Kambala Christabel, Chinangwa Angela, Chipeta Effie, Torondel Belen, Morse Tracy
The Polytechnic, Environmental Health Department, University of Malawi, Private Bag 303, Chichiri, Blantyre 3, Malawi.
Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Chimutu Building, Private Bag 360, Chichiri, Blantyre 3, Malawi.
Reprod Health. 2020 Nov 23;17(1):185. doi: 10.1186/s12978-020-01045-z.
A key challenge for menstruating girls and women in low-resource countries is the inadequate and unreliable supply of menstrual products. Although development partners are implementing menstrual product interventions to address this challenge in Malawi, there is a paucity of information on the distribution of menstrual products and the acceptability of these interventions among users.
We conducted in-depth interviews with girls (n = 20) and women (n = 26) and 4 focus group discussions (FGDs) with women (n = 35) and 7 FGDs with girls (n = 60) to explore the acceptability of menstrual products interventions in 8 districts. Teachers (n = 12), community leaders (n = 6), community health workers (n = 8) and service providers (n = 9) were also interviewed to explore implementation issues and their views regarding the effect of menstrual products interventions on girls and women. Data were analyzed using content analysis.
Common menstrual products being promoted include locally made reusable pads, commercially made disposable pads and menstrual cups. Overall, adult women preferred reusable pads and young girls preferred disposable pads. Reported benefits of using any type of material distributed included enhanced cleanliness and reduced school absenteeism for girls. While community leaders and teachers applauded the use of disposable menstrual products they expressed concern that they are not affordable for an average Malawian and bemoaned the indiscriminate disposal of used disposable pads. Women and girls highlighted their lack of facilities to effectively wash and dry reusable pads. Service providers bemoaned poor coordination and the lack of national standards to regulate the quality of menstrual products distributed at national level. Improved inclusion of males and health workers could enhance the sustainability of programmes.
While the available menstrual products interventions are acceptable among participants, we note several challenges including affordability, poor disposal methods, lack of attention on sanitation facilities and the lack of standard protocols to regulate the quality of menstrual products. Recommendations to address these issues are reported.
在资源匮乏的国家，月经期间的女孩和妇女面临的一个关键挑战是月经用品供应不足且不可靠。尽管发展伙伴正在马拉维实施月经用品干预措施以应对这一挑战，但关于月经用品的分发情况以及这些干预措施在用户中的可接受性，相关信息却很匮乏。
我们对20名女孩和26名妇女进行了深入访谈，并与35名妇女进行了4次焦点小组讨论，与60名女孩进行了7次焦点小组讨论，以探讨8个地区月经用品干预措施的可接受性。我们还采访了12名教师、6名社区领袖、8名社区卫生工作者和9名服务提供者，以探讨实施问题以及他们对月经用品干预措施对女孩和妇女影响的看法。使用内容分析法对数据进行了分析。
目前推广的常见月经用品包括当地制作的可重复使用卫生巾、商业生产的一次性卫生巾和月经杯。总体而言，成年女性更喜欢可重复使用卫生巾，年轻女孩更喜欢一次性卫生巾。报告显示，使用分发的任何一种类型的用品都有好处，包括增强清洁度以及减少女孩的缺课情况。虽然社区领袖和教师对使用一次性月经用品表示赞赏，但他们担心普通马拉维人买不起，并且对用过的一次性卫生巾的随意丢弃表示不满。妇女和女孩强调，她们缺乏有效清洗和晾干可重复使用卫生巾的设施。服务提供者抱怨协调不力，且缺乏国家标准来规范在国家层面分发的月经用品的质量。提高男性和卫生工作者的参与度可以增强项目的可持续性。
虽然现有的月经用品干预措施在参与者中是可以接受的，但我们注意到了几个挑战，包括可负担性、处置方法不当、对卫生设施缺乏关注以及缺乏规范月经用品质量的标准方案。本文报告了应对这些问题的建议。
