How does Menstruation Impact Women's Economic Participation and Livelihoods in Uganda?

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Research will seek to answer the following questions: How do women experience menstruation? What impact does menstruation have on women's financial security? How is menstruation configured in the informalisation and improvisation of African cities? What challenges do women face when accessing sexual and reproductive healthcare? What strategies and coping mechanisms do women adopt to manage their menstruation to avoid stigmatisation whilst working and what could be done to improve the situation? The research will focus on Mbarara, based in the Ankole region, as 85.4% of women surveyed in 2016 Ugandan Demographic Health Survey (UDHS) were employed with over 75% of these women working in sales, services, craft/trade, and agricultural industries (Ugandan Bureau of Statistics, 2016:49-70). This research will utilise several different research methods including 1) a systematic review on the literature of menstruation and women's participation in the labour economy in Uganda; 2) an analysis of the health system and pathways for women regarding sexual and reproductive health as well as of the sanitation systems and structures in Uganda, and 3) qualitative semi-structured interviews, and participatory methods such as using art, photos, or drawings to further explore the private issue of menstruation with those interviewed. Purposive maximum variation sampling will be utilised to conduct 30-40 qualitative semi-structured qualitative interviews with women who have diverse experiences of menstruation, exploring further how menstrual stigma impacts their financial wellbeing when employed within the informal sector. Interviews will be conducted in the local language of ruNyankore with a research assistant and translated to English. I will take ruNyankore lessons to make better observations during interviews conducted in the local language and to have simple conversations with women. It is also likely that some young women can communicate in English, which they would have learned at school and to access services such as healthcare. For those who feel comfortable speaking English, interviews will be conducted in English. Women aged 18 to 49 will qualify to be included in this research project. This age group was selected as I can analyse how attitudes towards menstruation vary across the life course. Interview questions will cover themes such as women's beliefs and knowledge regarding menstruation, behaviours and practices whilst menstruating, access to and availability of sanitation and menstrual health resources, and gendered relations and discriminatory action in the workplace. Women will be given a consent form prior to taking part in the study and their identities will be anonymous. Appropriate ethical approval from the university and Ugandan IRB and UNCST will be sought. Data will be stored and transcribed using NVivo and analysed using thematic analysis. In addition, I will partner with Endometriosis Care Centre Uganda, a non-governmental organisation (NGO) based in Kampala, who help women and girls living with the condition in Kampala and surrounding areas. This research aims to advance the theoretical synthesis between embodiment and urban theory through an exploration of menstruation. This is important because the ways in which women experience menstruation in an urban context, particularly one in the Global South, will differ based upon their access to resources, employment, cultural norms, and customs. Embedding embodiment and urban theory enables for an interdisciplinary approach between the disciplines of anthropology, human geography, demography, and public health. By synthesising embodiment and urban theory, this research will advance urban and health geographies by informing debates around women's bodies in the context of livelihoods and the economy. It can also inform reproductive health systems as well as the pathways and referral process for women's sexual and reproductive health care.