Menstrual hygiene management improvement in selected communities using nurturing care group approach

Improved menstrual hygiene management (MHM) is key to socioeconomic empowerment of women through improved well-being. Safe MHM is challenging in developing countries especially in rural and low-income settings. The study assessed the influence of World Visions piloted project of Nurturing Care Group approach on MHM in rural communities of Ghana. Four (4) communities each from Savelugu Municipal and Sekyere East District Assemblies were selected for a cross-sectional qualitative survey using 16 focus group discussions. Data was analysed using inductive mixed method with content analysis. Findings from 162 study participants showed satisfactory MHM awareness and practices among young and old females; MHM awareness and education sources included relatives, friends, NGOs, public and social institutions (e.g., health centres, churches, schools etc); intervention improved MHM understanding, behaviour and personal hygiene practices. Some MHM challenges that persisted included non-availability and prohibitive high cost of MHM materials, burden of managing menstrual pains, inadequate knowledge in handling menstrual intricacies, menstrual taboos, and stigma. Menstrual stigma was comparatively low among intervention communities than controls, but there was no difference regarding menstrual taboos across all communities largely due to religious and superstitious beliefs. Championing local production and use of reusable menstrual pads from fabrics was considered an innovation to ease sanitary pad cost burden and non-availability of menstrual pads. MHM was positively influenced through improved understanding of personal hygiene practices, and reduced stigmatization among others. Subsequent interventions would require adequate scope and resources to work with stakeholders to facilitate change processes with persistent MHM challenge like taboos.