Thapa Subash, Bhattarai Shivani, Aro Arja R
Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal.
SAGE Open Med. 2019 May 13;7:2050312119850400. doi: 10.1177/2050312119850400. eCollection 2019.
Unhealthy menstrual practices and the contexts surrounding them should be explored and clearly understood; this information could be useful while developing and implementing interventions to increase hygienic practices during menstruation and consequently increase health and well-being of women. Therefore, this study was conducted to explore traditional menstrual practices and the contextual factors surrounding the practices in the rural communities of far-western Nepal.
This was a qualitative case study conducted in the Achham district of Nepal. Semi-structured interviews were conducted among four women, three men and two female community health volunteers to collect data and thematic analysis was performed to analyze the data.
We found two commonly reported menstrual practices: seclusion practice (Chhaupadi) and separation practice. In the Chhaupadi practice, women are secluded to stay in a small shed away from the house and restricted to wash or take a bath in public water sources for 5-7 days of the periods, whereas in the separation practice, women can stay in the house, but they still have several restrictions. The contextual factors that were reported to influence the cultural practices are as follows: cultural beliefs that symbolize menstruation as impure, menstrual stigma, poverty, illiteracy, the influence of traditional healers and family members, and limited effect of Chhaupadi elimination interventions. We also found that some development in the reduction of cultural myths and practices is happening, but the rate of change is rather slow.
Most of the Nepalese women, especially in the rural areas of far-western Nepal, are forced to follow the harmful menstrual practices because of the socio-cultural context surrounding their lives. We believe the findings of this study would be relevant in terms of developing and implementing further menstrual health-related, community-based interventions that will be responsive to the local cultural context, beliefs, and practices.
应探索并清晰理解不健康的经期习俗及其周边环境；这些信息在制定和实施干预措施以增加经期卫生习惯从而提升女性健康和福祉时可能会有所帮助。因此，本研究旨在探索尼泊尔远西部农村社区的传统经期习俗及其相关背景因素。
这是一项在尼泊尔阿查姆地区开展的定性案例研究。对四名女性、三名男性和两名女性社区卫生志愿者进行了半结构化访谈以收集数据，并进行了主题分析来分析数据。
我们发现了两种常见的经期习俗：隔离习俗（Chhaupadi）和分居习俗。在Chhaupadi习俗中，女性被隔离在远离房屋的小棚子里，在经期的5至7天内被限制在公共水源处洗漱或洗澡，而在分居习俗中，女性可以待在屋内，但仍有一些限制。据报告，影响这些文化习俗的背景因素如下：将月经视为不纯洁的文化信仰、月经污名、贫困、文盲、传统治疗师和家庭成员的影响，以及消除Chhaupadi习俗干预措施的效果有限。我们还发现，在减少文化神话和习俗方面正在发生一些变化，但变化速度相当缓慢。
大多数尼泊尔女性，尤其是尼泊尔远西部农村地区的女性，由于其生活的社会文化背景，被迫遵循有害的经期习俗。我们相信，本研究的结果对于制定和实施进一步的、与经期健康相关的、基于社区且能响应当地文化背景、信仰和习俗的干预措施具有参考价值。
