A qualitative exploration of menstrual management practices and the impact of menstruation on the livelihoods of female sex workers in a peri-urban area of western Kenya - Report - MDSpire

A qualitative exploration of menstrual management practices and the impact of menstruation on the livelihoods of female sex workers in a peri-urban area of western Kenya

  • By

  • Elish McCullough

  • Garazi Zulaika

  • Edyth A. Osire

  • Cynthia Akinyi

  • Fredrick O. Otieno

  • Penelope A. Phillips-Howard

  • Supriya D. Mehta

  • Linda Mason

  • June 5, 2026

  • 0 min

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Clinical Report: Investigating Menstrual Hygiene Practices of Female Sex Workers

Overview

This study explores the menstrual hygiene management (MHM) practices of female sex workers (FSWs) in Kisumu, Kenya.

Background

Menstrual hygiene management is a critical aspect of health that significantly affects the economic well-being of female sex workers (FSWs). In Kenya, FSWs face heightened risks of sexually transmitted infections and economic precarity, which can be exacerbated by inadequate menstrual health resources.

Data Highlights

This qualitative study involved seven focus group discussions with 57 FSWs, revealing various menstrual hygiene practices and their implications for work and income.

Key Findings

  • FSWs primarily use disposable sanitary pads, but also employ tampons, reusable pads, cloths, and other materials.
  • Many FSWs continue to work during menstruation due to financial necessity.
  • Unsafe practices, such as intravaginal cleansing and inserting materials to hide menstrual flow, are common among FSWs.
  • Client attitudes towards sex during menstruation vary.
  • Most FSWs report a loss of income during menstruation.

Clinical Implications

Addressing the stigma and negative perceptions surrounding menstruation is crucial.

Conclusion

This study highlights the need for improved menstrual hygiene management among female sex workers.

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  2. American Journal of Epidemiology, 2023 -- Examining the Mediating Role of Unfair Gender Norms on Intimate Partner Violence and Contraceptive Practices in a Cluster Randomized Controlled Trial in Niger
  3. Open Forum Infectious Diseases, 2023 -- Shigellosis in Nairobi's Informal Settlements: Analyzing Risk Factors and Patterns of Antimicrobial Resistance
  4. Frontiers in Psychiatry, 2026 -- Understanding the Impact of the PM4M Intervention on Women's Mental Wellbeing in Zambia and Lessons for Implementation: A Qualitative Study
  5. WHO, 2026 -- Call for experts: new WHO guideline on menstrual health
  6. Epidemiology of menstrual-related absenteeism in 44 low-income and middle-income countries: a cross-sectional analysis of Multiple Indicator Cluster Surveys, 2024
  7. Water, sanitation and hygiene at sex work venues to support menstrual needs, 2024
  8. Call for experts: new WHO guideline on menstrual health
  9. Epidemiology of menstrual-related absenteeism in 44 low-income and middle-income countries: a cross-sectional analysis of Multiple Indicator Cluster Surveys - ScienceDirect
  10. Water, sanitation and hygiene at sex work venues to support menstrual needs

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