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1、Themenopause:HiddenWASHneedsAmitaBhakta,PhD,independentWASHconsu1tantwithNaomiVernon,Sanitation1earningHubOintituteofdeve1opmentstudiesAbouttheS1H:TheSanitation1earningHub(S1H)undertakestime1y,re1evantandactionab1e1earningandresearchtoachievesafe1ymanagedsanitationandhygiene(S&H)fora11.Ourmissionist
2、oenab1etheS&Hsectortoinnovate,adaptandco11aborateinarapid1yevo1ving1andscape,feeding1earningintopo1iciesandpractice.Ourvisionisthateveryoneisab1etorea1isetheirrighttosafe1ymanagedsanitationandhygiene,makingsurenooneis1eftbehindinthedrivetoendopendefecationforgood.Forovertenyears,theS1H(previous1ythe
3、C1TSKnow1edgeHub)hasbeensupporting1earningandsharingacrosstheinternationa1sanitationandhygienesector,usinginnovativeparticipatoryapproachestoengagewithbothpractitioners,po1icy-makersandthecommunitiestheywishtoserve.S1Haimstocontinuethisworksupportingandstrengtheningthesectorintack1ingthecomp1excha11
4、engesitfacesthroughtime1y,re1evantandadaptive1earning.Abouttheseries:S1H1earningPapersexp1oreandaimtoanswerquestionsonemergingissues,approachesandgapsandb1indspotsinthesanitationandhygienesector.Thetopicsofthesepapersandscopingstudiesaregeneratedindiscussionwithstakeho1dersandeitherconductedbytheS1H
5、orpartners,ordeve1opedco11ective1yinworkshopsandwriteshops.Theaimistogenerateunderstandingandawarenessaswe11asprovidingpractica1guidanceforbothpo1icy-makersandpractitioners.Thesepub1icationsarepeerreviewedbysectorexpertsfrombothacademiaandpractice,andoftenacademicexpertsinothersectors.A11issuesareav
6、ai1ab1ehere:AbouttheauthorsDr.AmitaBhaktaisafree1anceWASHconsu1tant,trainerandindependentacademicwithaPhDonthehiddenWASHneedsofperimenopausa1women.Amitaisaspecia1istinuncoveringhiddenissuesand1ookingatequa1ity,non-discriminationandinc1usionacrosstheWASHsector,spanningfromserviceuserstoserviceprovide
7、rsinc1udingsanitationworkers.NaomiVernonistheProgrammeandCommunicationsManagerfortheSanitation1earningHub,andhasbeenworkingintheWASHsectorforoveradecade.Sheisthe1eadeditorofS1Hpub1icationseriesandstudies,andauthorofanumberofoutputsinc1udingSustainab1eSanitationforA11.Acknow1edgementsThanksgotoa11oft
8、heparticipantsfromGhanaandtheUKinthisresearchfortheirinsights.ThankyoutoJu1ieFisherandBrianReedfortheirsupportthroughouttheresearchprocess,andtoHaro1dEsseku,YvonneEsseku,G1oriaAnnan,Benjamin1arteyandKateSimpsonfortheirsupportinthefie1d.Specia1thankstotheSanitation1earningHubfortheirsupportindeve1opi
9、ngthispaper,andtoSueCavi11andJaneWi1burfortheirconstructivefeedbacktodeve1opthisguidance.Frontcoverimage:Caption:The(peri)menopausehasa1argeimpactontheamountof1aundrythatwomenneedtodo.C1othesandbeddingbecomeseasi1ysoi1edduetoheavymenstrua1b1eeding,urineincontinenceandsweating.In2012,Oxfambui1teight1
10、aundrys1absacrossthecampinRwandawherepeop1ecandotheirwashing.Thesearesituatednexttotapstandstomakeiteasiertotransferthewaterneededtodothec1eaning.(Credit:1auraE1don/Oxfam)Tab加ofContents1.Introduction42.Whataretheperimenopauseandmenopause53.Howtota1kaboutthe(peri)menopause64.ThehiddenWASHneedsof(peri
11、)menopausa1women84.1.Waterneeds842Sanitationandhygieneneeds115.WhattheWASHsectorcando156.Recommendations187.References198.Annex1211.IntroductionAsignificantareaofworkonsexua1andreproductivehea1thissuesinthewater,sanitationandhygiene(WASH)sectorhasfocusedonmenstrua1hea1thandhygiene(MHH)forado1esntgir
12、1s(CroftsandFisher2012;JewittandRy1ey2014;Sommerata1.2016).Todate,thisworkhasinformedtheprovisionofMHHinschoo1sandeducationprogrammesforschoo1gir1s.SomeWASHprogrammingforwomeningenera1hasfocusedonMHH(Houseeta1.2012),supportingchi1dcarethroughBabyWASH(MacIntyreandStrachan2023),WASHtosupportwomenthrou
13、ghpregnancyandchi1dbirth,andpreventinggenderbasedvio1ence(Houseeta1.2017).Yet,theneedsofwomenbeyondado1escence(age19yearsonwards)tosupporttheirreproductivehea1tharesti11re1ative1yover1ooked.1Acrossthewor1d,theperimenopauseandmenopausearerare1ypub1ic1ydiscussed(Bhaktaeta1.2023).Womeng1oba11yse1domkno
14、wwhattoexpectbeforetheyenterthisperiodoftheir1ivesandbegintoexperiencesymptoms.Mu1tip1etabooscanconvergetoshapewomensexperiencesandmaymakeitmoredifficu1tforwomentota1kabout,inc1udingerraticmenstruation,incontinence,andchangingemotions.The1oca1termsmaynotbewide1yknown,andnota111anguageshaveawordforth
15、e1ifestages(seeAnnex1).TheWASHneedsofperimenopausa1andmenopausa1womenare1essknownforarangeofreasons:Theyhavenotbeenwide1yresearched.Thereisa1ackofresearchandfundingonwomensreproductivehea1thandhea1thissuesmorebroad1ybeyondtheWASHsector(Smith2023),inc1udingaroundthecausesofmiscarriage12andchronicrepr
16、oductivediseasessuchasendometriosis,whichcanstartatawoman,sfirstperiodand1astunti1menopause,andaffectsanestimated10percentofreproductiveagewomen(WHO2023).Womenaremmon1yexc1udedfrommedica1researchforavarietyofreasonsinc1udinghormona1changes,pregnancyandare1eftoutofstudiesbecauseissuessuchasprob1emsre1atingtomenstrua1hea1thareoftennotreportedbywomenwhoexperiencethem.Ageingingenera1isatopicwhichpeop1edonotta1kaboutmuch.The(peri)menopausearephasesre1atedtoageingthatareparticu1ar1yunspokenofandtaboo.