How Pathfinder supports menstrual hygiene management in Bangladesh’s fragile settings
In emergency and humanitarian settings, women and girls have specific needs that are often unmet. One of the most immediate—and least talked about—is support for menstrual hygiene management. Poor water quality, limited access to water and sanitary pads, and lack of privacy means a lack of resources for adequate menstrual hygiene. And in crises, damaged infrastructure and supply chains often cut off access to needed supplies for young women.
Iqra Rumi and sister Israt faced these challenges first-hand during a period of unprecedented flooding in Sylhet, Bangladesh. “When we were at the shelter,” says Iqra, “we were there for around four days. I was on my period and as there was no functional bathroom, I had to go through a lot of trouble. I was unable to use clean water to clean myself… Other women faced the same problem like I did. [They were not] able to buy sanitary pads and access clean water. Later, their brother or their fathers arranged [to get these supplies] with a lot of difficulty.”
Impacts of climate change on menstrual hygiene management
Climate change is exacerbating these challenges, and disproportionately affecting women and girls like Iqra and Israt. Climate change doesn’t just affect sexual and reproductive health and rights (SRHR) directly, through environmental exposures, but indirectly, exacerbating gender inequities, limiting water access, impacting supply chains, and shifting resources toward other needs—sometimes leaving girls like Iqra and her sister to simply manage as best they can.
During humanitarian response, menstrual hygiene management is often overlooked, in the face of more pressing needs. But with more than half of the displaced population consisting of women and girls, there is a growing urgency for the humanitarian community to better address this specific need, and increase awareness and resources dedicated to menstrual hygiene management.
Displaced adolescent girls and women face significant barriers to managing monthly menstruation in a safe, private, and dignified manner. Humanitarian crises exacerbate menstrual management challenges and insufficient access to sanitary supplies, latrines, and sanitary or disposal facilities challenge their safety and privacy. Social taboos that stifle discussions about menstruation, combined with limited comprehensive SRHR information, present additional barriers to managing menstruation safely, hygienically, and with dignity, particularly for pubescent girls who may experience their period for the first time while displaced.
To address the menstrual hygiene and other needs of girls like Iqra and Israt in flood-prone areas of Bangladesh, Pathfinder has worked on awareness raising campaigns for men and women through courtyard sessions, and adolescent boys and girls through school sessions. Pathfinder is also activating Union Disaster Management Committees and School Disaster Management Committees, as well as conducted a ‘rapid school assessment’ for schools that are used as shelters to identify needs and assess what support Pathfinder can provide during, and in advance of, floods.
Meeting menstrual hygiene management needs in refugee camps
In Cox’s Bazar, Bangladesh, Pathfinder has been working to improve menstrual hygiene management for Rohingya adolescent girls in refugee camps. Pathfinder’s pilot project aimed to do the following:
- Increase knowledge and use of menstrual products and services.
- Raise awareness about healthy menstrual health management behaviors and ensure menstruating Rohingya adolescent girls could manage their menstruation in a safe, hygienic, dignified, and sustainable manner.
- Test the feasibility of this menstrual hygiene management intervention model and share findings and lessons learned with other implementers to inform scale-up in additional camps in Cox’s Bazar and similar humanitarian contexts.
Pathfinder’s project reached 456 adolescent girls. By forming partnerships with key stakeholders— including the Camp in Charge of the Office of the Refugee Relief and Repatriation Commissioner1, the site management representative of the International Organization for Migration, and the Upazila Family Planning Office of Teknaf—the approach became feasible and sustainable, with potential for scale in more communities.
Through the project, Pathfinder developed new resources in the Rakhine language, including a facilitator’s handbook and information, education, and communication (IEC) leaflets for community health workers and peer leaders to raise awareness on key topics— menstrual hygiene management, early marriage and pregnancy, family planning, SRHR, and safe disposal of sanitary pads—with Rohingya adolescent girls.
Through the program, Pathfinder strengthened the capacity of community health workers, building upon Pathfinder’s existing work with partner RTMI, to connect adolescents and youth with SRHR information and services in the parts of Camp 22 where the project was implemented. And young volunteer peer leaders trained by Pathfinder facilitated awareness-raising sessions with adolescent girls to foster open communication that overcomes menstrual hygiene management taboos.
“I went door to door, reaching adolescent girls [to attend] the menstrual hygiene management sessions,” says peer leader and co-facilitator Nur Kayas. “After the first session, the adolescent girls were asking about next menstrual hygiene management sessions as they found these useful, felt comfortable, and wanted to know more about menstruation.”
Says Ranjuma, a 14-year-old participant in Pathfinder’s pilot project, “I felt shy and uneasy at first. But after some time, [the group facilitator] made the environment friendly to us … [and she gave] important information, like changing pad within six hours and how we can easily take any types of food. …Menstruation is not a disease. It’s normal and natural.”
The pilot project in Cox’s Bazar showed that during humanitarian crises and within fragile settings, numerous stakeholders have an important role to play in overcoming the challenges related to menstrual hygiene management. Public health systems need to ensure the availability of sanitary pads, consider alternative options, and facilitate disposal mechanisms during times of crises. When informed about the needs of adolescent girls, parents, teachers, and social and elected leaders can create a supportive environment for menstrual hygiene management.
Today, Pathfinder continues to apply learnings from its work in Bangladesh and integrate menstrual hygiene management into its global programs.
 8 The Office of the Refugee Relief and Repatriation Commissioner (RRRC) is a Bangladesh government agency, under the Ministry of Disaster Management and Relief, responsible for providing relief to Rohingya refugees in Bangladesh and plan their eventual repatriation to Myanmar. At the camp level, the RRRC office and an RRRC representative from the Camp in Charge (CIC), providing camp management and vetting partner implementers before they are approved to conduct activities.