This review examines menstrual hygiene management (MHM) waste disposal practices in low- and middle-income countries (LMICs), highlighting systemic neglect in sanitation systems. Despite growing use of disposable sanitary pads (linked to urbanization and affordability), improper disposal methods such as burning, burying, or flushing persist due to cultural taboos, inadequate facilities, and policy gaps. Menstrual waste (e.g., non-biodegradable pads) clogs sewer systems, burdens sanitation workers, and poses environmental/health risks. Incineration, while common, often lacks safety standards, risking toxic emissions. The review underscores the need for integrated solutions: user-centered infrastructure (e.g., bins, incinerators), policy reforms, and multi-sector collaboration to align MHM with Sustainable Development Goals (SDGs 3, 6, 12).
Author(s): Elledge, Myles F.; Muralidharan, Arundati; Parker, Alison; T. Ravndal, Kristin; Siddiqui, Mariam; Toolaram, Anju P.; Woodward, Katherine P.
Published: 2018
Language: English
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Additional Information
Menstrual hygiene management (MHM) has gained some attention and several literature reviews have been published. However, both original papers and reviews tend to focus on absorbent access and use and not on the disposal of menstrual waste. This review aims to fill a gap in the water, sanitation and hygiene (WASH) sector by bringing a focus specifically on menstrual hygiene safe disposal in low- and middle-income countries (LMIC). We reviewed published literature since 2002 on menstrual hygiene with a focus on menstrual waste management and menstrual absorbent disposal in LMIC. Database searches were conducted of both peer reviewed literature and grey literature, in addition to hand searching of references of relevant earlier literature reviews. In total 152 articles and reports were identified and 75 met the inclusion criteria and was included in the final review. Existing polices on MHM was also reviewed with a focus on India and South Africa. The review showed that disposal of menstrual waste is often neglected MHM and sanitation value chains, leading to improper disposal and negative impacts on users, the sanitation systems and the environment. Findings call for further research to gain better understandings of MHM waste streams, disposal behaviors, absorbent materials and waste management technologies to deliver health, safety, mobility and dignity for women and girls.