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A visual, community-engaged exploration of menstrual practices and motivations among adolescent girls in far-west Nepal

Baumann, Sara (2019) A visual, community-engaged exploration of menstrual practices and motivations among adolescent girls in far-west Nepal. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Menstrual health, a growing global public health issue, is the study of social, political, structural, educational and environmental factors that affect experiences of menstruation and impact health. Challenges associated with menstruation include the lack of access to materials and sanitation facilities, low knowledge about menstruation, and taboos and stigma that perpetuate unsafe practices. In Nepal, menstrual restrictions are widespread, putting menstruators at risk for poor health outcomes. Menstrual health research and interventions in Nepal must thoughtfully examine practices and beliefs, and propose solutions considering social values and the health and development context.

Arts-based methods and community-engaged approaches are particularly appropriate for investigating sensitive topics such as menstrual health. This dissertation first analyzes studies that have applied film methods in public health research. It then introduces a novel, visual, community-engaged research method called Collaborative Filmmaking. Finally, it presents the results from applying Collaborative Filmmaking to study menstruation in Nepal.

Results from the scoping review identified 15 film methods used in public health, which offer numerous methodological strengths such as providing rich descriptions, capturing emic perspectives, increasing comfort in participation, and empowering participants. Collaborative Filmmaking is a six-step method that builds upon these strengths. Adopting a community-engaged approach, participants of Collaborative Filmmaking are trained to create, analyze, and screen their own films in the community. Piloting Collaborative Filmmaking in far-west Nepal provided nuanced, sensory insight into menstrual practices and motivations among adolescent girls. An array of menstrual practices related to cleansing, cooking, eating and drinking, touching, worshipping, sleeping, and maintaining physical distance were uncovered. The practices fell along a continuum and varied by caste/ethnic and religious background. Motivations for following menstrual practices included religious and spiritual beliefs, family tradition, negative consequences, and social pressure.

This dissertation contributes to both visual methods and menstrual health scholarship. Collaborative Filmmaking is an effective method for engaging participants in exploring a sensitive topic, generating nuanced data, and is powerful for disseminating results. In terms of menstrual health, this dissertation extends the literature by describing key differences in menstrual practices among girls from different caste/ethnic and religious groups in Nepal for consideration in future interventions and polices.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Baumann, Sarasab269@pitt.edusab2690000-0002-6544-2825
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBurke,
Committee MemberAyyagari,
Committee MemberFinkel,
Committee MemberSommer,
Committee MemberTerry,
Date: 26 September 2019
Date Type: Publication
Defense Date: 18 July 2019
Approval Date: 26 September 2019
Submission Date: 23 July 2019
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 195
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: menstruation, menstrual health, Nepal, caste, chhaupadi, adolescent health, menstrual hygiene management, health behaviors
Date Deposited: 26 Sep 2019 16:49
Last Modified: 26 Sep 2019 16:49


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