Prevalence and Factors Associated with Chhaupadi in Nepal: Evidence from Nepal Multi-Cluster Indicator Survey (NMICS) 2019
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Abstract
Chhaupadi, a harmful menstrual exile practice, persists in parts of Nepal despite legal bans. This study examines the prevalence of Chhaupadi and its sociodemographic determinants in Sudurpaschim province, Nepal. Researchers analyzed data from the Nepal Multiple Indicator Cluster Survey (NMICS) 2019, a publicly available dataset from the United Nations Children’s Fund (UNICEF), and the Multiple Indicator Cluster Survey (MICS). The study was limited to 1,117 women in the Sudurpaschim province of Nepal. The analysis applied chi-square, bivariate, and multivariable logistic regression. The findings reveal that a significant proportion of women in Nepal’s far western region still adhere to menstrual restrictions. Results indicate that 94% of respondents avoid performing religious activities during menstruation, and 14% are kept away from school. Chhaupadi remains practiced by 17% of women overall. The practice is less prevalent among younger women (17%) than older women (21%). Logistic regression further confirmed that women with no education level (OR = 2.36, 95% CI [1.10, 5.45], p < .05), those living in rural areas (OR = 2.04, 95% CI [1.49, 2.79], p < .001), and those belonging to the lowest wealth quintiles (OR = 4.24, 95% CI [2.51, 7.17], p < .001) were significantly more likely to practice Chhaupadi. Despite criminalization, the persistence of Chhaupadi highlights deep-rooted sociocultural norms, economic disadvantage, and gender power relations. Effective interventions must therefore move beyond legal enforcement to include community-based norm change, female education, and gender sensitive empowerment initiatives to advance menstrual health equity and social justice.
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References
• Abdullah, S. Z. S. (2022). Menstrual food restrictions and taboos: A qualitative study on rural, resettlement and urban indigenous Temiar of Malaysia. PLOS ONE, 17(12), Article e0279629. https://doi.org/10.1371/journal.pone.0279629
• Amatya, P., Ghimire, S., Callahan, K. E., Baral, B. K., & Poudel, K. C. (2018). Practice and lived experience of menstrual exiles (Chhaupadi) among adolescent girls in far-western Nepal. PLOS ONE, 13(12), Article e0208260. https://doi.org/10.1371/journal.pone.0208260
• Amaya, L., Marcatili, J., & Bhavaraju, N. (2020, April). Advancing gender equity by improving menstrual health: Opportunities in menstrual health and hygiene. FSG. https://www.fsg.org/wp-content/uploads/2021/08/Advancing-Gender-Equity-by-Improving-Menstrual-Health.pdf
• Central Bureau of Statistics (CBS). (2020, November). Nepal multiple indicator cluster survey 2019: Survey finding report. Central Bureau of Statistics and UNICEF Nepal. https://www.unicef.org/nepal/media/11081/file/nepal%20mics%202019%20final%20report.pdf
• Central Bureau of Statistics (CBS) & United Nations Children’s Fund (UNICEF). (2020, November). Nepal Multiple Indicator Cluster Survey 2019: Final report. Central Bureau of Statistics and UNICEF Nepal. https://www.unicef.org/nepal/reports/multiple-indicator-cluster-survey-final-report-2019
• Dannals, J. E., & Li, Y. (2024). A theoretical framework for social norm perception. Research in Organizational Behavior, 44, Article 100211. https://doi.org/10.1016/j.riob.2024.100211
• Global Health 50/50. (2020). The Global Health 50/50 Report 2020 – A review of the equality and gender related policies and practices of 200 global organizations active in health and health policy. https://global5050.org/wp-content/uploads/2020/03/Power-Privilege-and-Priorities-2020-Global-Health-5050-Report.pdf
• Government of Nepal. (2017). Muluki Ain (Criminal Code), 2074 (2017) [Criminal Code of Nepal]. https://lawcommission.gov.np/content/13454/criminal-code-2074/
• Hennegan, J. M. (2017). Menstrual hygiene management and human rights: The case for an evidence-based approach. Women’s Reproductive Health, 4(3), 212–231. https://doi.org/10.1080/23293691.2017.1388720
• Hennegan, J., Winkler, I. T., Bobel, C., Keiser, D., Hampton, J., Larsson, G., Chandra-Mouli, V., Plesons, M., & Mahon, T. (2021). Menstrual health: A definition for policy, practice, and research. Sexual and Reproductive Health Matters, 29(1), Article 1911618. https://doi.org/10.1080/26410397.2021.1911618
• Hochbaum, G. M. (1958). Public participation in medical screening programs: A socio-psychological study. U.S. Public Health Service. https://nysl.ptfs.com/aw-server/rest/product/purl/NYSL/s/51e7a638-c546-413a-a993-42dd40dba75a
• Kadariya, S., & R. Aro, A. R. (2015). Chhaupadi practice in Nepal: Analysis of ethical aspects. Medicolegal and Bioethics, 5, 53–58. https://doi.org/10.2147/mb.s83825
• Loughnan, L., Mahon, T., Goddard, S., Bain, R., & Sommer, M. (2020). Monitoring menstrual health in the Sustainable Development Goals. In C. Bobel, I. T. Winkler, B. Fahs, K. A. Hasson, E.A. Kissling, & T. A. Roberts (Eds.), The Palgrave Handbook of Critical Menstruation Studies (pp.577–592). Palgrave Macmillan. https://doi.org/10.1007/978-981-15-0614-7_44
• Ministry of Health and Population (Nepal), New ERA, & ICF. (2023). Nepal Demographic and Health Survey 2022. Ministry of Health and Population. https://dhsprogram.com/pubs/pdf/FR379/FR379.pdf
• Molm, L. D. (1986). Gender, power, and legitimation: A test of three theories. American Journal of Sociology, 91(6), 1356–1386. https://www.jstor.org/stable/2779800
• Mukherjee, A., Lama, M., Khakurel, U., Jha, A. N., Ajose, F., Acharya, S., Tymes-Wilbekin, K., Sommer, M., Jolly, P. E., Lhaki, P., & Shrestha, S. (2020). Perception and practices of menstruation restrictions among urban adolescent girls and women in Nepal: A cross-sectional survey. Reproductive Health, 17(1), Article 81. https://doi.org/10.1186/s12978-020-00935-6
• National Statistics Office. (2023, March 24). 12th national population and housing census 2021. Government of Nepal. https://censusnepal.cbs.gov.np/results
• Pednekar, S., Some, S., Rivankar, K., & Thakore, R. (2022). Enabling factors for sustainable menstrual hygiene management practices: A rapid review. Discover Sustainability, 3, Article 97. https://doi.org/10.1007/s43621-022-00097-4
• Real Relief. (2016). Why menstruation matters to achieve the Sustainable Development Goals (SDGs). CMP CoWASH Ethiopia. https://www.cmpethiopia.org/media/safepad_towards_sdgs.pdf
• Robinson, H. (2015). Chaupadi: The affliction of menses in Nepal. International Journal of Women’s Dermatology, 1(4), 193–194. https://doi.org/10.1016/j.ijwd.2015.10.002
• Rosenstock, I. M. (1974). The health belief model and preventive health behavior. Health Education Monographs, 2(4), 354–386. https://doi.org/10.1177/109019817400200405
• Sommer, M., Torondel, B., Hennegan, J., Phillips-Howard, P. A., Mahon, T., Motivans, A., Zulaika, G., Gruer, C., Haver, J., & Caruso, B. A. (2021). How addressing menstrual health and hygiene may enable progress across the Sustainable Development Goals. Global Health Action, 14(1), Article 1920315. https://doi.org/10.1080/16549716.2021.1920315
• Subedi, M., & Parker, S. (2021). Menstrual exclusions in Nepal: Some evidence of transition. Dhaulagiri Journal of Sociology and Anthropology, 15, 1–9. https://doi.org/10.3126/dsaj.v15i01.41921
• Tan, D. A., Haththotuwa, R., & Fraser, I. S. (2017). Cultural aspects and mythologies surrounding menstruation and abnormal uterine bleeding. Best Practice and Research: Clinical Obstetrics and Gynaecology, 40, 121–133. https://doi.org/10.1016/j.bpobgyn.2016.09.015
• Thakuri, D. S., Thapa, R. K., Singh, S., Khanal, G. N., & Khatri, R. B. (2021). A harmful religio-cultural practice (Chhaupadi) during menstruation among adolescent girls in Nepal: Prevalence and policies for eradication. PLOS ONE, 16(9), Article e0256968. https://doi.org/10.1371/journal.pone.0256968
• Thapa, S., & Aro, A. R. (2021). Menstruation means impurity: Multilevel interventions are needed to break the menstrual taboo in Nepal. BMC Women’s Health, 21(1), Article 84. https://doi.org/10.1186/s12905-021-01231-6
• Thompson, N., & Thompson, S. (2001). Empowering older people: Beyond the care model. Journal of Social Work, 1(1), 61–76. https://doi.org/10.1177/146801730100100105
• United Nations. (2020, January). Literature review on harmful practices in Nepal. https://un.org.np/resource/literature-review-harmful-practices-nepal
• United Nations Children’s Fund (UNICEF). (2018). Menstrual hygiene in schools in South Asia: Bhutan country snapshot. UNICEF Regional Office for South Asia.
• Vashisht, A., Pathak, R., Agarwalla, R., Patavegar, B. N., & Panda, M. (2018). School absenteeism during menstruation amongst adolescent girls in Delhi, India. Journal of Family and Community Medicine, 25(3), 163–168. https://doi.org/10.4103/jfcm.JFCM_161_17
• Yadav, M. (2018). Menstrual cycle and the misconceptions associated with it among young women in Delhi-NCR, India. International Journal of Health Sciences and Research, 8(4), 185–191. https://www.ijhsr.org/IJHSR_Vol.8_Issue.4_April2018/28.pdf
