Menstrual hygiene management considerations during Ebola response: a qualitative exploration

Abstract

AbstractThere is increased recognition within humanitarian response practice about the importance of addressing the menstruation-related needs of women and girls in emergencies. To date, however, menstruation has been minimally considered during Ebola virus disease (EVD) response efforts. Reasons for integrating menstrual hygiene management (MHM) into EVD response include suspicions and alarm arising from associating menstrual blood as a symptom of EVD and the need to assure that menstruating patients have menstrual products materials and supplies. The aim of this qualitative study was to understand how menstruation is, or should be, addressed most appropriately during EVD outbreak response. Data collection was conducted from June to August 2020 and included a global document review and semi-structured key informant interviews with cross-sectoral humanitarian and EVD experts (n = 21). Data were analyzed using thematic analysis. Four themes were prominent across the data: (1) limited guidance for addressing menstruation in EVD outbreak response, (2) Inconsistent access to female-friendly toilets, (3) unmet need for menstrual materials, and (4) overlooked menstrual challenges of EVD response staff. Key gaps in current EVD response include an insufficiency of clear guidelines and standards, limited best practices for ensuring consistent access to female-friendly toilets and menstrual materials, and insufficient attention to the menstrual needs of EVD response staff. While there have been efforts to address the menstruation-related needs of patients, communities, and response staff within some EVD outbreak zones, the full range of MHM considerations has infrequently been incorporated. Important lessons from this exercise may be useful for the mainstreaming of menstruation into EVD response during future response efforts.