Abstract

Displaced adolescent girls and women face many challenges managing their monthly menstrual flow with dignity and comfort in various challenging settings around the world, such as refugee camps, informal settlements, and while in transit across geographies as they flee disaster or conflict. Menstrual hygiene management requires easy access to safe, private water and sanitation facilities, along with appropriate menstrual materials and supplies, discreet disposal and waste management, and basic information on menstrual hygiene for displacement contexts. Yet, a significant gap exists in terms of available guidance on effective, coordinated multi-sectoral approaches for a complete menstrual hygiene management response. This paper describes one effort to address this gap, the development and pilot testing of the Menstrual Hygiene Management in Emergencies Toolkit in three camps hosting Burundian and Congolese refugees in Northwest Tanzania. Multiple methods were used to evaluate the implementation of the toolkit, which included a process and endline evaluation. Key findings included the identification of content gaps in the draft toolkit, the mapping out of a training and capacity building approaches needed for integrating menstrual hygiene management into ongoing programming, the relevancy and appropriateness of the guidance prescribed, and the potential for novel approaches to be identified by both water, sanitation and hygiene (WASH) and non-WASH sector actors subsequent to sufficient training. Important lessons from this exercise may be useful for the introduction of MHM programming into future global humanitarian response efforts.

Highlights

  • Displaced adolescent girls and women face significant barriers to managing monthly menstruation in a safe, private, and dignified manner

  • When the pilot began in October 2016, there were 66,370 Congolese refugees currently residing in the Nyaragusu camp, many having lived in Tanzanian camps for 20 years (UNHCR 2016)

  • The staff continuously conducted higher-level advocacy with the United Nations High Commissioner for Refugees (UNHCR), coordination and interagency, WASH, shelter, Camp Coordination and Camp Management (CCCM), non-food items (NFIs), and education working group meetings. This was concluded to be valuable in terms of positioning good menstrual hygiene management (MHM) practice on the agenda during the period when standard operating procedures for various sectors were being drafted for improved response in the camps

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Summary

Introduction

Displaced adolescent girls and women face significant barriers to managing monthly menstruation in a safe, private, and dignified manner. The International Rescue Committee (IRC) and Columbia University’s Mailman School of Public Health (CU MSPH) created a new research and practice partnership in 2015 to focus on three objectives for MHM in humanitarian response: (1) describing the evidence base, (2) developing effective cross-sectoral guidance for programming to improve MHM outcomes for girls and women, and (3) developing evidence-based monitoring measures. This effort culminated in the development of the Menstrual Hygiene Management in Emergencies Toolkit, a cross-sectoral resource (Sommer et al 2017).

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