Understanding Nurturing Care Group Approach in Addressing Menstrual Challenges in Selected Ghanaian Communities

Improved menstrual hygiene management (MHM) is key to socioeconomic empowerment of women through improved well-being. However, Safe MHM remains a challenge in developing countries particularly in rural and low-income settings. This study assessed the influence of a pilot project that adopted nurturing care group approach to improve MHM in rural communities of Ghana. Four (4) communities each from Savelugu Municipal and Sekyere East District Assemblies were selected for a qualitative study using 16 focus group discussions. Data was analysed inductively using content analysis. Findings from 162 study participants showed satisfactory MHM awareness and practices among beneficiaries. MHM awareness and education sources included close relatives, friends, NGOs, public and social institutions (e.g., health centres, churches, schools). The intervention improved MHM behaviour and personal hygiene practices. Persistent challenges included menstrual taboos and stigma, limited availability and prohibitive cost of commercial sanitary pads, burden of managing menstrual pain, and inadequate knowledge of menstrual complexities. Menstrual stigma was comparatively lower in intervention communities than controls, but no differences were observed regarding menstrual taboos which were largely sustained by religious and superstitious beliefs. Promoting local production and use of reusable menstrual pads from fabrics was considered an innovation to reduce the cost burden and address non-availability of commercial alternatives. Overall, the intervention positively influenced understanding of personal hygiene practices and contributed to reducing stigmatisation. Future interventions would require extensive collaboration with key stakeholders in facilitating change processes, particularly in addressing entrenched menstrual taboos.