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Improving Menstrual Hygiene Management in Emergency Contexts: Literature Review of Current Perspectives

Management  of  menstruation  in  contexts  of  humanitarian  emergencies  can  be  challenging.  A  lack  of  empirical  research  about  effective  interventions  which  improve  menstrual  hygiene  management  (MHM)  among  female  populations  in  humanitarian  emergencies  and  a  lack  of  clarity  about  which  sectors  within  a  humanitarian  response  should  deliver  MHM  interventions  can  both  be  attributable  to  the  lack  of  clear  guidance  on  design  and  delivery  of  culturally  appropriate  MHM  intervention  in  settings  of  humanitarian  emergencies.  The  objective  of  this  review  was  to  collate,  summarize,  and  appraise  existing  peer-reviewed  and  gray  literature  that  describes  the  current  scenario  of  MHM  in  emergency  contexts  in  order  to  describe  the  breadth  and  depth  of  current  policies,  guidelines,  empirical  research,  and  humanitarian  aid  activities  addressing  populations’  menstrual  needs.  A  structured-search  strategy  was  conducted  for  peer-reviewed  and  gray  literature  to  identify  studies,  published  reports,  guidelines,  and  policy  papers  related  to  menstrual  response  in  emergency  humanitarian  contexts.  Of  the  51  articles  included  in  the  review,  16  were  peer-reviewed  papers  and  35  were  gray  literature.  Most  of  the  literature  agreed  that  hardware  interventions  should  focus  on  the  supply  of  adequate  material  (not  only  absorbent  material  but  also  other  supportive  material)  and  adequate  sanitation  facilities,  with  access  to  water  and  private  space  for  washing,  changing,  drying,  and  disposing  menstrual  materials.  Software  interventions  should  focus  on  education  in  the  usage  of  materials  to  manage  menstruation  hygienically  and  education  about  the  female  body’s  biological  processes.  There  was  clear  agreement  that  the  needs  of  the  target  population  should  be  assessed  before  designing  any  intervention.  Although  there  is  insight  about  which  factors  should  be  included  in  an  effective  menstrual  hygiene  intervention,  there  is  insufficient  empirical  evidence  to  establish  which  interventions  are  most  effective  in  humanitarian  emergencies  and  which  sectors  should  be  responsible  for  the  coordination  and  implementation  of  such.  Increased  monitoring  and  evaluation  studies  of  interventions  should  be  completed  and  publicly  shared,  in  order  to  feed  evidence-based  guidelines  in  the  humanitarian  sector.

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