Menstrual Hygiene Management Naomi Radke seecon international Gmb

Menstrual Hygiene Management Naomi Radke, seecon international Gmb. H Menstrual Hygiene Management

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Find this presentation and more on www. sswm. info Contents 1. Introduction 2. Beliefs, Myths and Taboos 3. Menstrual Hygiene, Human Rights and MDGs 4. Health Risks of Poor Menstrual Hygiene Management 5. Menstrual Hygiene Management: Hardware 6. Menstrual Hygiene Management: Software Menstrual Hygiene Management 3

Find this presentation and more on www. sswm. info 1. Introduction Menstruation 52% of women worldwide are in reproductive age and most of them thus are menstruating monthly. Still, the majority of them are not in conditions to take care of their menstruation in a hygienic manner or are impaired by it. Menstruation is supposed to be invisible and silent. Source: KJELLEN ET AL. (2012) Menstrual Hygiene Management Source: http: //www. mcmaster. ca/museum/Exhibitions_Fierce. html [Accessed: 07. 08. 2013] 4

Find this presentation and more on www. sswm. info 2. Beliefs, Myths and Taboos Harmful restrictions In some cultures, women and girls are told that • During their menstrual cycle they should not bathe (or they will become infertile) • Touch a cow (or it will become infertile) • Look in a mirror (or it will lose its brightness) • Touch a plant (or it will die) Young women chatting about menstrual issues. Source: UNICEF (2008) Menstrual Hygiene Management 5

Find this presentation and more on www. sswm. info 2. Beliefs, Myths and Taboos Other restrictions Restrictions on girls during their menstrual period in Afghanistan, India, Iran and Nepal. Source: (HOUSE et al. 2012). Menstrual Hygiene Management 6

Find this presentation and more on www. sswm. info 2. Beliefs, Myths and Taboos Relieving restrictions Women may appreciate the ‘banishment’ to menstrual huts as they are given a rest period from the normal intensity of daily chores. Zulu menstruation hut. Source: RINDSTAD (2013) Menstrual Hygiene Management 7

Find this presentation and more on www. sswm. info 2. Beliefs, Myths and Taboos Parental Education by parents about reproductive health, sexuality and related issues is often a no-go area leading to a low knowledge and understanding on these issue Source: http: //phil 2100 dsu 12 a. wordpress. com/2012/07/10/abortion-the-solution-is-viability/ [Accessed: 07. 08. 2013] Menstrual Hygiene Management 8

Find this presentation and more on www. sswm. info 3. Menstrual Hygiene, Human Rights and MDGs Lack of facilities and sanitary products (1/2). . . Can push many girls out of school. Relationship between menstrual hygiene and school drop-out of girls from the higher forms due to lack of facilities, affordable sanitary products, fear of bloodstains and more. Millenium Development Goal (MDG) 2: Achieve universal primary education Participation of girls especially in Africa and Asia lags far behind the boys’ in higher forms of primary education Millenium Development Goal (MDG) 3: Promote gender equality and promote women The lacking behind in primary education to not providing adequate facilities and sanitary products infringes gender equality and the promotion of women Menstrual Hygiene Management 9

Find this presentation and more on www. sswm. info 3. Menstrual Hygiene, Human Rights and MDGs Lack of facilities and sanitary products (2/2) Stigma around menstruation hurts human rights, especially human dignity but also the right to non-discrimination, equality, bodily integrity, health, privacy and the right to freedom from inhumane and degrading treatment from abuse and violence. Menstrual Hygiene Management 10

Find this presentation and more on www. sswm. info 4. Health Risks of Poor Menstrual Hygiene Management Health risks • Poor protection and inadequate washing facilities may increase susceptibility to infection • In case of female genital cutting: blockage and build-up of blood clots is created behind the infibulated area: pain, additional infection risk • Risk of infection higher than normal during period as the blood forms a pathway into the uterus Menstrual Hygiene Management 11

Find this presentation and more on www. sswm. info 4. Health Risks of Poor Menstrual Hygiene Management Inappropriate hygiene practices (1/3) Certain practices are more likely to increase the risk of infection e. g. using unclean rags. Inappropriate practices often due to the nonaffordability of sanitary products for poor women. Findings from Bangladesh: • 80% of factory workers are women • 60% of them were using highly chemically charged rags from the factory floor for menstrual cloths • Infections are common, leading to 73% of women missing work for on average six days a month • Women had no safe place either to purchase cloth or pads or to change/dispose of them • When women are paid by piece, those six days away present a huge economic damage to them but also to the business supply chain Menstrual Hygiene Management 12

Find this presentation and more on www. sswm. info 4. Health Risks of Poor Menstrual Hygiene Management Inappropriate hygiene practices (2/3) • Unclean sanitary pad materials (local infections/bacteria can travel up the vagina and enter uterine cavity) • Changing pads infrequently (skin irritation by wet pads) • Insertion of unclean material into vagina (easier infection , also of uterine cavity) • Using highly absorbent tampons during light blood loss or no menstruation (toxic shock syndrome, vaginal irritation) Source: HOUSE ET AL. (2012) Menstrual Hygiene Management 13

Find this presentation and more on www. sswm. info 4. Health Risks of Poor Menstrual Hygiene Management Inappropriate hygiene practices (2/2) • Wiping from back to front following urination or defecation (bacteria can travel easier into vagina) • Unprotected sex (increased risk of sexually transmitted diseases) • Unsafe disposal of used sanitary materials or blood (risk of infecting others with diseases) • Frequent douching (forcing liquid into vagina can introduce bacteria into uterine cavity) • Lack of hand-washing after changing a sanitary towel (can spread infections) Source: HOUSE ET AL. (2012) Menstrual Hygiene Management 14

Find this presentation and more on www. sswm. info 5. Menstrual Hygiene Management: Hardware Sanitary protection materials (1/4) It is critical that any programme aiming to support women or girls with sanitary protection materials involves them in the planning discussions and decisions about the options to be supported. Schoolgirls participating in a menstrual cup project. Source: APHRC (2010) Menstrual Hygiene Management 15

Find this presentation and more on www. sswm. info 5. Menstrual Hygiene Management: Hardware Sanitary protection materials (2/4) Disposable sanitary towels • In resource-poor settings often very expensive and hard to dispose of • Often difficulty of proper disposal (generates solid waste) • But reduce barriers of girls staying at school Source: HOUSE ET AL. (2012) Menstrual Hygiene Management 16

Find this presentation and more on www. sswm. info 5. Menstrual Hygiene Management: Hardware Sanitary protection materials (3/4) Cloth or cloth pads • A sustainable sanitary option, but it must be hygienically washed and dried in the sunlight (natural steriliser) • But shame of drying the clothes outside, so often hide them in damp unhygienic places Locally made reusable cloth pads and cloth in Kenya. Source: HOUSE ET AL. (2012) Menstrual Hygiene Management 17

Find this presentation and more on www. sswm. info 5. Menstrual Hygiene Management: Hardware Sanitary protection materials (4/4) Menstrual cup • New technology appropriate for poor women and girls • Cup made of medical silicone rubber that is inserted into the vagina to collect menstrual blood • Removed and emptied less frequently than sanitary pads • Needs to maintain a high standard of hygiene especially during insertion, removal and general cleaning Menstrual Cup by The Moon Cup (UK). Instructions for menstrual cups. Source: RUBYCUP (2013) Menstrual Hygiene Management Source: http: //www. mooncup. com/photographs. html [Accessed: 07. 08. 2013] 18

Find this presentation and more on www. sswm. info 5. Menstrual Hygiene Management: Hardware Sanitary protection materials – advantages/disadvantages (1/2) Sanitary protection option Natural materials (e. g. mud, cow dung, leaves) Advantages Disadvantages Free Locally available High risk of contamination Difficult and uncomfortable to use Strips of clothes Easily available in the local market Re-usable Easily available in the local market If old cloths are not cleaned well they can become unhygienic. Users need somewhere private, with a water supply and soap, to wash and dry the cloths. Loses strength when wet and can fall apart. Difficult to hold in place. May be too expensive for the poorest users Users need somewhere private, with a water supply and soap, to wash and dry the pads. Cost is prohibitive to many potential users, if commercially produced Toilet paper or tissues • • Re-usable pads Available locally or on the internet Income generation opportunity, if locally made Cost effective as are reusable More environmentallyfriendly than disposable pads Source: HOUSE ET AL. (2012) Menstrual Hygiene Management 19

Find this presentation and more on www. sswm. info 5. Menstrual Hygiene Management: Hardware Sanitary protection materials – advantages/disadvantages (2/2) Sanitary protection option Tampons Advantages Disadvantages Convenient and comfortable to use Menstrual cups Panties/ Underwear • Re-usable Only need emptying, washing and drying Useful for keeping a sanitary product in place. Good for keeping the vaginal area hygienic. Not available in many contexts. Cost is prohibitive to any potential users. Generates a lot of waste to dispose, not environmentally-friendly. May not be culturally appropriate, particularly for adolescent girls, as need to be inserted into the vagina. Hygiene and availability of water and soap for hand-washing are particularly important, as need to be inserted into the vagina. May not be culturally appropriate for use, particularly for adolescent girls, as need to be inserted into the vagina. Hygiene and availability of water and soap are particularly important, for washing hands and menstrual cup, as need to be inserted into the vagina. Expensive first investment outlay. Cost may be prohibitive to potential users. Cheap elastic can wear out relatively quickly. Source: HOUSE ET AL. (2012) Menstrual Hygiene Management 20

Find this presentation and more on www. sswm. info 5. Menstrual Hygiene Management: Hardware Sanitary infrastructure Absence of clean and private sanitation facilities that allow for menstrual hygiene may discourage girls from attending school when they menstruate. • Menstrual hygiene: e. g. lockable toilets, closed bin for sanitary item disposal, sink for hand washing and cleaning of clothes (both inside toilets) • 1 in 10 school-age African girls do not attend school during menstruation or drop out, due to this absence • Teachers’ instruction time in school will be reduced by 1020% To manage menstruation hygienically, it is essential that women and girls have access to water and sanitation Source: HOUSE ET AL. (2012) Menstrual Hygiene Management 21

Find this presentation and more on www. sswm. info 5. Menstrual Hygiene Management: Hardware Disposal • If lack of opportunities, dispose secretly and easily: thus on defecation field, river or garbage dump • Blocking toilets/filling up pits Disposing of non-biodegradable sanitary pads in pit latrines leads to quick filling and thus shortened service of the pit. Source: HOUSE ET AL. (2012) Menstrual Hygiene Management 22

Find this presentation and more on www. sswm. info 6. Menstrual Hygiene Management: Software Education • Education and information (in combination with hygiene and sex education) empowers women and girls with factual information about their bodies and how to look after them • Teachers are rarely trained in teaching menstrual hygiene and consequently rarely teach it; male teachers may feel cultural norms forbid them Menstrual Hygiene Management 23

Find this presentation and more on www. sswm. info 6. Menstrual Hygiene Management: Software Further software. Awareness Raising • Promoting good practices for Menstrual Hygiene Management: - How to capture the blood How to dispose of the cloth, pad, cotton How to keep yourself clean during the period How to manage the stomach pain from your period For an overview see Table 1. 6 (p. 39, HOUSE et al. 2012) • Community-wide approaches that include boys and men (Physical barriers are often connected to social barriers. Social barriers have to be overcome!) • Integrate Menstrual Hygiene Management into a wider hygiene promotion approach on Water, Sanitation and Hygiene including risks and good practices Menstrual Hygiene Management 24

Find this presentation and more on www. sswm. info 6. Menstrual Hygiene Management: Software Example of promoting menstrual hygiene management: Mother’s Day - Zambia Mother’s day: one day off work per month. Silent belief that this day was thought for a day of relief whilst having menstruation. Menstrual Hygiene Management 25

Find this presentation and more on www. sswm. info References KJELLEN, M. , PENSULO, C. , NORDQVIST, P. , FOGDE, M. (2012): Global Review of Sanitation System Trends and Interactions with Menstrual Management Practices. Report for the Menstrual Management and Sanitation Systems Project. Stockholm: Eco. San. Res, Stockholm Environmental Institute (SEI). URL: http: //www. irc. nl/docsearch/title/180836 [Accessed: 05. 08. 2013] HOUSE, S. ; MAHON, T. ; CAVILL, S. (2012): Menstrual hygiene matters. A resource for improving menstrual hygiene around the world. London: Water. Aid. URL: http: //www. wateraid. org/what%20 we%20 do/our%20 approach/research%20 and%20 publications/view%20 publication? id=0 2309 d 73 -8 e 41 -4 d 04 -b 2 ef-6641 f 6616 a 4 f [Accessed: 05. 08. 2013] RINDSTAD, S. (2013): Symbolic Meaning of Menstruation. Available at: http: //pub 209 healthcultureandsociety. wikispaces. com/Symbolic+meaning+of+menstruation+across+different+cultures+ and+perspectives [Accessed: 07. 08. 2013] RUBY CUP (2013): http: //www. ruby-cup. com [Accessed: 08. 03. 2013] UNICEF (2008): Sharing simple facts. Useful information about menstrual health and hygiene. New York: United Nations Children's Fund (UNICEF). URL: http: //www. unicefiec. org/document/sharing-simple-facts-useful-information-aboutmenstrual-health-and-hygiene-booklet-english [Accessed: 08. 03. 2013] Menstrual Hygiene Management 26

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