April 30, 2013 | The Editors

How to manage menstruation

For women the world over, it’s a monthly fact of life as common as a quarter moon. And yet for many, it’s incredibly difficult to discuss.

“Because menstruation is a taboo subject in most cultures, women’s menstrual management needs are often overlooked by health programs and policies,” explains Nancy Muller, who works with our Technology Solutions Global Program. “We simply don’t have enough information on how women and girls in developing countries manage their menstruation to know how to accommodate their needs.”

Cameras break the silence

Muller and her team have been working with women in three South African communities to remedy that situation. They’re gathering information that could help women manage their menstrual periods more effectively while also improving the sanitation systems they use. To encourage the women to open up about a deeply personal subject, the team used the Photovoice research method, giving women disposable cameras and asking them to photograph how they manage their periods.

After using their cameras, the women spoke with the researchers about the images they captured—and about how they manage menstruation. You can see a selection of their photographs, accompanied by some of their comments, below.

Click to enlarge images.

A private matter in a public place

Menstruation must come out from behind closed doors in part due to urban women’s increased access to disposable sanitary pads. While convenient and comfortable, the pads can contribute to waste management problems and cause blockages in sanitation systems. But in order to design systems that meet women’s needs better, it’s important to know how women are using the systems and menstrual hygiene supplies they’ve got now.

The research team aimed to answer two related questions: Do sanitation systems influence women’s hygiene practices and the products they use? And how do the menstruation hygiene management products women choose impact sanitation systems?

VIPs and CABs

Each of the three communities participating in the Photovoice project managed sanitation in different ways. Some had access to ventilated, improved pit toilets, called “VIPs,” located near their homes. The Durban municipality provided community ablution blocks—CABs, for short—communal bathrooms with flush toilets and showers, but often a 5-to-10-minute walk from home. The CABs were locked in the evening and women didn’t feel safe going there, so some built simple pit latrines adjacent to their homes. In a third community, participants used flush toilets within their own homes.

The participants’ recommendations for changes in sanitation systems ranged from complex to relatively simple. For example, everyone who didn’t have a flush toilet in their home wanted one—a relatively complex solution and one the global community is moving away from. And all asked for disposal bins dedicated specifically for menstrual waste located near toilets—simpler to accomplish.

Now, the PATH team is analyzing the women’s photographs and comments, searching for information that can help design sanitation systems that fit the lives of women.

“I would like to see more attention paid to girls’ and women’s menstrual hygiene needs,” says Muller, “including education, appropriate and affordable menstrual hygiene products, and sanitation systems designed with women in mind—their needs for dignity, safety, privacy, water, and a place to dispose of menstrual hygiene waste.”

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