Perspectives on menstrual policymaking and community-based actions in Catalonia (Spain): a qualitative study.

Background: Menstrual research and policymaking have become imperative worldwide. It is necessary that these are informed by women and people who menstruate (PWM) alongside expert professionals and activists. Methods: The main aim of this study was to identify and propose policies and community-based actions to address menstrual inequity and promote menstrual health in Catalonia (Spain). This study consisted of two qualitative studies: (a) 34 individual photoelicitation interviews with women and PWM, (b) a World Café study with 22 professionals and activists. Sampling for both studies was purposive and selective. Recruitment was conducted through healthcare centres, social media, key contacts, and snowball sampling techniques. Data were collected in December 2020-September 2022, and analysed using Framework Analysis. Results: Participants considered the implementation of menstrual policies that address the taboo and stigma of menstruation to be crucial. They stressed the need for menstrual education, which should be integrated into formal education curricula. Participants, and especially women and PWM, highlighted the need to improve the access and quality of healthcare services, so that the menstrual cycle and menstruation are seen as health indicators. Health professionals should encourage agentic informed decisions, hence why both participant groups considered menstrual health education amongst health professionals to be pivotal. Taking action to improve the access and affordability of menstrual products was also imperative for participants, especially for socioeconomically vulnerable populations. Participants agreed on guaranteeing fully equipped menstrual management facilities, and and professionals discussed gender-neutral and sex-segregated bathrooms. Workplace menstrual policies to accommodate and ensure menstrual self-care were also suggested. Conclusions: Our study highlights the need for multi-dimensional menstrual policies. These should include actions to address menstrual taboo and stigma, to promote menstrual education that goes beyond the hegemonic biomedical prism, to improve the access and quality of menstrual health services, along with policies ensuring adequate menstrual management facilities in public spaces and the access to menstrual products. Policymaking should also focus on how to ensure menstrual management and care in workplaces. Menstrual policies and community-based actions should be framed within intersectionality, to consider how societal structures of power and oppression influence menstrual experiences. Plain language summary: Research has shown the growing importance of understanding and creating policies related to menstruation worldwide. In Catalonia, Spain, a study was conducted involving both women and individuals who menstruate, as well as experts and activists to uncover the best ways to address menstrual-related issues. Through interviews and group discussions, participants shared their thoughts on how to improve menstrual health and reduce inequities. They highlighted the urgency of tackling societal taboos surrounding menstruation and incorporating menstrual education into school curricula. There was a call for better healthcare services that view menstrual health as an indicator of overall health. Participants felt strongly about improving access to menstrual products, especially for those with financial difficulties. There was also consensus on the need for well-equipped public facilities to manage menstruation, including discussions on gender-neutral and separate bathrooms. Suggestions were made to have policies in workplaces that support individuals during their menstruation. The study concludes that comprehensive policies are needed to address a range of menstrual concerns, from education to public facilities, with an emphasis on understanding the diverse experiences and challenges individuals face due to societal structures. [ABSTRACT FROM AUTHOR]