Department of Public Health, Central Institute of Science and Technology (CIST) College, Pokhara University, Kathmandu, Nepal.
Agrata Health and Education (AHEAD)-Nepal, Kathmandu, Nepal.
PLoS One. 2018 Dec 10;13(12):e0208260. doi: 10.1371/journal.pone.0208260. eCollection 2018.
Menstrual exile, also known as Chhaupadi, is a tradition of "untouchability" in far-western Nepal. Forbidden from touching other people and objects, women and girls are required to live away from the community, typically in a livestock shed, during menstruation. We assessed the lived experiences of Chhaupadi among Nepalese adolescent girls in the far-western Achham district of Nepal, observed the safety and sanitation of their living spaces during Chhaupadi, and assessed the perceptions of local adult stakeholders towards the practice of Chhaupadi.
We collected data from 107 adolescent girls using a self-administered survey in two local schools in Achham. We also conducted a focus group discussion with seven girls, held key informant interviews, and observed the girls' living spaces during Chhaupadi, using a checklist. Descriptive statistics of the quantitative survey and thematic analyses of qualitative interviews are presented.
The majority of the girls (n = 77, 72%) practiced exile, or Chhaupadi, during their menstruation, including 3 (4%) exiled to traditional Chhau sheds, 63 (82%) to livestock sheds, and 11 (14%) to courtyards outside their home. The remaining girls (n = 30, 28%) stayed inside the house, yet practiced some form of menstrual taboos. Of the 77 observed living spaces where the girls stayed during exile, only 30% (n = 23) had a toilet facility. Most exiled girls (97.4%) were restricted from eating dairy products. Participants reported having various psychological problems, including lonliness and difficulty sleeping while practicing Chhaupadi. Three of the girls were physically abused; nine were bitten by a snake. Notably high proportions of the living spaces lacked ventilation/windows (n = 20, 26%), electricity (n = 29, 38%), toilets (n = 54, 70%) and a warm blanket and mattress for sleeping (n = 29, 38%). Our qualitative findings supported our quantitative results.
Chhaupadi has been condemned by human rights organizations. While the government has banned the practice, implementation on the ban is proceeding slowly, especially in far-western Nepal. Thus, as a temporary measure, public health professionals must work towards promoting the health and safety of Nepalese women and girls still practicing Chhaupadi.
经期禁忌，也被称为 Chhaupadi，是尼泊尔远西部的一种“贱民”传统。在经期，女性和女孩被禁止触摸他人和物品，她们被要求离开社区居住，通常是在牲畜棚里。我们评估了尼泊尔远西部阿恰姆地区的青春期女孩对经期禁忌的生活体验，观察了她们在经期禁忌期间居住空间的安全性和卫生状况，并评估了当地成年利益攸关方对经期禁忌做法的看法。
我们在阿恰姆的两所当地学校使用自我管理的问卷调查了 107 名青春期女孩。我们还与 7 名女孩进行了焦点小组讨论，进行了关键知情人访谈，并使用检查表观察了女孩在经期禁忌期间的居住空间。对定量调查的描述性统计和定性访谈的主题分析进行了介绍。
大多数女孩（n=77，72%）在经期时实行了流亡或经期禁忌，包括 3 名（4%）流亡到传统的 Chhau 棚，63 名（82%）到牲畜棚，11 名（14%）到自家院子外面。其余的女孩（n=30，28%）呆在屋子里，但实行了某种形式的经期禁忌。在观察到的 77 个女孩流亡期间居住的空间中，只有 30%（n=23）有厕所设施。大多数流亡女孩（97.4%）被限制食用奶制品。参与者报告说有各种心理问题，包括孤独和在实行经期禁忌时难以入睡。有 3 名女孩遭受了身体虐待；9 名女孩被蛇咬伤。值得注意的是，很大比例的居住空间缺乏通风/窗户（n=20，26%）、电力（n=29，38%）、厕所（n=54，70%）和温暖的毯子和床垫供睡眠（n=29，38%）。我们的定性研究结果支持了我们的定量研究结果。
经期禁忌已被人权组织谴责。虽然政府已经禁止这种做法，但禁令的执行进展缓慢，特别是在尼泊尔远西部。因此，作为一种临时措施，公共卫生专业人员必须努力促进尼泊尔仍然实行经期禁忌的妇女和女孩的健康和安全。
