“But there’s nothing written about it!”: An alternative to the conventional literature review

I sat in the resources centre of my department on the first day of my PhD. I was incredibly excited at the prospect of starting my research on the WASH needs of perimenopausal women! A fresh-faced first year PhD student, I set off on my journey and had it all planned out: do literature review, set objectives, plan methodology, choose case study, collect data, write it up, and voila! PhD done! It was all going to be smooth running. But of course, it was research, which… never goes to plan, and my journey of finding hidden knowledge began on my very first day, and has informed my work ever since.

I started searching the WEDC knowledge database, which I was told had a vast amount of WASH  resources, and typed in “WASH + perimenopause”, and waited for the resources to come to me. But then, the computer said “Your search returned no results”. Did I spell it wrong? No…. I tried “menopause” “hot flushes” “night sweats”, anything that seemed relevant. Still, after several attempts there was nothing. I then tried Google to see if there was anything on this elusive matter, but nothing came back. Yes, I had managed to break not only Google, but Science Direct, SAGE Journals and all the databases I had at my fingertips in the weeks ahead! There was literally nothing written, anywhere, about the WASH needs of perimenopausal women. I could not read any papers or books about women’s WASH practices during the perimenopause, and had no literature for my literature review. I was not just dealing with a knowledge ‘gap’, but rather a really, really, big, black hole where there was no visible evidence. But in order to justify my research, I had to find this evidence somehow, and to do an alternative to a standard literature review.

A phenomena-what review?!

After realising that there really was nothing (literally, nothing) written about the WASH needs of perimenopausal women, I set out to search for something to resolve my dilemma and came across a paper which mentioned an alternative, with a difficult name to pronounce: a PHENOMENOLOGICAL REVIEW. It may sound like a complex method, but essentially, a phenomenological review just means talking to people, letting them share their experiences with you, and then using these experiences to write a report (or in my case a PhD chapter). Because there was no literature, I went to the next available source of information: the perimenopausal women themselves. My goal was to use the experiences of perimenopausal women to shape the aims, objectives and research questions. I used a feminist oral history technique to allow women to narrate their WASH experiences to me through a conversational approach. I wanted to identify what the hygiene needs of perimenopausal women were – irrespective of whether they lived in a high- or low-income country. I decided to go for the lowest-hanging fruit, and interviewed 23 women from diverse ethnic  backgrounds from my home town in the UK about their WASH experiences during the perimenopause. My sample was representative of the physical experiences of perimenopausal symptoms of women in low- and middle-income countries, because I spoke to women of Black, Asian and minority ethnic backgrounds, as well as White British.

As the interviews progressed, all that was hidden from the texts was revealed to me through our chats. During the perimenopause, the women were starting to have showers in the middle of the night as they would wake up soaked through having experienced night sweats. Their periods started to become irregular in their late 40s and early 50s: sometimes a tampon just was not enough and a pad was needed to support the heavy blood flow they experienced. Their laundry loads increased drastically as they changed their sweat-, blood- and urine-stained clothes more often. Drinking plenty of water was key to avoid skin getting too dry and to keep rehydrated. Urinary incontinence meant more trips to the toilet and keeping hold of pads even if their periods had stopped. By enabling the women to talk to me, I could begin to piece together what the hygiene needs of perimenopausal women were. The themes of the phenomenological review gave me a wide range of research questions to answer, such as:

  • How are laundry needs affected during the perimenopause?
  • How are the bathing needs of women affected during the perimenopause?
  • What techniques are used by perimenopausal women for menstrual hygiene management and to what extent are they effective?
  • How are the solid waste management needs of women affected during the perimenopause?

Once I had my research questions established, I could then go about establishing my research methodology (see my blog, Leaving no one behind in the Sustainable Development Agenda: we need to look at hidden knowledge).

Standard literature review not possible? There are alternatives!

Hidden knowledge is something which I have grown to appreciate as being very important to understanding the world. The process of trying to find it through a phenomenological review, and then using that information to plan my research has taught me how we need to be creative and flexible in our approaches to finding hidden knowledge. Do not give  up at the first hurdle, but instead use hiddenness as an opportunity for discovery and exploration!