Constraints and current practices of menstrual hygiene among Rohingya adolescent girls

Background: Although half of Rohingya refugees are women and adolescent girls, the sexual and reproductive health issues of these vulnerable groups are still unexplored. The aim of this study was to review and describe menstrual hygiene management (MHM) along with the existing challenges of MHM among Rohingya adolescent girls. Methods: This concurrent mixed methods study was conducted among adolescents aged 13-18 years living in Kutupalong refugee camps in Ukhiya, Cox's Bazar, Bangladesh. Camp-based surveys along with focus group discussions were performed for data collection. The findings of a total of 12 FGDs and 101 survey responses were included for data analysis. Descriptive statistics were used for quantitative data analysis, and thematic analysis was considered for the qualitative data. Observation and results: Approximately one-fourth of the adolescent girls (28.71%) had premenstrual knowledge. Only 8% had "Good" knowledge, and 12% had a basic understanding. Half of the women used cloths during menstruation, while others (20.79%) used homemade clean pads, disposable sanitary pads (17.82%), and used only underwear without absorbance (10.89%). The frequency of changing sanitary pads varied, but the majority of respondents (48.51%) changed padding at least once daily. Common disposal places were inside the toilet (30.69%), open spaces (17.82%), dustbins (6.93%) and water sources (3.96%). An inadequate and irregular supply of sanitary napkins or absorbents leads to poor MH practices. Limited cleaning and disposal facilities, lack of privacy in camps or informal settlements, confined and crowded places and nonsupportive environments in the camp were also factors affecting the use of pads and disposal. Family and cultural beliefs, stigma, restrictions, and fear of sexual violence were also noted within typical day-to-day activities during menstruation. Conclusions: The provision of adolescent-friendly wash facilities, appropriate information and adequate menstrual supplies is needed to improve the MH response in an emergency context. Despite some limitations, this study could lead to future changes relative to MH for women and adolescents in Rohingya.