A role for enabling actors to support MHM in schools

A role for enabling actors to support MHM in schools

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Menstrual Hygiene day allows the world to stop and reflect on how we can address this neglected subject. In many countries, a lack of adequate water and sanitation leads to increased barriers for girls, especially during menstruation, to effectively enjoy the rewards of education. This year’s theme #NoMoreLimits, provides an opportunity to reflect on how enabling actors can support achieving good Menstrual Hygiene Management (MHM) in schools.

What’s needed for good MHM in schools

An assessment of MHM in schools in South East Asia by WaterAid and Unicef (2017), best describes the key focus areas for ensuring good MHM. These are, social support, materials and their effective disposal, accurate, age-appropriate and pragmatic information, and MHM-friendly WASH facilities.

For many girls, having their period is difficult due to the stigma attached to menstruation. Living in an environment where menstruation is not talked about, or responded to with silence – signalling shame, or where there is limited knowledge on managing menstruation, makes it hard for girls to speak up about their discomfort or ask for help. Social support from parents, community and fellow students is required to establish the social norms that promote good practices, reduce practices that promote any level of discomfort for girls (such as teasing), and ensure these practices are replicated at home too.

To support this, schools can provide safe spaces for parents, girls and teachers to speak openly about the challenges they face, including addressing any myths. In an assessment of MHM in public primary schools in the National Capital District Province in Papua New Guinea by WaterAid and the International WaterCentre (2017), it was reported that teachers use the gender segregated assemblies to talk about topics that are not adequately covered in the curriculum or which students did not comfortably discuss in the classroom. A teacher’s resource, “Addressing Menstrual Hygiene Management in Rural Schools in PNG”, was designed from this program to support teachers use these gender assemblies and other safe space-type sessions to create a social, supportive environment for both girls and boys to deal with MHM.

Having the materials to manage menstruation

Access to, and the safe and effective disposal of, sanitary products presents a challenge for schools, particularly where there are no options for collection services from external service providers. Often there are many sanitary products available, most commonly sanitary pads and tampons. In some countries such as Kenya, the government has passed legislation to ensure free distribution of sanitary pads to public schools in addition to waiving the Value Added Tax (GST equivalent) for sanitary pads. The increased availability of products is only one part of the story though. Schools must come up with ways to ensure girls can privately and safely dispose of these materials.

For many schools, particularly those in rural areas, there are limited options for safe disposal; the use of incinerators are unaffordable for most resource-constrained schools. This has led to unsafe practices, such as waste disposal into pit latrines, flushed down toilets, disposed of in solid waste pits that are burnt, and in other cases, girls take them home after school. Participation of the private sector in supporting safe disposal has proven effective in tackling this challenge. For example, in Rwanda the Sustainable Health Enterprise (SHE) program is helping women create social businesses to manufacture and distribute affordable menstrual pads, while also supporting education and advocacy efforts. There are also efforts around the world to produce low-cost and environmentally friendly sanitary products (Sommer, 2010).

Another option is the use of reusable products such as menstrual cups and reusable pads, though these require access to an adequate supply of water to achieve the necessary hygiene standards. However, in some communities the use of products such as menstrual cups and tampons are frowned upon or prohibited due to taboos and customs against the insertion of products into the vagina. Such beliefs make it hard to get girls to use these products even where there is accurate information on their safe use provided at school. In some countries in South East Asia there are also reports of reusable pads and cloths not being hygienically dried in the sun, but hidden in drawers or the rafters of roofs, due to embarrassment or socio-cultural beliefs about menstrual blood (WaterAid, Unicef, 2017).

Creating menstrual hygiene-friendly schools

Ensuring that both girls and boys have access to accurate, age-appropriate and pragmatic information is a key component of achieving menstrual hygiene friendly school standards. Achieving this is best described in the Menstrual Hygiene Matters toolkit (2012), which identifies the following key factors to consider when supporting MHM in schools:

  • Ensure that there is basic information on menstruation available,
  • address institutional responsibilities,
  • build the competencies of teachers and other staff to speak confidently about menstrual hygiene, and
  • ensure there are ways to provide feedback and monitor how menstrual hygiene is implemented in the schools.

The above can only be effective of course where schools can offer girls appropriate water, sanitation and hygiene facilities to manage their periods safely, hygienically and in private. Most organisations are in agreement that common features for MHM friendly facilities include, but are not limited to:

  • gender-segregated facilities,
  • are private/lockable and safe,
  • have handwashing facilities that always have water and soap,
  • supply adequate water for bathing/personal cleaning,
  • offer secure, safe disposal bins in toilets,
  • are universally accessible,
  • have proper cleaning schedules that are adhered to,
  • provide changing facilities for staff, boys and girls, and
  • there is a mechanism for secure and safe disposal of used sanitary products.

An enabling environment for MHM 

For many schools, achieving these standards requires external support. Governments can support MHM in schools through increased budget allocations, engaging with the private sector on behalf of schools, supporting improved sector coordination to advocate for MHM, and implementing supportive policies and standards. Governments are also taking steps to ensure that MHM is integrated into the curriculum. For example in Thailand, MHM has been integrated into the ‘Guideline on sexuality Education’s Learning Activity’¸ a subject taught in primary schools (UNICEF, 2016).

Private sector involvement in MHM in schools occurs through partnerships with schools, NGOs and governments in the construction of MHM friendly facilities and access to MHM-related products and services. For example, in Ethiopia, Proctor and Gamble has partnered with Save the Children on a school-based project that provides latrines, education and sanitary products (Sommer, 2010). Meanwhile their puberty and confidence-building education programme is delivered free of charge in the countries in which they operate (WaterAid, Unicef, 2017). Meanwhile, Marni Sommer’s Growth and Changes series is an example of how academic institutions can support schools to access accurate information. This series is popular because it is published in multiple languages, has series for both boys and girls and has been adapted to the menstrual hygiene context of the respective countries.

Teachers play a big role in ensuring that this information is accurately communicated to students, but they are not always well equipped to do so, or MHM is not well covered in teacher training curriculums. The government can support teachers through in-service training on MHM, while health professionals can support addressing self-reported health impacts such as menstrual cramps/pain/discomfort experienced by girls during their menses. Parents should then be engaged through awareness creation. Their participation is crucial in ensuring that these practices are transferred to households and communities.

Ensuring good menstrual hygiene management will not be achieved by schools alone. Support and engagement from enabling actors in the school setting, teachers, parents, governments, the private sector, and NGOs will be necessary to create a world in which there are #NoMoreLimits for women and girls.

Author

Edith Kamundi

IWC WASH Project Officer

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[Photo credit: Diana Gonzalez-Botero]

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