In remote regions of Nepal, some women and girls are still forced to sleep in isolated huts or avoid kitchens, water taps and temples while menstruating due to cultural stigma and religious beliefs surrounding menstrual “impurity.”
Researchers at the University of Pittsburgh, through the School of Public Health’s Global Women’s Health Research Collective (GLOWHER)—a space that brings together students, researchers and community members working at the intersection of women’s health and creative research methods—are partnering with Nepali communities to better understand those experiences and develop culturally grounded menstrual health interventions.
Three of the group’s recent publications explored how caste/ethnicity, religion, social norms, culture and policy shape menstrual health across Nepal at the individual, community and policy levels, including research on social media interventions for menstrual health education in Nepal, collaborative filmmaking and menstrual health stigma, and participatory approaches to menstrual health intervention development.
“We are leaning into local practices and context to ensure the intervention is something the community actually believes in and will use,” said Sara Baumann, assistant professor of behavioral and community health sciences, School of Public Health, and founder and director of GLOWHER. “Menstrual health and hygiene interventions must be culturally adapted.”
One of the projects, led by Megan Rabin, a 2023 graduate of the master of public health program, as part of her graduate thesis work, examined the feasibility of using social media interventions to address menstrual stigma and gaps in reproductive health education in Nepal.
“Social media has become a huge part of life in Nepal, not just in urban areas,” Rabin said. “It allows us to expand beyond English or standard Nepali into local dialects, reach people outside of urban centers and even engage men and boys.”
Much of Baumann and Rabin’s research focuses on chhaupadi, an illegal practice in which menstruating women and girls are isolated from their communities because they are viewed as “unclean.” The practice has been associated with physical and psychological risks including injury, assault, smoke inhalation and social exclusion.
Baumann said many women involved in the research described tension between respecting cultural traditions and wanting different experiences for future generations.
“Even though women follow these practices, many told us, and showed us visually through their collaborative filmmaking projects, they do not want to pass these traditions on to their daughters,” Baumann said. “They recognize the hardship. This tells us we need to work across generations in our messaging.”
The research team has increasingly incorporated participatory, arts-based and human-centered design methods into its work. In one project, women used a traditional folk song practice called Deudato to share experiences surrounding menstruation and stigma.
“Using local language, local practices and local voices is proving to be a very innovative and effective way to talk about complex health topics,” Baumann said.
The films created as a part of the research process can be viewed here.