Why MHH and not just MHM? - Menstrual hygiene and health and not just menstrual hygiene management

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  • LizWamera
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Why MHH and not just MHM? - Menstrual hygiene and health and not just menstrual hygiene management

Dear All;

I would like to raise an issue as I know it may be a question that some of us are mulling over in our minds. This is in relation to why we have MHH (Menstrual hygiene and health) and not just MHM (menstrual hygiene management).

We at WSSCC and other stakeholders believe that MHH is a better term than Menstrual hygiene management (MHM) because MHH reaches out beyond the WASH sub sector and encompasses the broader partnership on MHM with other sub sectors such as the “Sexual Reproductive Health” sub sector.

We are open to hear what others think about this. This is an ongoing conversation whether "Hygiene Management" would cover all that is required or "Hygiene and Health" would provide a greater opportunity of various partnerships that are way beyond our traditional players. The SDGs calls for us to work beyond our sectors and cultivate partnerships that would yield sustainable results. We have to think outside the box and not work as we previously did, if we continue running business as usual, it will take us much longer to produce the desired outcome. We have to shift our mind set and expand our partnerships if we expect to cover more ground with the critical issue of menstruation.

Looking forward to your views and contributions on this matter and more.

Regards;
Liz
Elizabeth Wamera PhD
Technical Expert: Water Sanitation & Hygiene (WASH) Technical Support Unit
Water Supply & Sanitation Collaborative Council (WSSCC)
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  • lindasemana
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Re: Why MHH and not just MHM

It indeed goes beyond hygiene and covers psychosocial development, reproductive health, infrastructure, quality standard etc.

I had shared this model last week on the platform illustrating that.

It feels good to know that the ideal is here now.
Linda Lilian
Team Leader and Founder of Cause Effect Initiative Limited ( CEIL)
CIEL is located in Mpigi District

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  • inajurga
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Re: Why MHH and not just MHM

Hello everyone,
Ina here from WASH United - Menstrual Hygiene Day, In this post I share a bit of the discussion and our take on this. Because we have had the debate for a few years about the terminologies *

Summary: I am using MHH to acknowledge broader aspects beyond the personal management of menstruation.
We understand it in this way that good menstrual hygiene contributes to menstrual health. By using Menstrual Health & Hygiene we ensure that hygiene (such as personal hygiene, water & toilets) is not forgotten by health practitioners. To note, for the term menstrual health there is no agreed definition as of now.


There were two critiques on the terminology of MHM:
1) some believe that using the term menstrual hygiene suggests that menstruation is inherently dirty or unhygienic. Hygiene refers to conditions and practices that help maintain health and prevent the spread of disease and we see hygiene as positive, such as in dental hygiene and personal hygiene. It is the combination of a stigma topic of menstruation that seems negative.
2) It focus on the personal management, but does not encompass factors required to achieve behaviour and the enabling environment.

We have also seen organisations using menstrual health, to strategically position it closer to the Sexual & Reproductive Health & Rights sector - which I think is a fair move , as interventions needs to be seen across a woman& girl's life-cycle.

The confusion comes, because there is no agreed definition what menstrual health means.
  • Some organisations/ individuals use it interchangeably with menstrual hygiene
  • Some organisations/individuals use it as menstrual hygiene AND systemic factors
  • Some organisation/individuals understand only the physical (and eventually psychological) aspects of an individual’s menstruation, including pain, fertility, endometriosis, etc

We see there is a risk in using the term menstrual health only, as it could limit the scope to addressing only health related issues (see third bullet), and it would not necessarily encapsulate the systemic factors that keep women and girls from managing their menstruation such as access to water and adequate sanitation facilities, and affordable hygienic menstrual absorbents, which is particularly challenging for women and girls in developing countries. So by using Menstrual Health & Hygiene (MHH) it is clearer.

There is a committee drafting a definition for menstrual health, so there will hopefully be some clarity sooner or later. 


*I remember some time back that there was a similar term discussion around ecological sanitation, (=UDDT or more the approach), sustainable sanitation, environmental sanitation, ...)
International Coordinator Menstrual Hygiene Day
WASH United
www.wash-united.org
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  • Elisabeth
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Re: Why MHH and not just MHM

Thank you, Ina, for your very interesting post which gives the background to the recent name change.

Are you planning to also change the name of your day, which is currently "Menstrual hygiene day", or the description on your website?:
https://menstrualhygieneday.org/  

Is there anything we should change on the Wikipedia article on menstrual hygiene day?:
https://en.wikipedia.org/wiki/Menstrual_Hygiene_Day

With regards to "official" definitions, there is this publication by UNICEF from 2019:

UNICEF (2019). Guidance on Menstrual Health and Hygiene. UNICEF, New York, USA
https://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/3805

In that publication on page 8 the following definition is given - do we all agree with that?

Menstrual hygiene management (MHM) refers to management of hygiene associatedwith the menstrual process. WHO and UNICEF Joint Monitoring Programme (JMP) for drinking water, sanitation, and hygiene has used the following definition of MHM: ‘Women
and adolescent girls are using a clean menstrual management material to absorb or collect
menstrual blood, that can be changed in privacy as often as necessary for the duration of
a menstrual period, using soap and water for washing the body as required, and having
access to safe and convenient facilities to dispose of used menstrual management
materials. They understand the basic facts linked to the menstrual cycle and how to
manage it with dignity and without discomfort or fear1.

Menstrual health and hygiene (MHH) encompasses both MHM and the broader
systemic factors that link menstruation with health, well-being, gender equality, education,
equity, empowerment, and rights. These systematic factors have been summarised by
UNESCO as accurate and timely knowledge, available, safe, and affordable materials,
informed and comfortable professionals, referral and access to health services, sanitation
and washing facilities, positive social norms, safe and hygienic disposal and advocacy and
policy

These definitions seem OK to me. Has the wider WASH sector subscribed to them?

By the way: Interesting that WSSCC has MHH as "hygiene and health", whereas UNICEF has it the other way around "health and hygiene". Not sure if this should be streamlined.

Regards,
Elisabeth
Dr. Elisabeth von Muench
Independent consultant located in Ulm, Germany
This email address is being protected from spambots. You need JavaScript enabled to view it.
Twitter: @EvMuench
Founder of WikiProject Sanitation: en.wikipedia.org/wiki/Wikipedia:WikiProject_Sanitation
My Wikipedia user profile: en.wikipedia.org/wiki/User:EMsmile
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  • inajurga
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Re: Why MHH and not just MHM

Hi Elisabeth, and other discussants here

I am not fully happy with the definition you quoted from the UNICEF publication. 
Because it is actually the menstrual health definition PATH uses and is still not linking enough to sexual & reproductive health (except "health services".) 
As you can see  there is still a lot of unclarity on the term.
That is why it is crucial to work in a definition for menstrual health, and menstrual health & hygiene.
But, yes, for a lack of better definition, I use the one quoted.

Has the WASH sector subscribed to it?

I think WASH sector has mostly been fine with the term menstrual hygiene (management), it is now organisations coming from other sectors that ask for branching out to health or are not confident with using the term hygiene.

Are you planning to also change the name of your day, which is currently "Menstrual hygiene day", or the description on your website?:

As long this is not sorted, we will not rename Menstrual Hygiene Day. Because it is a "brand name" not a "terminology". But we are fine with people saying on Menstrual Hygiene Day (or MH Day) we work in menstrual health, menstrual health & hygiene, period poverty, etc.
No need to change anything.

Interesting that WSSCC has MHH as "hygiene and health", whereas UNICEF has it the other way around "health and hygiene". Not sure if this should be streamlined.

Well, this is where the confusion comes from, but I think it is internally not streamlined between different people at WSSCC.  But mostly they use health & hygiene.
International Coordinator Menstrual Hygiene Day
WASH United
www.wash-united.org
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