Menstruation is a natural process. However, in most parts of the world, it remains a taboo and is rarely talked about. In Nepal, for instance, menstrual hygiene has been an emerging and an alarming issue. While the sanitation movement is progressing rapidly, menstrual hygiene management is out of mainstream WASH (water, sanitation and hygiene) agenda.

Although over 70% schools in Nepal have toilets facilities, only half of them can be considered  “gender friendly”. Many young girls miss important school days every month due the absence of menstruation friendly facilities.

A few years ago Helpcode introduced a ‘Girls Friendly School’ pilot project in 9 secondary schools in Chitwan, providing:

  • awareness and promotion of reproductive health to some 200 adolescent girls;
  • provision of awareness on Menstrual hygiene management;
  • Supply of sanitary pads at schools,
  • Facilitate the creation of a girls club, where girls are meeting monthly guided by a female teacher

These activities are extremely important for the students. It is not only about supplies and pads, but in fact the action is first and foremost about “Breaking the silence” about the taboo which violate the rights of every women and girl.

 

 

“We all need to understand how important the menstruation issue is for the dignity, pride and health of women and girls”, stressed a Nepali Minister during a recent workshop on Mestrual Hygiene Management.

However, in Nepal, some old social traditions bring to the seclusion of girls during their period. (Chaupadi). Women, in some part of the County, are prohibited from undertaking the usual activities of daily life during the time of menstruation, they are considered impure. Women are kept out of the house – usually in outdoor sheds/barns – for the duration of their period.

During a meeting in Mugling, last September, we had the opportunity to meet the 9 members of a Girls Club. Sheila – Helpcode Education and Health trainer – spoke with the adolescent girls who participated in the pilot project, asking for their feedback:

“Menstruation always resulted in banishment to the cowshed for 5 days every month. It is always acknowledged as the topic of shame and embarrassment. Students almost miss 9-10 days of school every month with a tremendous effect to their education. It also brings to health problems due to lack of nutritious food. Changes have taken place only at schools but are yet to come in community level’. Ms. Rasmi, student (class 7, 13 years old) –  Chitwan

 

 

“Menstruation is common to all so we do not need to be shy. Now we can speak with other friends also about this issue and talk to teachers regarding how we feel. We are getting many support from Helpcode staff. I hope also my younger sister will have such support in the future.” Ms. Anisha, student (class 6, 13 years old) – Mingling

 

Knowledge of menstruation is definitely the building block for confidence building. As per now, management of menstruation at school is difficult and disposal of sanitary materials is stressful. Helpcode is working to improve capacity of teachers and developing child friendly approaches to provide age appropriate information. Improvement in access to comfortable, secure, quick-fry and cheap menstrual hygiene management material is also a must along with strengthening of waste disposal facilities.

Helpcode is promoting WASH in Schools in Nepal, Cambodia and Mozambique to foster social inclusion and individual self-respect. By offering an alternative to the stigma and marginalization associated with hygiene issues, this intervention empowers all students – and especially encourages girls and female teachers and provide a positive impact on girls’ school attendance and achievement at school.

 

Why WASH at school is so important?

WASH in Schools fosters social inclusion and individual self-respect. By offering an alternative to the stigma and marginalization associated with hygiene issues, it empowers all students – and especially encourages girls and female teachers. In recognition of the positive impact on girls’ school attendance and achievement, initiatives around the world are addressing adolescent girls’ menstrual hygiene management (MHM) needs through WASH in Schools programming. Such interventions are increasingly implemented in both development and humanitarian emergency contexts.

Menstruation is still considered to be a taboo in many places throughout the world; with such taboos and misconceptions resulting in exclusions and discriminations that impede empowerment of girls and women in all areas of life. It has also consequently led to an unfortunate situation where significant proportion of women and girls are deprived of safe, accessible and hygienic spaces for managing personal hygiene during menstruation. Such stigma surrounding menstruation impinges on women and girls’ everyday lives. Being able to deal with periods in a hygienic and dignified way is crucial to women and girl’s well being. It helps women and girls feel that they are able to play a full role in society with self-esteem, irrespective of the menstrual time period of the month.

Nepal context

A study conducted in Nepal by WaterAis in 2017, shows that WaterAid Nepal presented their research on MHM with improving facilities, research and campaigns, institutional accountability and sanitary material supply chains as the key elements. Only 26.9% of girls in Udaypur, and 36.9% girls in Sindhuli were aware of menstruation before menarche. Most were unaware of cause of menstruation i.e. 74.6% in Udayapur and 54.6 % in Sindhuli. 64% girls reported elder sisters as the main source of information and 57% of girls reported that mothers as key informants. It was stated that Elder sisters often gave practical advice, whereas mothers gave more information about maintaining restrictions, hiding menstruation, and generally telling girls not to worry. Although, mothers were the main source of information for menstruating girls, they were uninformed and unprepared to talk to their daughters about the causes of menstruation. Furthermore, around a third of girls change their sanitary materials while they are at school (32.3% in Udaypur, and 42% in Sindhuli) stating difficulties to change in available toilet. in 13 districts showed that the distribution of sanitary pads and training on reusable cotton cloth was impressive and evident. However, there is a lack in management on in toilet disposal of sanitary pads.

Almost all girls go to their own house (if nearby), a friend’s house, or a tea shop (canteen) to change their sanitary materials unless necessary. Girls who reported missing a whole day of school was 12.3% in Udaypur and 21.5% in Sindhuli. Absence was attributed to pain and fear of leakage. No schools had a specific place for girls to rest, therefore girls rested in another classroom or the staff room. Girls were not comfortable taking information from their teachers and preferred non-governmental organizations or community based organizations to teach subjects relating to reproductive and menstrual health. Similarly, teachers reported a lack of training and teaching materials to teach reproductive health and a few teachers explained menstruation in a very scientific way, perhaps to hide their discomfort or avoid answering at all. Disposing of sanitary materials was stressful for most participants because it was important that others did not see them.

Discrimination

Most women in Nepal are more likely to face the moderate forms of discriminatory practice related to menstruation rather than severe forms. Of moderate forms of discriminatory practice, 25% had to stay in different rooms within their homes, 9% had to bathe in a separate place whereas 58% had to avoid social gatherings. Of severe forms of discriminatory practices, 3% had to stay in Chhaupadi, 3% had to stay in animals sheds, 3% had to eat separately and 2% had to be absent from school or work (11% in MW Mountain, 1% in Urban and 3% in Rural). Menstruation related discrimination in its severest forms was most prevalent in the Mid-Western Mountains, whereas 71% women have had experienced Chhaupadi. Three star approach form mainstreaming MHM was also presented in which each star group (one, two and three) had parameters regarding MHM facilities with three star being the best.

‘The findings of the research suggested that menstruation is still perceived as being related to disease, illness, and bacteria. This definitely results in girls feeling excluded and deprived of affection.

Furthermore, most girls are unaware of causal effects of menstruation. Mothers are the main source of information for menstruating girls, but they themselves are uninformed and unprepared to talk to their daughters about the causes of menstruation.

Knowledge of menstruation is definitely the building block for confidence building. As per now, management of menstruation at school is difficult and disposal of sanitary materials is stressful. There is a need to improve capacity of teachers and developing child friendly approaches to provide age appropriate information. Improvement in access to comfortable, secure, quick-fry and cheap menstrual hygiene management material is also a must along with strengthening of waste disposal facilities.”

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