Menstruation and Menstrual Hygiene Management (MHM)

What is Menstruation?

  • Menstruation or more commonly known as periods is a normal biological process, in which the monthly expulsion of blood and cellular fragments from the uterus occurs, that start at puberty.
  • It is a normal vaginal bleeding that occurs as a part of woman’s monthly cycle.
  • Menstruation is a hormonal process that occurs in the woman’s body to prepare for the possible pregnancy. It is also a key sign of reproductive health.
  • Menstruation is necessary to rid the body of the uterine inside layer that has built up in preparation for pregnancy.

What is Menstrual Hygiene?

  • Menstrual hygiene basically is dealing the days during periods, cleanly and applying safe practice from using sanitary pads to regular change and cleaning the area with soap and water.

What is Menstrual Hygiene Management (MHM)?

  • According to Joint Monitoring Programme (JMP) of WHO and UNICEF, menstrual hygiene management refers to:
    “Women and adolescent girls are using a clean menstrual management material to absorb or collect menstrual blood, that can be changed in privacy as often as necessary for the duration of a menstrual period, using soap and water for washing the body as required, and having access to safe and convenient facilities to dispose of used menstrual management materials”
  • Menstruation hygiene management is a process where women and adolescent girls during menstruation use clean material to absorb menstrual blood.
  • MHM also consists of using soap and water for cleaning the reproductive parts and have access to proper disposal of used materials without affecting the environment.

Conditions for Good MHM practices:

According to Joint Monitoring Programme (JMP) of WHO and UNICEF, pre-conditions that need to be met for ensuring good MHM are:

  • Access to accurate and pragmatic information (for females and males) about menstruation and menstrual hygiene
  • Access to menstrual hygiene materials to absorb or collect menstrual blood
  • Access to facilities that provide privacy for changing materials and for washing body with soap and water
  • Access to water and soap within a place that provides an adequate level of privacy for washing stains from clothes and drying reusable menstrual materials
  • Access to disposal facilities for used menstrual materials (from collection point to final disposal

Furthermore, according to the Indian national guidelines for Menstrual Hygiene Management, following things need to be considered for proper MHM pratices:

A: The Action Guides and Technical guides

  • Availability of funds for IEC material and to raise awareness and skills on Menstrual Hygiene Management in all places.
  • Focusing awareness specifically amongst adolescent girls in school. IEC plans should include the Menstrual Hygiene Component for raising awareness among all the stakeholders.
  • Subjects relating to women personal hygiene namely menstrual hygiene are to be focused under the Swachh Bharat guideline. Girls and women hygiene and sanitation needs linked to their menstrual cycle. Absence of knowledge about safe practices leads women vulnerable in terms of health.

2: Know what, why and how

  • Menstruation is important to understand and to know how the basic along with simple interventions with encouraging and helpful attitudes can make a sustainable difference to the lives of every adolescent girl and woman.
  • As per the rule of nature, adolescent girls and women go through menstruation period. Therefore everyone in the community and society needs to have the basic knowledge and understanding the phases of menstruation instead of making it as a cultural barrier.
  • For example, State level officials as they have the responsibility to formulate relevant state policies and strategies. Likewise, District education, health officers, health staff, community frontline workers, schools, communities ‘and various ministries need to have basic knowledge on menstruation because without their collaboration and cooperation programs like Menstruation Health Management programs couldn’t be accomplished and menstruation would be a barrier for women empowerment.

3. Providing adolescent girls with menstrual hygiene management choices

  • In this part, it has discussed the choices for menstrual hygiene management and the ways to tackle menstruation periods without shame and embarrassment. The choices include use of locally reusable napkins, commercial reusable napkins, and commercial disposal napkins with their advantages along with disadvantages.

4. MHM infrastructure in schools and safe disposal of menstrual waste

  • This part focuses on the development of infrastructures with the provision of basic facilities which are as:
  • Separate toilets for girls and boys and if possible also for male and female teachers
  • Facilities for safe disposal of used menstrual absorbent.
  • Clean and safe water supply with the availability of soap for hand washing laundering menstrual absorbent.

Importance/Necessity of MHM:

  • Menstrual hygiene management provides an important step not only regarding a sanitation matter but also towards helping women and girls both physically and mentally.
  • Menstrual hygiene management helps to point out the problems experienced monthly by the women and girls whether it’s at home or at work.
  • MHM combat with health issues through awareness of menstrual hygiene, behavioral change, and cope-up mechanisms.
  • Menstrual hygiene management enables women to realize that hygiene matters and in lack of it, it’s highly associated with reproductive infections and invites more health issues.
  • Menstrual hygiene management acknowledges menstrual hygiene education, gives more focus on effective functioning water and safe private sanitation facilities along with access to sanitary materials.
    Measures for effective MHM
  • Building an atmosphere encouraging to discuss menstruation and hygiene practices.
  • Conducting scientific research on menstrual hygiene management to fill the gaps between knowledge and practices.
  • Promotion of hardware and software interventions where hardware interventions are designed to notify material deficiencies and software interventions are designed to notify knowledge of menstruation and management through provision of instructions.
  • Establishment of feminine health education core curriculum in all levels of school that helps to create a female-friendly environment.
  • Encouraging the use of sanitary pads through the collaboration among the local initiatives, the local government which promotes the use of affordable sanitary napkins by the women and girls

Harmful Effects of Poor MHM:

  • School absenteeism and disengagement
  • Psychosocial effects (shame, insecurity, embarrassment)
  • Unsafe with wild animals especially in under developed countries where during menstruation women are kept outside the house, near to the forests that tend to be the victims of wild animals.
  • Poor MHM means women and girls would not have the knowledge to different the pros and cons of cloth and sanitary napkins, which makes them vulnerable to various reproductive infections. Likewise, the ones having knowledge on the use of sanitary napkins might not know the correct way to use it.
    For example: How often to change sanitary napkins? Change at least once a day/ every six-eight hours.

References and For More Information:

http://www.unicef.in/Story/1177/The-National-Guidelines-on-Menstrual-Hygiene-Management-

https://mdws.gov.in/sites/default/files/Menstrual%20Hygiene%20Management%20-%20Guidelines_0.pdf

https://www.girlsglobe.org/2014/05/28/28-reasons-why-menstrual-hygiene-matters/

https://books.google.ca/books?id=pj_ourS3PBMC&pg=PA94#v=onepage&q&f=false

https://study.com/search/text/academy.html?q=menstrual+hygiene#/topresults/menstrual%20hygiene

https://menstrualhygieneday.org/about/why-menstruationmatters/

https://washdata.org/

https://washdata.org/sites/default/files/documents/reports/2017-06/JMP-2012-post2015-consultation.pdf

http://www.wash-united.org/our-work/issues/menstrual-hygiene-management

https://www.wvi.org/clean-water-sanitation-and-hygiene-wash/menstrual-hygiene

https://ehg.lshtm.ac.uk/menstural-hygiene/

Menstrual Hygiene Management Enables Women and Girls to Reach Their Full Potential. 2018.

The National Guidelines on Menstrual Hygiene Management.

About Kusum Wagle 214 Articles
Hello and greetings everyone! I am Kusum Wagle, MPH, WHO-TDR Scholar, BRAC James P. Grant School of Public Health, Bangladesh. I have gained profound experiences in public health sector under different thematic areas of health, nutrition, sexual and reproductive health, maternal and newborn health, research etc., targeting diverse audience of different age groups. I have performed diverse roles ranging from lecturer in the public health department of colleges, nutrition coordinator, research coordinator and consultant, in different programs, projects and academic institutions of Nepal. I also hold immense experience in working closely and persistently with government organizations, non-government organizations, UN agencies, CSOs and other stakeholders at the national and sub-national level. I have successfully led and coordinated different projects involving multi-sector participation and engagement. Moreover, I am also regularly involved in the development of different national health related programs and its guidelines.