Background: There is growing attention to addressing the menstrual hygiene management (MHM) needs of the over 21 million displaced adolescent girls and women globally. Current approaches to MHM-related humanitarian programming often prioritize the provision of menstrual materials and information. However, a critical component of an MHM response includes the construction and maintenance of water, sanitation and hygiene (WASH) facilities, including more female-friendly toilets. This enables spaces for menstruating girls and women to change, dispose, wash and dry menstrual materials; all of which are integral tasks required for MHM. A global assessment identied a number of innovations focused on designing and implementing menstruation-supportive WASH facilities in the refugee camps located in Cox’s Bazar (CXB), Bangladesh. These pilot efforts strove to include the use of more participatory methodologies in the process of developing the new MHM-supportive WASH approaches.
Methods: A qualitative assessment was conducted in the Rohingya refugee camps in CXB in September of 2019 to capture new approaches and practical insights on innovating for menstrual disposal, waste management and laundering. This included Key Informant Interviews with 19 humanitarian response staff from the WASH and Protection sectors of a range of non-governmental organizations and UN agencies; Focus Group Discussions with 47 Rohingya adolescent girls and women; and direct observations of 8 WASH facilities (toilets, bathing, and laundering spaces).
Results: Key ndings included one, the identication of new female-driven consultation methods aimed at improving female beneciary involvement and buy-in during the design and construction phases; two, the design of new multi-purpose WASH facilities to increase female beneciary usage; three, new menstrual waste disposal innovations being piloted in communal and institutional settings, with female users indicating at least initial acceptability; and four, novel strategies for engaging male beneciaries in the design of female WASH facilities, including promoting dialogue to generate buy-in regarding the importance of these facilities and debate about their placement.
Conclusions: Although the identied innovative participatory methodologies and design approaches are promising, the long term viability of the facilities, including plans to expand them, may be dependent on the continued engagement of girls and women, and the availability of resources.