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Breaking the silence on menstruation is a first step towards improving the lives of women and girls
Despite its measurable impact on health, education, work, the environment, the economy and much more, Menstrual Hygiene Management (MHM), or the practice of managing menstruation in a safe and hygienic way, remains a neglected subject.
The need for girls and women to have both safe spaces to manage menstrual hygiene and the mechanisms for safe disposal of the materials used to absorb menstrual blood is often ignored, even though the WASH sector deals with sanitation infrastructure and other taboo subjects such as excreta.
“For girls and women, MHM means a healthier and more confident adolescence, better school attendance and learning outcomes, greater mobility and opportunities and eventually delayed marriage, age of first conception and greater self-determination and well-being,” says Archana Patkar, Head of Policy at WSSCC.
Entry point for gender equality
Sustainable Development Goal Target 6.2 aims for sanitation and hygiene for everyone, everywhere, at all times. MHM provides the important link to a woman’s sanitary needs across her life course, while promoting dignity for all regardless of age, gender or physical ability.
WSSCC’s MHM programme promotes behaviour change, dignity and a holistic integration of MHM into government policies.
It comprises four interlinked elements: MHM research; consultations to listen to and understand the specific needs of vulnerable groups; technical support to governments in policy development; and practical MHM training.
“MHM is practical in that it is about a very real challenge that affects every woman and every girl. It presents practical solutions that governments and communities can really buy into,” says Patkar.
WSSCC’s Global Sanitation Fund (GSF) plays a central role in this work, with its supported programmes incorporating the needs of women and girls.
For instance, the GSF-supported programme in India promotes toilet designs that have a safe and secure space for changing menstrual materials with water available for cleansing, and women are consulted at every step of the process. Boys and men are being made aware of the different needs of men and women, so that toilet design is more gender-appropriate. In Senegal, the programme has championed MHM in communities and schools by developing training modules, facilitating training sessions and developing indicators to monitor progress across all target regions. In addition, the Tanzania programme has promoted MHM through workshops, 144 school clubs and advocacy, leading to the construction of adequate facilities in schools.
By addressing the sanitation and hygiene needs of women and girls, MHM stands as an entry point to approach the wider issues of gender inequality and injustice in WASH and beyond- with Ministries of Health, Education, Gender, Women and Children and the Environment.
“MHM is an issue of life, not a gender issue, it provides an entry point for many other issues that we are not comfortable talking about and initiating a wider discussion on equality and power that is long overdue,” says WSSCC’s Executive Director Chris Williams.
Policy and Practice
WSSCC works with national and local governments to integrate MHM in national policies across sectors.
In the case of India and Senegal, the Council has been successful in introducing guidelines on national sanitation policies, setting a bar for Kenya, Nepal, Niger, Pakistan, Malawi, Tanzania and Madagascar, where it continues engagement.
WSSCC has also set in motion direct training for local governments to increase the capacity of civil servants to monitor the implementation of national policies.
Through its joint programme with UN Women on Gender, Hygiene and Sanitation in West and Central Africa, WSSCC is working to change policies and behaviour in the region to improve women and girls’ human right to water and sanitation.
By promoting the safe management of menstruation and menstrual waste management, the programme has made real progress in breaking the silence on menstruation, involving policy and decision makers at all levels and initiating practical work on the ground to adapt facilities.
Last February, WSSCC and The Nepalese Ministry of Water Supply and Sanitation (MoWSS), hosted a high-level MHM Policy Consultation workshop in Nepal where the government committed to ending the silence on menstruation and to initiate the development of a policy framework on MHM.
Since 2012, the Council has conducted training for around 1400 people in Burkina Faso, Cameroon, India, Kenya, Mali, Nepal, Niger, Senegal, Tanzania and Togo. Most training sessions are for MHM trainers linked to governments, who will take the knowledge forward to train many others.
In August 2016, the first national training of trainers in Kenya organized by WSSCC, UNICEF and the Ministry of Health gained traction when ten County First Ladies were crowned as MHM champions, committing to help break the silence on MHM.
WSSCC offers three types of MHM training: Training of Trainers (ToTs) for middle level government officials and relevant partners who have the mandate to train practitioners at different levels within government ranks; MHM Policy Training for decision makers who are responsible for policy development; and Strategies and Implementation Plans Training for specific groups. Content and duration and tailored to the needs of each group. Participants include government officials from sanitation and related ministries, including water, health, education, gender and the environment.
“When we point out that women and girls menstruate around 3,500 days over their lifetime and that the silence, myths and misinformation leads to infections, pain, school and work absences and that this affects the family and the economy – we get heard,” says Patkar.
Leaving No One Behind
WSSCC's MHM approach ensures that no one is left behind. It addresses the needs of women and girls and the most vulnerable and empowers them to end the taboo on menstruation.
This month, the India team tested new menstrual hygiene management materials in braille with students at the National Association for the Blind.
Our inspiring MHM champion, Patricia Mulongo who after attending the Council’s ToT training braved her hearing impairment and has trained more than 200 people with hearing difficulties in Kenya to ensure that no one is left behind. (Read her story here)
WSSCC MHM work targets schools to promote good WASH habits and improve attendance, health and girls’ participation.
In Senegal, MHM training has taken place in 57 schools, reaching 1,800 students. 54 schools. In Kenya, 31,500 students were reached with efforts to sensitize teachers and students to MHM as part of broader national advocacy support.
In Nepal, 3,700 schools have been reached since 2010, including 671 schools in 2016 alone. In Tanzania, 112,000 students were reached with a programme that empowers girls through the creation of school WASH clubs and sensitization to menstrual hygiene management.
WSSCC's national coordinators work to achieve the WASH agenda in 16 countries. In Uganda, Ms. Jane Nabunnya Mulumba worked with the National Menstrual Hygiene Management Taskforce to lobby for the integration of menstrual hygiene management (MHM) in school curricula and has made great achievements for school girls. (Read her story here)
“I now commit to be a champion for MHM. I realize that I have been unfair to ladies in the past. I commit to include MHM in the workplace in the budget in my county. This is within my reach, and it must start from me,” says Melitus Kabar, a male participant of WSSCC’s MHM training in Kenya.