Sustainable Menstrual Hygiene Practices and Their Environmental and Health Implications: A Systematic Review in the Indonesian Context
DOI:
https://doi.org/10.46799/ijssr.v6i1.1352Keywords:
Menstrual hygiene management, sustainable menstrual products, reproductive health, environmental health, health behaviorAbstract
Menstrual hygiene management (MHM) intersects with critical domains of public health, environmental sustainability, and gender equity, particularly in low- and middle-income countries (LMICs) such as Indonesia. Despite increasing global discourse, MHM and sustainable menstrual products remain underrepresented in national health and development agendas. Hence, their adoption and impact within the Indonesian context require further investigation. A systematic literature review was conducted following the PRISMA methodology to explore patterns, challenges, and public health implications associated with the use of sustainable menstrual products in LMICs. A total of seventeen studies were selected based on their methodological robustness, topical relevance, and specific focus on the use of reusable menstrual hygiene products. Multiple benefits were consistently reported, offering advantages such as improved user health outcomes, enhanced long-term cost efficiency, and reduced environmental hazards. However, utilization remained low across reviewed settings due to major barriers to implementation, including deficiencies in water, sanitation, and hygiene (WASH) infrastructure, persistent sociocultural taboos, limited market availability, and prevalent misconceptions regarding intravaginal product safety. An ongoing theme across studies was the observed disconnect between product awareness and actual use—a gap frequently attributed to fragmented health education initiatives. The findings underscore the potential of sustainable menstrual hygiene interventions to enhance both public health and ecological outcomes in Indonesia. Successful implementation is made possible through concurrent investments in foundational infrastructure, culturally responsive education, and multisectoral coordination, while systemic barriers must be addressed through integrated policy and community engagement strategies.
References
Agustian, M., Prabawanti, B. E., & Handayani, P. (2024). Inovasi produksi pembalut kain untuk menyelamatkan bumi: Studi kasus Kelompok PKK RW 004 Kampung Muka. Abdine, 4(2), 267–274. https://ejurnal.sttdumai.ac.id/index.php/abdine
Aini, K. N., Mizuno, K., & Wardhana, Y. M. A. (2024). Pilihan pintar, lingkungan sehat: Strategi untuk pembalut yang berkelanjutan. Al Qalam: Jurnal Ilmiah Keagamaan dan Kemasyarakatan, 18(6), 3893. https://doi.org/10.35931/aq.v18i6.3341
Alfiani, F., Fauzia, Y., & Azkya, F. (2025). A study on the knowledge and attitudes of Indonesian women regarding menstrual cups as environmentally friendly menstrual products. Medical Sains: Jurnal Ilmiah Kefarmasian, 10, 57–64. https://doi.org/10.37874/ms.v10i1.1338
Alzate, E., & Sanchez, Y. (2020). The use of sanitary pads and menstrual cups and their impact on environment. In Proceedings of the 2020 Congreso Internacional de Innovación y Tendencias en Ingeniería (CONIITI). https://doi.org/10.1109/CONIITI51147.2020.9240278
Aridi, R., & Yehya, A. (2023). Sustainability assessment of sanitary pad solutions to reduce period poverty. Environment, Development and Sustainability. https://doi.org/10.1007/s10668-023-04338-y
Assa, I., Bouway, D. Y., Innah, H., Asmuruf, F., Bowaire, A., Yufuai, A., Hukubun, M., Sawias, O., Ratnasariani, W., & Daniel, D. (2024). Menstrual hygiene management in the remote rural highlands of eastern Indonesia. Journal of Water, Sanitation and Hygiene for Development, 14(3), 199–208. https://doi.org/10.2166/washdev.2024.183
Babbar, K., & Garikipati, S. (2023). What socio-demographic factors support disposable vs. sustainable menstrual choices? Evidence from India’s National Family Health Survey-5. PLoS ONE, 18(8). https://doi.org/10.1371/journal.pone.0290350
Bano, S., Saji, J., K., M. S., M., F. F., Shaji, N., Koshy, R., Valsraj, S. P., Samad, S., & Eranhikkal, A. (2024). Study examines sanitary pad side effects and promotes menstrual cup use among college students. Saudi Journal of Nursing and Health Care, 7(11), 237–244. https://doi.org/10.36348/sjnhc.2024.v07i11.004
Blair, L. A. G., Bajón-Fernández, Y., & Villa, R. (2022). An exploratory study of the impact and potential of menstrual hygiene management waste in the UK. Cleaner Engineering and Technology, 7. https://doi.org/10.1016/j.clet.2022.100435
Bouchouk, O., & Ayaz, M. (2024). The relationship between Islamic teachings and cultural values in shaping attitudes towards gender roles in Indonesia. Review of Multidisciplinary Education, 3(3). https://ojs.transpublika.com/index.php/ROMEO/
Cassolatti Gracioli, B., et al. (2023). The use of menstrual cups is associated with the maintenance of healthy vaginal microbiota: A prospective longitudinal study. Placenta and Reproductive Medicine, 2. https://doi.org/10.54844/prm.2022.0288
Chavan, S. P., et al. (2024). Innovative and biodegradable sanitary napkins with focus on affordability and environmental impact. Journal for Research in Applied Sciences and Biotechnology, 3(5), 237–245. https://doi.org/10.55544/jrasb.3.5.24
Davis, J., et al. (2018). Menstrual hygiene management and school absenteeism among adolescent students in Indonesia. Tropical Medicine & International Health, 23(12), 1350–1363. https://doi.org/10.1111/tmi.13159
Diiniyati, D., & Kusmaryati, P. (2020). Pengembangan pembalut kain yang ramah lingkungan sebagai alternatif pilihan untuk kesehatan reproduksi perempuan. Jurnal Media Kesehatan, 13, 18–29. https://doi.org/10.33088/jmk.v13i1.488
Elledge, M. F., et al. (2018). Menstrual hygiene management and waste disposal in low and middle income countries: A review of the literature. International Journal of Environmental Research and Public Health, 15(11). https://doi.org/10.3390/ijerph15112562
Fourcassier, S., et al. (2022). Menstrual products: A comparable life cycle assessment. Cleaner Environmental Systems, 7. https://doi.org/10.1016/j.cesys.2022.100096
Habibie, M., et al. (2019). Pemberdayaan wanita melalui pelatihan pembuatan pembalut ramah lingkungan. Prosiding Konferensi Pengabdian Masyarakat, 1, 75–79.
Hait, A., & Powers, S. E. (2019). The value of reusable feminine hygiene products evaluated by comparative environmental life cycle assessment. Resources, Conservation and Recycling, 150. https://doi.org/10.1016/j.resconrec.2019.104422
Sommer, M., et al. (2021). Menstrual hygiene management in schools: Midway progress update on the “MHM in Ten” 2014–2024 global agenda. Health Research Policy and Systems, 19(1). https://doi.org/10.1186/s12961-020-00669-8
UNICEF Indonesia. (2019). Guidance on menstrual health and hygiene: WASH in schools. https://www.unicef.org/indonesia/topics/menstrual-hygiene
van Eijk, A. M., et al. (2019). Menstrual cup use, leakage, acceptability, safety, and availability: A systematic review and meta-analysis. The Lancet Public Health, 4(8), e376–e393. https://doi.org/10.1016/S2468-2667(19)30111-2
World Bank. (2022). Menstrual hygiene management: Improving access and education for girls and women. https://www.worldbank.org/en/topic/water/brief/menstrual-health-and-hygiene
Zahra, F. T., Sultana, U. F., & Quinn-Walker, N. (2025). Overview of menstrual hygiene management and other risk factors concerning bacterial vaginosis. Discover Public Health, 22(1). https://doi.org/10.1186/s12982-025-00416-w
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