Everyone everywhere should have access to safe, timely and quality health education, services and information, so that they can make their own decisions about their health. It is a human right. Yet the right to health is threatened for millions globally by conflict, the climate crisis, disasters, disease, resource constraints, and cultural beliefs and attitudes.
Menstruation has long been neglected in research and policy and much of the work that has taken place has centred around access to physical infrastructure such as toilets and the provision of materials such as period pads. Menstrual pain is extremely common, yet little has been done to advance our understanding of it and pain management is often absent from menstrual health interventions. In addition, the impacts of menstrual stigma and taboos on physical, psychosocial and mental health are under researched, despite cultural norms and beliefs significantly restricting what menstruators can do.
Nepal, for example, is characterised by particularly severe menstrual taboos that limit adolescent girls’ freedoms. These taboos are perpetuated by religious beliefs about the impurity of menstrual blood and mean many girls must stay away from their homes in a chhau goth, or shed, for the duration of their menstrual period – a practice known as chhaupadi. During this time, they face multiple threats to their health including the physical threat of human and animal attack, and feelings that may negatively impact mental health such as fear, anxiety and loneliness. Girls may not have access to pain relief or social support and may also face limits on water access and the foods that they can consume while menstruating.
World Health Day serves as an important reminder that the fundamental right to health includes factors that can enable us to live a healthy life, such as adequate sanitation, nutrition and housing, and is closely related to other human rights including the right to participation and the right to freedom from discrimination. Menstrual restrictions such as chhaupadi negatively impact adolescent girls’ menstrual experiences and threaten these rights. They act as a barrier to gender equality and the achievement of the Sustainable Development Goals (SDGs) and therefore warrant investment in research to better understand their impacts.
The MeJARa project is contributing towards addressing this knowledge gap and creating lasting solutions in partnership with adolescent girls, their families and wider communities. One component involves the development of a framework of menstrual justice that addresses the various disadvantages faced by menstruators. This includes acknowledging how health disadvantages differ across contexts and prioritising the perspectives and needs of adolescent girls in low- and middle-income countries (LMICs).
By focusing on the lived experiences of girls in Nepal and Guatemala, we hope to further our understanding of menstrual health knowledge gaps; approaches to pain management; access to and availability of menstrual products; and the impacts of menstrual taboos and stigma. We will also explore risks to security and personal safety associated with menstruation which may impact health. The development and validation of tools to measure menstrual justice consistently across different contexts will help prioritise menstruation in achieving global goals such as the SDGs. Through this, we hope to transform the menstrual experiences of adolescent girls, including those in Nepal, supporting them to lead healthier and more fulfilling lives.
Written by:
Josephine Mcallister