Understanding the impacts of humanitarian Menstrual Health Management for women’s confidence and agency: A case study on the Thai/Burma border

Abstract

Menstrual Health Management (MHM) is a growing focus within global humanitarian and development work. MHM aims to increase women and girls’ ability to care for their menstruating bodies through period products, hygiene facilities and education. It also seeks to challenge wider barriers that women face during menstruation – stigma, shame and ‘period poverty’ (the lack of access to menstrual products). NGOs promote ‘menstrual activism’ campaigns to ‘Reduce the stigma’ and ‘Help women and girls. Period.’ They tell stories of girls who, with their menstrual products, can now attend school during their period.

Academic studies into the complexities of such programmes are sparse, however; particularly studies which privilege the experiences of the women involved and affected. Research on menstruation within the humanitarian field is also limited. This is despite the fact that women living in refugee camps and precarious spaces can have heightened difficulties due to scarcity of menstrual resources, disruption of support networks and facilities with inadequate privacy. Contextually and culturally embedded research that recognises the contributions and perspectives of these women can strengthen humanitarian MHM programmes and scholarship so that menstruating women can feel confidence and agency rather than stigma and shame.

In light of these gaps, this study investigates Partners Relief & Development’s (Partners) ‘Days for Girls’ menstrual health programme in Thailand. The programme employs migrant women from Burma to make reusable menstrual hygiene kits and donates these kits to women in conflict-affected areas. The research worked within a feminist epistemology and mixed-methods methodology informed by principles of Appreciative Inquiry, to explore what is working well and what could be improved in Partners’ menstrual health programme. It involved refugees and migrants from Myanmar living over the border in Thailand, as well as the programme’s staff.

Through thematic analysis, I found that the Days for Girls programme improves women’s agency (through increased community participation) and confidence (through menstrual literacy and menstrual provision). For the women who sew the Days for Girls kits, confidence and agency are also gained through income and skills-education. The strengths and challenges of Partners’ programme reveal the importance of menstrual literacy education, the use of women’s knowledge in NGO work with women, and a whole-of-community response to menstruation needs. The research also informs wider understandings of how MHM discourse and development practice affects menstrual stigma.