Do Menstrual Hygiene Management Interventions Improve Education and Psychosocial Outcomes for Women and Girls in Low and Middle Income Countries?
A Systematic Review
This review considers how effective menstruation management interventions are in improving women and girls’ education, work, and psychosocial wellbeing in low and middle income countries.
Do Menstrual Hygiene Management Interventions Improve Education and Psychosocial Outcomes for Women and Girls in Low and Middle Income Countries? A Systematic Review
Julie Hennegan, Paul Montgomery
Hennegan J, Montgomery P (2016) Do Menstrual Hygiene Management Interventions Improve Education and Psychosocial Outcomes for Women and Girls in Low and Middle Income Countries? A Systematic Review. PLoS ONE 11(2)
WASH in schools, education, LMIC, MHM interventions,
Type of Research
Systematic review, peer-reviewed, quantitative research, summary, Guidelines
There is insufficient evidence to establish the effectiveness of menstruation management interventions, although current results are promising. Eight trials have been conducted, but a high risk of bias was found and clinical heterogeneity precluded synthesis of most results. Whilst trials provided some indication of positive results, further research is needed to establish the role of menstruation hygiene management in education performance, employment and other psychosocial outcomes. This review provides a concise summary of present trials and highlights improvements for future work. Recommendations: Trials must compare the various intervention strategies proposed; including both hardware and software interventions and the interaction between them. To aid this process, interventions should be based on a clear theory of change which includes the various individual and contextual factors which contribute to women and girls MHM. Such theories should be tested, and mediators and moderators of effects identified, for example the distribution of reusable sanitary pads may not be effective in the absence of improvements to WASH. Absorbent sustainability, acceptability, comfort, and risk of reproductive tract infections must all be considered when selecting sanitary products appropriate for interventions. A reliable and consistent assessment of all aspects of MHM  in observational studies and trials may serve to draw attention to the various aspects of MHM contributing to outcomes.
Identified Research Gaps
- Further rigorous research establishing the role of MHM in school performance and at the workplace is needed.
- Many existing studies are highly biased.
- There is a shortage of literature addressing the impact of MHM on adult women
- Sparse data exists regarding optimal genital cleaning practices for women and girls during menstruation, or the contribution of menstrual absorbent types to genital infection, comfort or education or psychosocial outcomes.
- According to a 2016 systematic review, further research is needed to understand how MHM interventions affect women and girl’s lives.
- Many existing studies concerning menstrual management interventions are highly biased, according to a recent systematic review published in 2016.
- Larger, randomised trials are needed to determine the impact of MHM interventions.