Power, danger, and secrecy-a socio-cultural examination of menstrual waste management in urban Malawi



Roxburgh H, Hampshire K, Kaliwo T, Tilley EA, Oliver DM & Quilliam RS (2020) Power, danger, and secrecy-a socio-cultural examination of menstrual waste management in urban Malawi. PLoS ONE, 15 (6), Art. No.: e0235339.

Menstrual blood is not just a physical substance; it is laden with symbolism and often powerfully stigmatised. It is important to understand local perceptions and attitudes towards menstrual blood, as well as the preferred practices of menstruating women, in order to design appropriate sanitation and solid waste systems to support menstruation. Failure to take account of socio-cultural factors can jeopardise the effectiveness of such infrastructure. This study, conducted in Blantyre, Malawi, is a qualitative socio-cultural examination of how women manage and view menstruation. Thirty nine interviews, conducted with individuals and with small groups of friends, were carried out with thirty one women using pit latrines, flush toilets, and urine-diverting dry toilets in early 2019. Menstruation in Blantyre was found to be shrouded in secrecy because it was viewed as ‘dirty’, and therefore remained concealed. There was widespread anxiety about menstrual blood being used in ufiti (witchcraft), which affected how women used and disposed of their menstrual absorbents. At the same time, menstrual blood was also viewed as a powerful healing substance with uses in traditional medicine. The type of infrastructure required by women to support their menstruation depended on the type of menstrual absorbent used. Those using reusable cloth generally preferred a private bathroom with discreet drainage, whilst those using disposable pads needed a discreet and convenient disposal system. Increased preference for disposable pads over reusable cloth (particularly for younger women in education or employment) suggested that menstrual waste profiles of urban areas may be changing. Understanding these changing needs will be crucial for planning effective, sustainable waste disposal and sanitation infrastructure.

Waste management; Health; Gender issues

PLoS ONE: Volume 15, Issue 6

FundersParkes Foundation and Natural Environment Research Council
Publication date26/06/2020
Publication date online26/06/2020
Date accepted by journal12/06/2020
PublisherPublic Library of Science (PLoS)

People (3)


Dr David Oliver
Dr David Oliver

Associate Professor, Biological and Environmental Sciences

Miss Heather Purshouse
Miss Heather Purshouse

PhD Researcher, Biological and Environmental Sciences

Professor Richard Quilliam
Professor Richard Quilliam

Professor, Biological and Environmental Sciences