Peer-reviewed article
Menstrual Health Under Constraint: A Meta-Synthesis of Refugee Women's Experiences.
Marchetti F, Staccioli F, Smith M, Rasi F, Zambri F et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This meta-synthesis reviewed 24 qualitative studies on menstrual health experiences among refugee women and girls. The research found that menstrual management is constrained by structural barriers such as limited access to products and sanitation, combined with socio-cultural norms and stigma. Women and girls developed coping strategies and relied on informal support networks, but often at the cost of health and dignity. The findings show that effective interventions require comprehensive, multisectoral approaches beyond simply providing menstrual products, including education, community engagement, and healthcare support.
Key points
- Structural constraints, including limited access to menstrual products and safe sanitation facilities, interact with socio-cultural norms to limit safe and dignified menstrual management
- Significant knowledge gaps and lack of preparedness exist, particularly before menarche, among refugee women and girls
- Women and girls rely on informal support networks and coping strategies despite trade-offs for health and dignity
- Menstrual health is shaped by conditions of displacement, structural inequalities, and stigma that compromise agency and dignity
- Addressing menstrual health requires integrated approaches including literacy strengthening, community engagement, and support for healthcare professionals such as midwives
Limitations
This is a meta-synthesis analysing qualitative studies with heterogeneous contexts and varying methodological quality, so findings cannot quantify the prevalence of specific barriers or compare their relative importance across different refugee populations. The synthesis does not evaluate specific interventions or their effectiveness.
Abstract
Background/Objectives: Refugee populations face significant barriers in accessing healthcare services, particularly in sexual and reproductive health (SRH), with important implications for menstrual health. Limited access to adequate menstrual products, safe sanitation facilities, and appropriate information contributes to period poverty among migrant and refugee women, exacerbating conditions of vulnerability and discrimination. The present study aims to explore the lived experiences, barriers, and facilitating factors in the management of menstrual health and menarche among refugee women and girls. Methods: A systematic meta-synthesis was carried out between January and May 2026 using the PubMed, Cochrane Library, Scopus and LILACS databases and grey literature sources. The SPIDER framework was applied to guide the research question and search strategy. Qualitative and mixed-method primary studies and grey literature reports containing qualitative findings describing experiences of menstruation among refugee women and girls were included. Studies published in English, Italian, Spanish, and Portuguese were eligible. Study quality was appraised using the Joanna Briggs Institute (JBI) critical appraisal checklist. Data were analysed using a thematic synthesis approach as described by Thomas and Harden. Results: A total of 24 studies were included. Six analytical themes were identified: (1) structural constraints affecting access to resources and services; (2) context-dependent menstrual management practices; (3) female support networks; (4) menstruation as a socially constructed and learned experience; (5) constrained agency and compromised dignity under conditions of stigma; and (6) physical and psychological impacts. Overall, menstrual health was shaped by the interaction of structural barriers and socio-cultural norms, which limited safe and dignified management. Significant gaps in knowledge and preparedness were observed, particularly prior to menarche. Women and girls relied on coping strategies and informal support networks despite associated trade-offs for health and dignity. Conclusions: Menstrual health among refugee women and girls is shaped by structural inequalities, socio-cultural norms, and conditions of displacement. Addressing these challenges requires integrated, multisectoral approaches that go beyond product provision to tackle underlying determinants. Strengthening menstrual health literacy, engaging communities, and supporting the role of healthcare professionals such as midwives is essential to support more equitable and sustainable menstrual health interventions. Findings should be interpreted in light of the heterogeneity of study contexts and methodological quality.