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Published on: 19/08/2019

A menstrual hygiene management (MHM) session at Kitale Main Women’s prison.

A menstrual hygiene management (MHM) session at Kitale Main Women's prison. Most of the inmates have been convicted at a perimenopausal age, or at least, their sentence will run in to perimenopausal years.

Let us start by understanding the meaning of perimenopausal. The word describes the period shortly before menopause. According to the WHO, perimenopause ‘includes time immediately prior to menopause (when endocrinological, biological and clinical features of the menopause commence) and the first year after menopause’. Menopause is distinct from perimenopause, and begins one year from the final menstrual period and marks the permanent cessation of menstruation (WHO, 1981). For most women, the average menopause age is 51. Which translates to the average age for perimenopause to be around mid to late 40s. However, it is possible for perimenopause to start in the late 30s (early or premature menopause) and early 40s.

Water, Sanitation and Hygiene (WASH) sector actors and players have paid extensive attention to the menstrual hygiene management (MHM) needs of adolescent girls. Perhaps with the sole aim of improving class attendance rates through addressing menstrual health needs of these girls since it is the notorious cause of absenteeism among adolescent school-going girls. However, the MHM needs for perimenopausal women have been constantly ignored, especially at the intervention level of WASH programming that mainstreams MHM in project design and approach/execution.

As the global population ages, it is estimated that of the 1.2 billion women projected to be over the age of 50 and therefore likely to be passing or have passed through the perimenopause by 2030, 76% will be living in low-income countries (Hill, 1996). MHM for these perimenopausal women therefore warrants greater attention as their number increases.

A significant number of perimenopause women is found in prisons. Especially, when it is highly likely that sentences will spill into their perimenopause age. Since women’s prisons are connected to reliable sources of water, reusable MHM materials could be a sustainable option. Therefore; governments, partners and stakeholders within the WASH space ought to invest and get involved in evidence-based research that will inform key deliverables while addressing the needs of perimenopause female inmates

Apart from diet needs that include consumption of foods and drinks rich in iron to avert instances of anaemic conditions, women in these correctional government-owned facilities and institutions require resilient WASH systems that embrace learning for programme adaptiveness among other building blocks that facilitate implementation at scale. Implementation targeting to address both their menstrual hygiene software and hardware needs. Health and WASH professionals should be more aware of the menstruation issues perimenopausal women face and empower them with information that it is a normal part during this stage in life as well as hygiene education and promotion through good MHM practices. In terms of hardware, a 24-hour water supply would allow perimenopausal women to keep clean; wash MHM materials and clothes stained with menstrual blood during heavy periods. It is therefore needless to mention that research and technology too ought to offer solutions with regard to affordability of quality menstrual materials/products that are environmentally friendly. Are we are leaving no one behind? Only time will tell.


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