How do women and girls experience menstrual health interventions in low- and middle-income countries? Insights from a systematic review and qualitative metasynthesis

Abstract

Increasing recognition of the difficulties women and adolescent girls face during menstruation has the prompted rapid implementation of menstrual health programmes and policies. Yet, there remains limited understanding of the influence of these interventions on individuals' menstrual experiences. We systematically reviewed and synthesised qualitative studies of participant experiences of menstrual health interventions. Included studies were undertaken in 6 countries (India, Uganda, Kenya, Ethiopia, Zimbabwe, South Africa) and involved over 900 participants. Interventions focused on menstrual product or education provision. Only 6 of the 12 included studies were rated as high or medium trustworthiness. Exposure to new menstrual products led to changes in women's and girls' expectations of what a menstrual material should offer, with recipients highly valuing reduced fears of leakage and improved freedom of movement. After learning how to use new products or receiving educational materials, women and girls reported feeling more empowered and aware of the physiological process of menstruation, and in some cases wanted to share this knowledge with others in their communities. For each intervention, the process of introduction, trial and error, and acceptance of the new technologies or information was influenced by the sociocultural environment including parents, peers and teachers.

Keywords: Menstrual hygiene; menstrual health; qualitative metasynthesis; systematic review; women and girls.