Blood flows: mapping journeys of menstrual waste in Blantyre, Malawi

ABSTRACT

The interplay between menstrual waste and urban sanitation infrastructure is largely hidden from view. Qualitative research has highlighted socio-cultural aspects of menstruation, but few quantitative studies have mapped the physical situation at scale. This study surveyed 258 women in Blantyre, Malawi about their menstrual absorbent choices, disposal practices, and socio-demographic characteristics. A Sankey diagram visualised flows of menstrual waste in the urban environment and identified ultimate disposal points. Most participants used either disposable pads and/or old cloth and disposed of them by either burning and/or throwing in pit latrines. Pad and cloth use were associated with age, education, employment, marital status, and household wealth. Younger women’s preference for disposable pads suggests that demographic shifts may cause volumes of menstrual waste to increase. However, differences in waste volume produced by disposable and reusable absorbents was less than previously assumed. The volume of menstrual waste discarded in pit latrines, and cultural barriers to disposing it elsewhere, highlights challenges for the pit emptying industry and faecal sludge value recovery sector, with the problem anticipated to be most acute in high-density settlements. Widening access to sustainable disposal strategies, affordable reusable menstrual products, and tackling stigma, are key to addressing this social and environmental challenge.

KEYWORDS:

• Menstruation
• solid waste
• sanitation
• faecal sludge
• gender

This article is related to:

Research for city practice

Acknowledgments

Many thanks to the research participants for generously sharing their time and experiences with us, and also to the anonymous reviewers for their helpful comments which greatly improved the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

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Additional information

Funding

This research was supported by the Natural Environment Research Council as part of the IAPETUS Doctoral Training Programme [grant number NE/L002590/1]; and the Royal Geographical Society (with IGB) with a Slawson Award [grant number SLAW05/19]. In-kind support was kindly provided by WASHTED, The Polytechnic - The University of Malawi.

Notes on contributors

Heather Roxburgh

This research is a result of a collaboration between the ESHH research group, at the University of Stirling, UK, and WASHTED, at The Polytechnic, University of Malawi. The ESHH research group tackles global issues of sustainability and environmental management by combining methods and theories from the natural and social sciences. The WASHTED Centre for Water, Sanitation, Health and Appropriate Technology Development is a multidisciplinary training and research centre for capacity building and technology development appropriate to the local environment.