MeJARa is an ambitious and innovative undertaking that seeks to improve the menstrual experiences of women and girls in Nepal and Guatemala. With the support of UK Research and Innovation, this project is spearheaded by Dr. Melanie Channon, Reader in Social Policy at the University of Bath, in collaboration with Dr. Mahesh Puri of CREHPA Nepal and Dr. Carmen Alvarado Benitez of 32 Volcanes, Guatemala. Over the next five years, MeJARa will work toward developing a framework and theory of menstrual justice, ultimately resulting in the development and evaluation of an intervention to address issues of menstrual justice in both case study countries.

Current State of Menstrual Policies

Menstrual policies and laws are still in their infancy, with many countries barely mentioning the issue in health, education, or gender policies. International policies and discourse often overlook the subject, as evidenced by the World Health Organization’s exclusion of menstruation from its list of sexual and reproductive health topics. MeJARa will begin by critically reviewing existing menstrual policies and laws to identify gaps and potential areas for improvement.

Understanding Menstrual Experiences and Needs

MeJARa will employ a multi-modal case study design to explore the lived experiences of adolescent girls within their school, work, home, and community contexts. This research will involve multiple phases, starting with qualitative data collection, followed by a quantitative phase of longitudinal data collection. This approach will allow for a comprehensive understanding of the causes and consequences of various menstrual practices, policies, and taboos in Nepal and Guatemala.

Developing the Theory of Menstrual Justice

The project aims to develop a universal, multidimensional framework of menstrual justice that fully incorporates the perspectives and priorities of low- and middle-income countries (LMICs). This framework will build upon existing definitions of menstrual injustice, expanding upon the interrelated categories proposed by Margaret E. Johnson, and adding additional dimensions such as environmental injustices, risks to security and personal safety, and state power and the law.

MeJARa will develop and validate appropriate quantitative survey instruments to measure the dimensions of menstrual justice across time and space. These instruments will be essential for monitoring progress and shaping priorities in the field of menstrual health and justice.

Community-based Interventions

The project will identify and assess the feasibility of innovative interventions to address menstrual pain and injustice among adolescent girls in complex contexts. By moving beyond school-based interventions and incorporating the perspectives of families, religious leaders, and traditional healers, MeJARa will develop a more comprehensive approach to addressing the root causes of menstrual stigma and injustice.

One of the critical aspects of MeJARa is its focus on menstrual pain, which has been largely overlooked in previous interventions. By exploring the experiences and needs of adolescent girls in Nepal and Guatemala, the project will develop innovative strategies to address menstrual pain and the associated disability.

Environmental Considerations

MeJARa will also address the environmental aspects of menstrual health, ensuring that interventions take into account the need for sustainable practices while balancing informed choice and rights.

Stratified Cluster Randomized Controlled Trial

To assess the acceptability, feasibility, and effectiveness of the developed intervention, MeJARa will employ a stratified cluster randomized controlled trial approach. This rigorous evaluation will provide valuable insights into the potential impact of the intervention on menstrual justice in Nepal and Guatemala.

Study Duration and Area

MeJARa is a five-year study, running from November 2022 to October 2027. In Nepal the proposed study area includes the Karnali and Gandaki provinces.

Written by:

Josephine Mcallister