinerator to the structure for easier and quicker disposal of waste bin contents (compared to transporting full waste bins elsewhere) costs $2110 USD. CONCLUSIONS People who menstruate lack access to safe, private spaces for menstrual health and product disposal in humanitarian settings. The Cocoon Mini provides a solution for the safe and effective management of menstruation. Customizing and scaling up dedicated menstrual health spaces should be considered a high-priority intervention in humanitarian settings.
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Affiliation(s)
- Aly Beeman
- Youth Development Labs (YLabs), KN 14 St, Kigali, Rwanda.
| | - Joseph Kwesiga
- Youth Development Labs (YLabs), KN 14 St, Kigali, Rwanda
| | | | - Tanya Bhandari
- Youth Development Labs (YLabs), KN 14 St, Kigali, Rwanda
| | - Geetika Pandya
- Youth Development Labs (YLabs), KN 14 St, Kigali, Rwanda
| | | | - Saehee Lee
- Youth Development Labs (YLabs), KN 14 St, Kigali, Rwanda
| | - Rebecca Hope
- Youth Development Labs (YLabs), KN 14 St, Kigali, Rwanda
| | - Theodora Gibbs
- Youth Development Labs (YLabs), KN 14 St, Kigali, Rwanda
| | - Jordan Levine
- Youth Development Labs (YLabs), KN 14 St, Kigali, Rwanda
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Brizuela V, Bahamondes L, Gómez Ponce de León R, Aslanyan G, Feletto M, Bonet M, Thorson A. Strengthening locally led research to respond to the sexual and reproductive health and rights of migrants from Venezuela and Central America. Rev Panam Salud Publica 2023; 47:e36. [PMID: 36895678 PMCID: PMC9989552 DOI: 10.26633/rpsp.2023.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 03/08/2023] Open
Affiliation(s)
- Vanessa Brizuela
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP)Department of Sexual and Reproductive Health and ResearchWorld Health OrganizationGenevaSwitzerlandUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
| | - Luis Bahamondes
- Department of Obstetrics and GynaecologyUniversity of Campinas Medical FacultyCampinasBrazilDepartment of Obstetrics and Gynaecology, University of Campinas Medical Faculty, Campinas, Brazil.
| | - Rodolfo Gómez Ponce de León
- Center for PerinatologyWomen’s, and Reproductive Health (CLAP-PAHO/WHO)MontevideoUruguayCenter for Perinatology, Women’s, and Reproductive Health (CLAP-PAHO/WHO), Montevideo, Uruguay.
| | - Garry Aslanyan
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR)World Health OrganizationGenevaSwitzerlandUNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.
| | - Marta Feletto
- Alliance for Health Policy and Systems ResearchWorld Health OrganizationGenevaSwitzerlandAlliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland.
| | - Mercedes Bonet
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP)Department of Sexual and Reproductive Health and ResearchWorld Health OrganizationGenevaSwitzerlandUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
| | - Anna Thorson
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP)Department of Sexual and Reproductive Health and ResearchWorld Health OrganizationGenevaSwitzerlandUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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Brizuela V, Bahamondes L, Gómez Ponce de León R, Aslanyan G, Feletto M, Bonet M, Thorson A. Fortalecimiento de la investigación local para abordar la salud y los derechos sexuales y reproductivos de las personas migrantes de Venezuela y América Central *. Rev Panam Salud Publica 2023; 47:e37. [PMID: 36895676 PMCID: PMC9989547 DOI: 10.26633/rpsp.2023.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 03/08/2023] Open
Affiliation(s)
- Vanessa Brizuela
- Programa Especial de Investigación, Desarrollo y Capacitación en Investigación sobre Reproducción Humana (HRP) de PNUD/UNFPA/UNICEF/OMS/Banco MundialDepartamento de Salud Sexual y Reproductiva e Investigaciones relacionadasOrganización Mundial de la SaludGinebraSuizaPrograma Especial de Investigación, Desarrollo y Capacitación en Investigación sobre Reproducción Humana (HRP) de PNUD/UNFPA/UNICEF/OMS/Banco Mundial, Departamento de Salud Sexual y Reproductiva e Investigaciones relacionadas, Organización Mundial de la Salud, Ginebra, Suiza.
- Vanessa Brizuela, .
| | - Luis Bahamondes
- Departamento de Obstetricia y GinecologíaFacultad de Medicina de la Universidad de CampinasCampinasBrasilDepartamento de Obstetricia y Ginecología, Facultad de Medicina de la Universidad de Campinas, Campinas, Brasil.
| | - Rodolfo Gómez Ponce de León
- Centro Latinoamericano de PerinatologíaSalud de la Mujer y Reproductiva (CLAP-OPS/OMS)MontevideoUruguayCentro Latinoamericano de Perinatología, Salud de la Mujer y Reproductiva (CLAP-OPS/OMS), Montevideo, Uruguay.
| | - Garry Aslanyan
- Programa Especial de Capacitación e Investigación en Enfermedades Tropicales (TDR) de UNICEF/PNUD/Banco Mundial/OMSOrganización Mundial de la SaludGinebraSuizaPrograma Especial de Capacitación e Investigación en Enfermedades Tropicales (TDR) de UNICEF/PNUD/Banco Mundial/OMS, Organización Mundial de la Salud, Ginebra, Suiza.
| | - Marta Feletto
- Alianza para la Investigación en Políticas y Sistemas de SaludOrganización Mundial de la SaludGinebraSuizaAlianza para la Investigación en Políticas y Sistemas de Salud, Organización Mundial de la Salud, Ginebra, Suiza.
| | - Mercedes Bonet
- Programa Especial de Investigación, Desarrollo y Capacitación en Investigación sobre Reproducción Humana (HRP) de PNUD/UNFPA/UNICEF/OMS/Banco MundialDepartamento de Salud Sexual y Reproductiva e Investigaciones relacionadasOrganización Mundial de la SaludGinebraSuizaPrograma Especial de Investigación, Desarrollo y Capacitación en Investigación sobre Reproducción Humana (HRP) de PNUD/UNFPA/UNICEF/OMS/Banco Mundial, Departamento de Salud Sexual y Reproductiva e Investigaciones relacionadas, Organización Mundial de la Salud, Ginebra, Suiza.
| | - Anna Thorson
- Programa Especial de Investigación, Desarrollo y Capacitación en Investigación sobre Reproducción Humana (HRP) de PNUD/UNFPA/UNICEF/OMS/Banco MundialDepartamento de Salud Sexual y Reproductiva e Investigaciones relacionadasOrganización Mundial de la SaludGinebraSuizaPrograma Especial de Investigación, Desarrollo y Capacitación en Investigación sobre Reproducción Humana (HRP) de PNUD/UNFPA/UNICEF/OMS/Banco Mundial, Departamento de Salud Sexual y Reproductiva e Investigaciones relacionadas, Organización Mundial de la Salud, Ginebra, Suiza.
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Patel K, Panda N, Sahoo KC, Saxena S, Chouhan NS, Singh P, Ghosh U, Panda B. A systematic review of menstrual hygiene management (MHM) during humanitarian crises and/or emergencies in low- and middle-income countries. Front Public Health 2022; 10:1018092. [PMID: 36249215 PMCID: PMC9555566 DOI: 10.3389/fpubh.2022.1018092] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/09/2022] [Indexed: 01/28/2023] Open
Abstract
Background Poor menstrual hygiene management (MHM) is linked to adverse health, and quality of life, particularly during emergencies. Although in recent times increased emphasis is being laid upon MHM during humanitarian crises-pandemics, disasters and conflicts, the essential components of complete MHM during an emergency are not clearly spelt out. We conducted a systematic review to examine, analyse and describe the existing evidence related to the challenges experienced by women and girls in practicing MHM during humanitarian crises and / or public health emergencies. Methods We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines and registered in PROSPERO (CRD42022328636). We searched online repositories: PubMed, Embase, and PsycINFO for articles published between January 2000 and April 2022. For presenting key findings, we used the descriptive statistics and thematic analysis approach. Results We identified a total of 1,078 published articles, out of which 78 were selected for a full-text review, and finally 21 articles were included. The pooled prevalence of lack of access to sanitary pads during humanitarian crises was 34 percent (95 percent CI 0.24-0.45). The prevalence of safe and proper sanitary pad disposal practices ranged from 11 to 85 per cent, with a pooled prevalence of 54 per cent (95 per cent CI 0.21-86). Qualitative analyses projected three themes that emerged on MHM during humanitarian crises (1) Availability and affordability of menstrual products, and accessibility to water, sanitation and health (WASH) services, (2) Availability of support system and coping with "period poverty," and (3) Gender dimensions of menstrual hygiene management. Most studies reported non-availability of MHM products and WASH services during emergencies. Existence of barriers at systemic and personal level posed challenges in practicing menstrual hygiene. Privacy was identified as a common barrier, as emergency shelters were reportedly not women-friendly. Conclusion Availability of limited evidence on the subject is suggestive of the need to invest resources for strengthening primary research in low- and middle-income countries and more specifically during emergencies. Context-specific state level policies on MHM during emergencies would help to guide district and sub-district managers in strengthening systems and address barriers for the provision of MHM services during emergencies. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022328636, identifier CRD42022328636.
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Affiliation(s)
- Kripalini Patel
- Indian Institute of Public Health (IIPH), Public Health Foundation of India (PHFI), Bhubaneswar, Odisha, India
| | - Nishisipa Panda
- Indian Institute of Public Health (IIPH), Public Health Foundation of India (PHFI), Bhubaneswar, Odisha, India
| | - Krushna Chandra Sahoo
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Shipra Saxena
- United Nations Children's Fund (UNICEF), Bhubaneswar, Odisha, India
| | | | - Pratibha Singh
- United Nations Children's Fund (UNICEF), New Delhi, India
| | - Upasona Ghosh
- Indian Institute of Public Health (IIPH), Public Health Foundation of India (PHFI), Bhubaneswar, Odisha, India
| | - Bhuputra Panda
- Indian Institute of Public Health (IIPH), Public Health Foundation of India (PHFI), Bhubaneswar, Odisha, India,*Correspondence: Bhuputra Panda
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Faruque ASG, Alam B, Nahar B, Parvin I, Barman AK, Khan SH, Hossain MN, Widiati Y, Hasan ASMM, Kim M, Worth M, Vandenent M, Ahmed T. Water, Sanitation, and Hygiene (WASH) Practices and Outreach Services in Settlements for Rohingya Population in Cox's Bazar, Bangladesh, 2018-2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159635. [PMID: 35954994 PMCID: PMC9368108 DOI: 10.3390/ijerph19159635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 05/14/2023]
Abstract
(1) Background: This study aimed to investigate the existing water, sanitation, and hygiene (WASH) policy and practice of the study population and strengthen the evidence base by documenting changes in the WASH policy and practice over 3 years of the Rohingya refugee humanitarian crisis, Cox's Bazar, Bangladesh. (2) Methods: A cross-sectional surveillance design was followed; the sampling of the study population included the Rohingya refugee population and neighborhood host nationals who required hospitalization soon after seeking care and enrolled into the diarrheal disease surveillance in diarrhea-treatment centers. Throughout the study period of 3 years, a total of 4550 hospitalized individuals constituted the study participants. (3) Results: Among the hospitalized Rohingya refugee population; the use of public tap water increased significantly from 38.5% in year 1 to 91% in year 3. The use of deep tube well water significantly changed from 31.3% to 8.2%, and the use of shallow tube well water reduced significantly from 25.8% to 0.4%. Households using water seal latrine were 13.3% in year 1 and increased significantly to 31.7% in year 3. ORS consumption at home changed significantly from 61.5% in the first year to 82.1% in third year. Multivariable analysis demonstrated patients' age groups at 5 to 14 years, and 15 years and more, drinking non-tube well water, soap use after using toilet, use of non-sanitary toilet facility, father's and mother's lack of schooling, and some and severe dehydration were significantly associated with the Rohingya refugee population enrolled into the diarrheal disease surveillance. (4) Conclusion: The findings indicate significant advances in WASH service delivery as well as outreach activities by aid agencies for the Rohingya refugee population living in settlements.
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Affiliation(s)
- ASG Faruque
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
- Correspondence:
| | - Baharul Alam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Baitun Nahar
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Irin Parvin
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Ashok Kumar Barman
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Soroar Hossain Khan
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - M Nasif Hossain
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Yulia Widiati
- UNICEF Bangladesh, Cox’s Bazar Field Office, Cox’s Bazar 4700, Bangladesh
| | - ASM Mainul Hasan
- UNICEF Bangladesh, Cox’s Bazar Field Office, Cox’s Bazar 4700, Bangladesh
| | - Minjoon Kim
- UNICEF Bangladesh Country Office, Dhaka 1207, Bangladesh
| | - Martin Worth
- UNICEF Bangladesh, Cox’s Bazar Field Office, Cox’s Bazar 4700, Bangladesh
| | - Maya Vandenent
- UNICEF Bangladesh Country Office, Dhaka 1207, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
- Office of Executive Director, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
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Anand U, Vithanage M, Rajapaksha AU, Dey A, Varjani S, Bontempi E. Inapt management of menstrual hygiene waste (MHW): An urgent global environmental and public health challenge in developed and developing countries. Heliyon 2022; 8:e09859. [PMID: 35815120 PMCID: PMC9260619 DOI: 10.1016/j.heliyon.2022.e09859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/26/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Uttpal Anand
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Meththika Vithanage
- Ecosphere Resilience Research Center, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, CO 10250, Sri Lanka
| | - Anushka Upamali Rajapaksha
- Ecosphere Resilience Research Center, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, CO 10250, Sri Lanka
- Instrument Center, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, 10250, Sri Lanka
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, 86/1 College Street, Kolkata 700073, West Bengal, India
| | - Sunita Varjani
- Gujarat Pollution Control Board, Paryavaran Bhavan, CHH Road, Sector 10A, Gandhinagar 382 010, Gujarat, India
| | - Elza Bontempi
- INSTM and Chemistry for Technologies Laboratory, Department of Mechanical and Industrial Engineering, University of Brescia, Via Branze, 38, 25123, Brescia, Italy
- Corresponding author.
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Robinson HJ, Barrington DJ. Drivers of menstrual material disposal and washing practices: A systematic review. PLoS One 2021; 16:e0260472. [PMID: 34860828 PMCID: PMC8641861 DOI: 10.1371/journal.pone.0260472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 11/10/2021] [Indexed: 11/26/2022] Open
Abstract
Background Disposal and washing facilities and services for menstrual materials are often designed based upon technical specifications rather than an in-depth understanding of what drives peoples’ choices of practices. Objectives and data sources This systematic review identified and summarised the main behavioural drivers pertaining to the choice of disposal and washing practices of menstrual materials through the thematic content analysis and study appraisal of 82 publications (80 studies) on menstrual health and hygiene published since 1999, reporting the outcomes of primary research across 26 countries. Results Disposal and washing behaviours are primarily driven by the physical state of sanitation facilities; however, this is intrinsically linked to taboos surrounding and knowledge of menstruation. Implications Using reasons given for disposal and washing practices by menstruators or those who know them well, or inferred by authors of the reviewed studies, we identify the key considerations needed to design facilities and services which best suit the desired behaviours of both planners and those who menstruate. Inclusivity The term menstruators is used throughout to encompass all those mentioned in the studies reviewed (girls and women); although no studies explicitly stated including non-binary or transgender participants, this review uses inclusive language that represents the spectrum of genders that may experience menstruation. Registration The review protocol is registered on PROSPERO: 42019140029.
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Affiliation(s)
| | - Dani Jennifer Barrington
- University of Leeds, Leeds, West Yorkshire, United Kingdom
- The University of Western Australia, Crawley, Western Australia, Australia
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Period poverty: menstrual health hygiene issues among adolescent and young Venezuelan migrant women at the northwestern border of Brazil. Reprod Health 2021; 18:238. [PMID: 34838038 PMCID: PMC8626730 DOI: 10.1186/s12978-021-01285-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 10/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background Adolescent and young women (10–24 years old) are habitually a neglected group in humanitarian settings. Menstrual hygiene management (MHM) is an unmet aspect of sexual and reproductive health (SRH) and an additional challenge if lack of hygiene products, inadequate access to safe, clean, and private toilets identified as period poverty. Our objective was to provide an overview of the main MHM issues affecting Venezuelan migrant adolescents and young women in the north-western border of Venezuela-Brazil. Method A cross-sectional study was conducted, early in 2021, with the use of a self-responded questionnaire, in Spanish, adapted from the Menstrual Practice Needs Scale (MPNS-36). All identified adolescents and young women aged between 12 and 24 years old were invited to participate (convenience sample-167 women). Women with complete questionnaires and who menstruate were included. Information on access to and quality of hygiene kits and toilets were retrieved, and a descriptive analysis performed, with an evaluation of frequencies for categorical variables (n, %) and mean (± SD-standard deviation) for continuous variables. In addition to the open-ended questions, we included one open question about their personal experience with menstruation. Results According to official reports, at the moment of the interviews, there were 1.603 Venezuelans living on the streets in Boa Vista. A total of 167 young women were invited, and 142 further included, mean age was 17.7 years, almost half of the participants who menstruate (46.4%) did not receive any hygiene kits, 61% were not able to wash their hands whenever they wanted, and the majority (75.9%) did not feel safe to use the toilets. Further, menstruation was often described with negative words. Conclusions Migrant Venezuelan adolescents and young women have their MHM needs overlooked, with evident period poverty, and require urgent attention. It is necessary to assure appropriate menstrual materials, education, and sanitation facilities, working in partnership among governmental and non-governmental organizations to guarantee menstrual dignity to these young women. Adolescent and young women (10–24 years old) are habitually a neglected group in humanitarian settings (situations of forced displacement, armed conflict, or natural disaster) and, in those contexts, they hardly have access to hygienic menstrual products, safe toilets, or water. This study provides an overview of the menstrual hygiene management issues among Venezuelan adolescents and young migrants living in the northwestern Brazilian border. We found almost half of the participants who menstruate (46.4%) did not receive any hygiene kits, 61% were not able to wash their hands whenever they wanted, and the majority (75.9%) did not feel safe to use the toilets evidencing the period poverty (lack of menstrual supplies, private toilets, sanitation conditions, and education) that affects the wellbeing of these women, especially during humanitarian crisis. Knowing about the Venezuelan adolescent migrant’s menstrual health management issues may help other humanitarian settings to discuss and address those needs, reducing the physical, psychological, and social consequences of menstrual poverty.
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Kouamé PK, Galli A, Peter M, Loss G, Wassa D, Bonfoh B, Utzinger J, Winkler MS. Access to Water and Sanitation Infrastructures for Primary Schoolchildren in the South-Central Part of Côte d'Ivoire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8863. [PMID: 34444615 PMCID: PMC8392625 DOI: 10.3390/ijerph18168863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022]
Abstract
In rural settings of Côte d'Ivoire, access to water, sanitation, and hygiene (WASH) at schools is often lacking. The purpose of this study was to assess the availability, quality, and use of WASH infrastructure in schools in the south-central part of Côte d'Ivoire, and to determine the hygiene practices of schoolchildren. A cross-sectional study was conducted in 20 primary schools with (n = 10) or without (n = 10) direct access to drinking water. The survey was comprised of a questionnaire directed at schoolchildren aged 8-17 years, an assessment of the WASH infrastructure, and the testing of drinking water samples for Escherichia coli and total coliforms. Overall, 771 schoolchildren were enrolled in the study. One out of four children (24.9%) reported that they used available toilets. Among those children not using toilets, more than half (57.5%) reported that they practised open defecation. Drinking water infrastructure was limited in most schools because of poor storage tanks, the low flow of water, or broken wells. All drinking water samples (n = 18) tested positive for total coliforms and 15 (83.3%) tested positive for E. coli. The lack of WASH infrastructures in primary schools in the south-central part of Côte d'Ivoire, in combination with poor hygiene practices, might govern disease transmission and absenteeism at school, especially among females.
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Affiliation(s)
- Parfait K. Kouamé
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303 Abidjan 01, Côte d’Ivoire; (P.K.K.); (B.B.)
| | - Anaïs Galli
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (G.L.); (J.U.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Maryna Peter
- Institute for Ecopreneurship, University of Applied Sciences and Arts Northwestern Switzerland, CH-4132 Muttenz, Switzerland;
| | - Georg Loss
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (G.L.); (J.U.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | | | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303 Abidjan 01, Côte d’Ivoire; (P.K.K.); (B.B.)
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (G.L.); (J.U.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Mirko S. Winkler
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (G.L.); (J.U.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
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Tasker A, Braam D. Positioning zoonotic disease research in forced migration: A systematic literature review of theoretical frameworks and approaches. PLoS One 2021; 16:e0254746. [PMID: 34310626 PMCID: PMC8312951 DOI: 10.1371/journal.pone.0254746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/27/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The emergence and transmission of zoonotic diseases are driven by complex interactions between health, environmental, and socio-political systems. Human movement is considered a significant and increasing factor in these processes, yet forced migration remains an understudied area of zoonotic research-due in part to the complexity of conducting interdisciplinary research in these settings. OBJECTIVES We conducted a systematic review to identify and analyze theoretical frameworks and approaches used to study linkages between forced migration and zoonotic diseases. METHODS We searched within eight electronic databases: ProQuest, SCOPUS, Web of Science, PubMed, PLoSOne, Science Direct, JSTOR, and Google Scholar, to identify a) research articles focusing on zoonoses considering forced migrants in their study populations, and b) forced migration literature which engaged with zoonotic disease. Both authors conducted a full-text review, evaluating the quality of literature reviews and primary data using the Critical Appraisal Skills Programme (CASP) model, while theoretical papers were evaluated for quality using a theory synthesis adapted from Bonell et al. (2013). Qualitative data were synthesized thematically according to the method suggested by Noblit and Hare (1988). RESULTS Analyses of the 23 included articles showed the increasing use of interdisciplinary frameworks and approaches over time, the majority of which stemmed from political ecology. Approaches such as EcoHealth and One Health were increasingly popular, but were more often linked to program implementation and development than broader contextual research. The majority of research failed to acknowledge the heterogeneity of migrant populations, lacked contextual depth, and insufficient acknowledgments of migrant agency in responding to zoonotic threats. CONCLUSIONS Addressing the emergence and spread of zoonoses in forced migration contexts requires more careful consideration and use of interdisciplinary research to integrate the contributions of social and natural science approaches. Robust interdisciplinary theoretical frameworks are an important step for better understanding the complex health, environment, and socio-political drivers of zoonotic diseases in forced migration. Lessons can be learned from the application of these approaches in other hard-to-reach or seldom-heard populations.
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Affiliation(s)
- Alex Tasker
- Department of Anthropology, University College London, London, United Kingdom
- * E-mail:
| | - Dorien Braam
- Disease Dynamics Unit, University of Cambridge, Cambridge, United Kingdom
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