Centring participant experience: a realist evaluation of a menstruator-friendly facility design project in a refugee settlement, Lebanon

Abstract Introduction Menstrual health in humanitarian contexts is a neglected topic. Its taboo nature presents difficulties for participants in menstrual health projects in these particularly challenging settings. Namely, their experiences may be concealed or overlooked in projects that are typical...

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Main Authors: Georgia Hales, Paul Hutchings, Katy Roelich, Mahua Das, Alexandra Machado, Debora Bonucci, Farah Salem
Format: Article
Language:English
Published: BMC 2024-03-01
Series:BMC Women's Health
Subjects:
Online Access:https://doi.org/10.1186/s12905-024-02961-z
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author Georgia Hales
Paul Hutchings
Katy Roelich
Mahua Das
Alexandra Machado
Debora Bonucci
Farah Salem
author_facet Georgia Hales
Paul Hutchings
Katy Roelich
Mahua Das
Alexandra Machado
Debora Bonucci
Farah Salem
author_sort Georgia Hales
collection DOAJ
description Abstract Introduction Menstrual health in humanitarian contexts is a neglected topic. Its taboo nature presents difficulties for participants in menstrual health projects in these particularly challenging settings. Namely, their experiences may be concealed or overlooked in projects that are typically outcome focused. Realist Evaluation is a useful method to unearth and explore the hidden mechanisms and their causes, which lead to positive or negative participant experiences. The authors have applied this approach to a robust humanitarian menstrual health project to explore how to centre the emotional wellbeing of participants at all stages: prior to, during, and post-participation. Study setting The project studied was led by the International Federation of Red Cross and Red Crescent Societies who piloted their adaptable manual for menstruator–friendly water, sanitation and hygiene (WaSH) facility design in humanitarian contexts. It was conducted by the Lebanese Red Cross in an informal tented settlement hosting Syrian refugees in Qaa, Lebanon. Methods The authors collected interview and focus group data on the contextual factors and processes within the project from nine project staff and 16 settlement inhabitants. They used a realist process of theory development, testing, and consolidation to understand how and under what circumstances the project inputs affected participants’ wellbeing. Results The contextual factors and causal mechanisms promoting participant experience comprised individual (choices influencing and experience during participation), interpersonal (group dynamics and the role of non-menstruators), and organisational (expertise and knowledge, relationship to participants and cultural differences) factors. Implications The research uses a case study from a renowned humanitarian organisation who provided a well-delivered project in a conducive environment to explore the mechanisms and contexts that can promote wider learning and refine understanding and programming in this under-researched and -theorised space. Specifically, it informs which contextual factors and project inputs must be present within a menstrual health project to ensure participant satisfaction whilst efficiently delivering well-designed menstruator-friendly WaSH facilities.
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spelling doaj.art-c859a68f7a844632931b6f01b768572e2024-03-10T12:21:15ZengBMCBMC Women's Health1472-68742024-03-0124111210.1186/s12905-024-02961-zCentring participant experience: a realist evaluation of a menstruator-friendly facility design project in a refugee settlement, LebanonGeorgia Hales0Paul Hutchings1Katy Roelich2Mahua Das3Alexandra Machado4Debora Bonucci5Farah Salem6University of LeedsUniversity of LeedsUniversity of LeedsUniversity of LeedsInternational Federation of Red Cross and Red Crescent Societies (IFRC) CHBritish Red CrossUniversity of LeedsAbstract Introduction Menstrual health in humanitarian contexts is a neglected topic. Its taboo nature presents difficulties for participants in menstrual health projects in these particularly challenging settings. Namely, their experiences may be concealed or overlooked in projects that are typically outcome focused. Realist Evaluation is a useful method to unearth and explore the hidden mechanisms and their causes, which lead to positive or negative participant experiences. The authors have applied this approach to a robust humanitarian menstrual health project to explore how to centre the emotional wellbeing of participants at all stages: prior to, during, and post-participation. Study setting The project studied was led by the International Federation of Red Cross and Red Crescent Societies who piloted their adaptable manual for menstruator–friendly water, sanitation and hygiene (WaSH) facility design in humanitarian contexts. It was conducted by the Lebanese Red Cross in an informal tented settlement hosting Syrian refugees in Qaa, Lebanon. Methods The authors collected interview and focus group data on the contextual factors and processes within the project from nine project staff and 16 settlement inhabitants. They used a realist process of theory development, testing, and consolidation to understand how and under what circumstances the project inputs affected participants’ wellbeing. Results The contextual factors and causal mechanisms promoting participant experience comprised individual (choices influencing and experience during participation), interpersonal (group dynamics and the role of non-menstruators), and organisational (expertise and knowledge, relationship to participants and cultural differences) factors. Implications The research uses a case study from a renowned humanitarian organisation who provided a well-delivered project in a conducive environment to explore the mechanisms and contexts that can promote wider learning and refine understanding and programming in this under-researched and -theorised space. Specifically, it informs which contextual factors and project inputs must be present within a menstrual health project to ensure participant satisfaction whilst efficiently delivering well-designed menstruator-friendly WaSH facilities.https://doi.org/10.1186/s12905-024-02961-zMenstrual health and hygieneLebanonRefugee settlementRealist evaluationParticipationMHM-facility design
spellingShingle Georgia Hales
Paul Hutchings
Katy Roelich
Mahua Das
Alexandra Machado
Debora Bonucci
Farah Salem
Centring participant experience: a realist evaluation of a menstruator-friendly facility design project in a refugee settlement, Lebanon
BMC Women's Health
Menstrual health and hygiene
Lebanon
Refugee settlement
Realist evaluation
Participation
MHM-facility design
title Centring participant experience: a realist evaluation of a menstruator-friendly facility design project in a refugee settlement, Lebanon
title_full Centring participant experience: a realist evaluation of a menstruator-friendly facility design project in a refugee settlement, Lebanon
title_fullStr Centring participant experience: a realist evaluation of a menstruator-friendly facility design project in a refugee settlement, Lebanon
title_full_unstemmed Centring participant experience: a realist evaluation of a menstruator-friendly facility design project in a refugee settlement, Lebanon
title_short Centring participant experience: a realist evaluation of a menstruator-friendly facility design project in a refugee settlement, Lebanon
title_sort centring participant experience a realist evaluation of a menstruator friendly facility design project in a refugee settlement lebanon
topic Menstrual health and hygiene
Lebanon
Refugee settlement
Realist evaluation
Participation
MHM-facility design
url https://doi.org/10.1186/s12905-024-02961-z
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