Table_3_The inclusion of disability within efforts to address menstrual health during humanitarian emergencies: A systematized review.docx

IntroductionWomen and girls with disabilities may be excluded from efforts to achieve menstrual health during emergencies. The review objectives were to (1) identify and map the scope of available evidence on the inclusion of disability in menstrual health during emergencies and (2) understand its focus in comparison to menstrual health for people without disabilities in emergencies.MethodsEligible papers covered all regions and emergencies. Peer-reviewed papers were identified by conducting searches, in February 2020 and August 2021, across six online databases (PubMed, MEDLINE, EMBASE, Global Health, ReliefWeb, and Cinahal Plus); gray literature was identified through OpenGrey, Gray Literature Report, Google Scholar, and Million Short. Eligible papers included data on menstrual health for women and girls with and without disabilities in emergencies.ResultsFifty-one papers were included; most focused on Southern Asia and man-made hazards. Nineteen papers contained primary research, whilst 32 did not. Four of the former were published in peer-reviewed journals; 34 papers were high quality. Only 26 papers mentioned menstrual health and disability in humanitarian settings, but the discussion was fleeting and incredibly light. Social support, behavioral expectations, knowledge, housing, shelter, water and sanitation infrastructure, disposal facilities, menstrual material availability, and affordability were investigated. Women and girls with disabilities rarely participated in menstrual health efforts, experienced reduced social support, and were less able to access water, sanitation and hygiene facilities, including disposal facilities. Cash transfers and hygiene kit distribution points were often inaccessible for people with disabilities; few outreach schemes existed. Hygiene kits provided were not always appropriate for people with disabilities. Caregivers (all genders) require but lack guidance about how to support an individual with disabilities to manage menstruation.ConclusionMinimal evidence exists on menstrual health and disabilities in emergencies; what does exist rarely directly involves women and girls with disabilities or their caregivers. Deliberate action must be taken to generate data about their menstrual health requirements during humanitarian crises and develop subsequent evidence-based solutions. All efforts must be made in meaningful participation with women and girls with disabilities and their caregivers to ensure interventions are appropriate.Systematic review registrationIdentifier: CRD42021250937.

引言：在紧急情况下，残疾人士和少女可能被排除在实现月经健康之外。本综述旨在（1）识别和描绘有关紧急情况下残疾人士月经健康纳入的证据范围，以及（2）与无残疾人员在紧急情况下的月经健康进行比较，以了解其关注点。方法：符合条件的研究涵盖了所有地区和紧急情况。通过在2020年2月和2021年8月对六个在线数据库（PubMed、MEDLINE、EMBASE、全球健康、ReliefWeb和Cinahal Plus）进行检索，确定了同行评审的论文；通过OpenGrey、灰色文献报告、Google Scholar和Million Short确定了灰色文献。符合条件的研究包括有关紧急情况下有和无残疾的妇女和少女月经健康的数据。结果：纳入了51篇论文；大多数研究集中在南亚和人为灾害。其中19篇包含原始研究，而32篇则没有。前者的四篇发表在同行评审期刊上；34篇论文质量较高。仅有26篇论文提及了人道主义环境下的月经健康和残疾问题，但讨论非常简略且不够深入。研究内容包括社会支持、行为预期、知识、住房、庇护所、水与卫生基础设施、废弃物处理设施、月经用品的可用性和可负担性。残疾人士和少女很少参与月经健康努力，她们的社会支持减少，且难以获取包括废弃物处理设施在内的水、卫生和卫生设施。现金转移和卫生包发放点往往对残疾人士难以到达；存在的外展计划很少。提供的卫生包并不总是适合残疾人士。护理者（涵盖所有性别）需要，但缺乏关于如何支持残疾人士管理月经的指导。结论：关于紧急情况下月经健康和残疾的证据极少；现有证据很少直接涉及残疾人士和少女或其护理者。必须采取有针对性的行动，以生成有关他们在人道主义危机期间月经健康需求的数据，并据此开发后续的循证解决方案。必须确保残疾人士和少女及其护理者的有意义参与，以确保干预措施适当。系统综述注册标识符：CRD42021250937。