Metrics Advancement &amp; Field Testing Plan: Advancement of Metrics for Menstrual Hygiene Management In the Workplace
Creators: name: Caruso, Bethany
name: Sinharoy, Sheela
name: Salinger, Allison
name: Patrick, Madeleine
name: Conrad, Amelia
Publisher: name: figshare
Year: 2025
Subjects: classificationCode: 420699
subject: Public health not elsewhere classified
classificationCode: 420602
subject: Health equity

description: <b>Preferred citation:</b>Caruso, B.A., Conrad, A., Ramaswamy, A., Stephen, A., Youm, A., Patrick, M., &amp; Sinharoy, S. 2021. Advancement of Metrics for Menstrual Hygiene Management in the Workplace: Metrics Advancement &amp; Field-Testing Plan. Washington, DC, USAID Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) Project.<b>Summary</b> Research to understand the lived experience of menstruation continues to increase globally1,2. However, qualitative research3, intervention evaluation4-8, measurement development9-11, agenda setting12-14, and investment in large-scale global programs15 have largely focused on school-aged, and most often school-going, girls. Research focused on women’s experiences of menstruation is limited3,16-18.The experiences of menstruators who are working remains particularly understudied and overlooked19-23. Workplace challenges identified thus far are similar to those in school settings, including inadequate facility, water, and material access; stigmatizing social environments; and institution rules preventing the ability to address needs19,22,24-26. Research has identified associations between the use of disposable pads and reduced work / absenteeism in Burkina Faso27 and Bangladesh28 and between symptoms and presenteeism/productivity and 'helpfulness' in India29 and the Netherlands30. Recent qualitative research has illuminated the importance of considering discomfort and anxiety in the work setting during menstruation including the specific challenges of those experiencing pain and heavy bleeding19 (Uganda), as well as irregular bleeding associated with menopause and additional labor associated with menstruation in the work place more broadly (UK)22.Measures have been developed to assess women's experiences of sanitation31 and menstruation23 in the household setting, but no validated measures exist to assess workplace-specific experiences, conditions, or impacts associated with menstruation. The absence of measures and assessments limit understanding of menstruation in the workplace, including outcomes (e.g., health, well-being, economic engagement) and determinants, including the workplace (e.g., access to facilities), individual-level (e.g., access to resources), and biological (e.g., heavy bleeding, pain) experiences of menstruation (See Figure 1). Robust measures would enable comparability across populations and geographies and evaluation of programs that aim to improve workplace experiences and outcomes. Further, robust measures would enable the establishment of indicators to assess changes related to menstruation and work in varied spaces and over time.This Metrics Advancement and Field Testing Plan (Deliverable 1) describes (1) primary themes related to menstruation in the workplace from the literature, including existing measures identified and preliminary assessment of adaptation potential, (2) the measurement adaptation process, and (3) current updates to the preliminary field testing plan.