Abstract:
Menstruation is a normal and healthy biological process, but one that is seen as taboo in many cultures. Menstruation matters – not just to those who experience pain, stigma, lack of menstrual knowledge, resources, and dignity but for society as it can also affect health, education, and gender equality. In the international development sector, work on menstruation has coalesced around the concept of Menstrual Hygiene Management (MHM), which grew largely from initiatives around girls’ education and the Water, Sanitation and Hygiene (WASH) sector.
While the concept of MHM is of critical importance to menstrual experiences and has helped to bring together a range of local and international bodies to work together on menstruation, it excludes multiple issues affecting the health and wellbeing of women, girls and others who menstruate. It is clear that a more expansive framework is vital in order to help scholars and practitioners move beyond MHM towards a more extensive and holistic approach to menstruation. Menstrual experiences are multidimensional and the use of MHM as a focal point for menstrual interventions and research has meant that dimensions other than hygiene (such as pain management, safety and security, and stigma and taboo) have been neglected.
Within this presentation I will discuss how menstrual justice applies to the case study of Nepal. Menstrual research here has focussed on Chhaupadi, a traditional practice in western parts of Nepal, which is associated with poor reproductive and mental health. It is a form of menstrual restriction which involves sleeping in a hut, animal shed or even outside during the menstrual period. Following multiple chhaupadi related deaths, enforcing this practice was criminalized in August 2018 and is punishable by a fine or imprisonment.
Research was conducted in Karnali Province in April 2019. Quantitative survey data was collected from 400 adolescent girls aged 14-19 and focus group discussions were conducted with both adolescent girls and adult women.
We found that 77% of girls who had started menstruating reported practicing chhaupadi. Women and girls said that this practice impacted their mental health, inducing fear, stress and anxiety. 60% of survey respondents knew that chhaupadi was illegal. Girls who knew about the law were just as likely to practice chhaupadi as those who did not know it was illegal. Chhaupadi was not associated with significantly increased risk of missing school or work; instead, the most common reasons given were pain and heavy bleeding. However, chhaupadi was associated with increased levels of depression, even when controlling for other factors.
I argue that criminalizing chhaupadi has been ineffective and even counter-productive; alternative policy solutions should be sought to address menstrual injustices, such as this, that negatively impact physical and mental health. Other areas of menstrual health also need to be prioritised, especially menstrual pain, as this was the leading cause of girls missing school and work during their periods.
I will also talk about our ongoing research, including developing and testing a menstrual justice intervention in two districts of Nepal using a cluster randomised controlled trial.
Bio:
Mel is a Reader in Social Policy at the University of Bath. By training she is a demographer and social statistician.
Mel has over 15 years of experience researching demographic and global health topics in low and middle income countries. Her research focuses on menstruation, sexual and reproductive health and rights, son preference, gender statistics, and fertility preferences. Much of her research is focussed on Nepal, but she also has experience working across South Asia, sub-Saharan Africa, and Latin America. She is currently leading a 5-year UKRI funded project looking at menstrual justice in Nepal and Guatemala. She is also Honorary Secretary of the British Society of Population Studies.
