Abstract

BackgroundAccess to washroom facilities and a place to dispose of menstrual waste are prerequisites for optimal menstrual hygiene management in schools. Like other low- and middle-income countries, Bangladeshi schools lack facilities for girls to change and dispose of their menstrual absorbents. We explored existing systems for disposing of menstrual absorbent wastes in urban and rural schools of Bangladesh and assessed the feasibility and acceptability of alternative disposal options.MethodsWe explored how girls dispose of their menstrual products, identified girls’ preferences and choices for a disposal system and piloted four disposal options in four different schools. We then implemented one preferred option in four additional schools. We explored girls’, teachers’, and janitors’ perspectives and evaluated the acceptability, feasibility, and potential for sustainability of the piloted disposal system.ResultsBarriers to optimal menstrual hygiene management included lack of functional toilets and private locations for changing menstrual products, and limited options for disposal. Girls, teachers, and janitors preferred and ranked the chute disposal system as their first choice, because it has large capacity (765 L), is relatively durable, requires less maintenance, and will take longer time to fill. During implementation of the chute disposal system in four schools, girls, teachers, and janitors reported positive changes in toilet cleanliness and menstrual products disposal resulting from the intervention.ConclusionsThe chute disposal system for menstrual products is a durable option that does not require frequent emptying or regular maintenance, and is accepted by schoolgirls and janitors alike, and can improve conditions for menstrual hygiene management in schools. However, regular supervision, motivation of girls to correctly dispose of their products, and a long-term maintenance and management plan for the system are necessary.

Highlights

  • Access to washroom facilities and a place to dispose of menstrual waste are prerequisites for optimal menstrual hygiene management in schools

  • Lack of menstrual hygiene management (MHM) facilities is a serious barrier to the academic success of schoolgirls in Bangladesh and other low- and middle-income countries (LMICs) [1]

  • The 2014 Bangladesh National Hygiene Survey [11] showed that 40% of schoolgirls missed school on an average of 2–3 days per month due to menstruation

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Summary

Introduction

Access to washroom facilities and a place to dispose of menstrual waste are prerequisites for optimal menstrual hygiene management in schools. Like other low- and middle-income countries, Bangladeshi schools lack facilities for girls to change and dispose of their menstrual absorbents. Lack of menstrual hygiene management (MHM) facilities is a serious barrier to the academic success of schoolgirls in Bangladesh and other low- and middle-income countries (LMICs) [1]. Inadequate MHM facilities in schools pose a major barrier to schoolgirls, making it difficult to maintain proper hygiene and privacy [1]. Lack of facilities for disposal, including water, sanitation and hygiene (WASH) infrastructure, make it difficult for schoolgirls to manage menstruation in schools [9, 10]. The survey found that 86% of girls did not change their menstrual absorbent products in school due to lack of privacy or disposal facilities [11]. Despite the substantial need for a disposal system for menstrual products in schools, there is no such standardized system

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