Barriers to Accessing Menstrual Healthcare for Adolescent Girls in Nepal: A Qualitative Study of Patient, Community, and Provider Perspectives

Melanie Channon, University of Bath
Mahesh Puri, Center for Research on Environment Health and Population Activities (CREHPA), Nepal
Rebecca Evans, University of Bath

Despite the high prevalence (>70%) and substantial negative impact of dysmenorrhea and heavy menstrual bleeding girls struggle to access healthcare for menstrual symptoms. This study explores the barriers adolescent girls in Nepal face when accessing healthcare for menstrual disorders. Data were collected through focus-group-discussions and in-depth-interviews with adolescent girls, healthcare workers, teachers, and community members in two districts of Nepal. They were analysed thematically using Levesque’s access to healthcare framework. Key barriers identified include stigma and social norms, lack of knowledge, symptom minimization, and concerns about future fertility. Girls rarely seek help for dysmenorrhea even if the pain is “unbearable”; this is exacerbated by beliefs that medication affects future fertility. Both pain and heavy bleeding are minimised and normalised. Healthcare workers, while theoretically willing to help, frequently shared these beliefs and were limited by inadequate training, lack of diagnostic tools, and not being allowed to use contraceptives as treatment options. Poor menstrual literacy and comprehensive sexuality education limited the ability of girls, parents, teachers, and healthcare workers themselves to recognise normal menstruation. Addressing these barriers requires a holistic approach integrating menstrual, sexual, and reproductive healthcare, with a focus on health literacy, social and community norms, and training for healthcare workers.

Keywords: Sexual and Reproductive Health and Rights, Children, Adolescents, and Youth, Qualitative data/methods/approaches, Health and Morbidity

See extended abstract.