Day 3 Session 9: MENSTRUAL HYGIENE MANAGEMENT(MHM) MHM IN THE COMMUNITY SANITATION, HYGIENE AND WATER MANAGEMENT PROJECT NEPAL Amar Mani Poudel Mukesh Singh 3 August,2017 Australian Red Cross THE POWER OF HUMANITY
Overview of the project Timeline: July 2014 to June 2018. Target: 5 Village Development Committees (VDCs) in Bajhang District, Nepal with low sanitation & water coverage Objectives: Improved health through enhanced WASH outcomes for targeted communities, improved WASH governance and capacity of local stakeholders. Government policy: National Sanitation and Hygiene Master Plan guided use of total sanitation & community based water supply approaches applied in project. 2
Taboos and Myths of Menstruation Considered unclean & impure Sleep outside of house Restricted in seeing relatives Restriction of various food Restriction in movement (including attending school) 3
Chhaupadi Practices in Nepal Chhaupadi is part of local culture. Menstrual Hut (Chhau) Different for married and unmarried women Cow pee for purity 4
BBC NEWS Dec 2016 CNN NEWS July 2017 5
MHM Challenges Govt s Chhaupadi Eradication Directive 2005 not effective Many continue to believe in Chhaupadi culture Enforced on girls and women Safety, security and hygiene issues 6
Chhaupadi districts in Nepal India Bajhang Humla Darchula CSO WASH Project Bajhang Mugu Bajura Baitadi Dadeldhura Doti Jumla China Dolpa Achham Kalikot Mustang Dailekh Jajarkot Kanchanpur Kailali Rukum Manang Surkhet Myagdi Salyan Bardiya Rolpa Kaski Baglung Lamjung Parbat Pyuthan Banke Dang Gulmi Arghakhanchi Rasuwa Syangja Tanahu Palpa Dolakha Nawalparasi Kapilbastu Rupandehi Chitawan India Sankhuwasabha Taplejung Ramechhap Makawanpur Parsa Solukhumbu Sindhuli Okhaldhunga Terhathum KhotangBhojpur Panchthar Bara RautahatSarlahi Dhankuta Ilam MahottariDhanusha Udayapur India Siraha Saptari SunsariMorang Jhapa 7
Problems seen within Bajhang District Unhygienic menstrual hut Unhygienic practices Lack of access to water Lack of Nutrients/food Lack of facilities in schools Shame and reduced school attendance during menstruation Poor results and school drop out 8
Findings of MHM Survey Stay place during menstruation 3% Inside home and safe place 32% Menstruation shed/different house or room Regular Place/Room 65% 9
Usages of material/sanitary pads 58% 42% No Yes Yes - Types of Pads Used No - Reasons for Not Using 54% 1% 6% 37% Old Clothes Reusable Old Clothes Reusable Pads (Local) Reusable Pads (Market) Sanitary Pads 4% 19% 20% 47% Uncomfortable No Idea Never Used Traditinally No Access to Pads 2% 10% Others
100 Main Food types consumed-normal vs menstruating days (% women) 80 74 60 48 40 36 20 16 20 10 0 0 4 only chapati Plain food (rice) Meat products Dairy products Normally During
APPROACH AND TOOLS 1. Social Awareness 2. Chaupadi Free Village Campaign 3. SaniShop Approaches are supported by capacity building of change agents and communities 12
Social Awareness Approach Interaction and Discussion Women Group Traditional healer and Priest Group Male Group Mobiliser conducts ongoing home visits and monitoring 13
Chaupadi Free Village Campaign Approach 1 2 3 Local Leadership Community leadership Support from government and NGO/CBOs Joint Monitoring Signature and commitment campaign Home visit Decision for date to announce Chaupadi free village Chaupadi Free Indicators No restriction of food No restriction touch to other persons Free movement Free from menstrual house Use of pads and sanitary facilities Personal sanitation Chaupadi Free Village 14
SaniShop Approach MHM training to women group Selection of women entrepreneur from training Support entrepreneur for SaniShop in remote place 15
Progress in MHM Sensitized households 3647 people participated in discussions to stop Chhaupadi Advocated to 1282 female including disable. 6 CGD institutional toilet constructed 156 (incl 5 males) trained on MHM and pad making Increased MHM knowledge Reduced use of menstrual huts Increase in women using reusable pads Reusable pads made and sold by entrepreneurs Reduced school drop out among menstrual girls 16
Lesson Learnt 1. Home visits by motivators provide one of the best way to initiate discussion on MHM 2. Entrepreneurship at local level in reusable pad making 3. Interaction and discussion in different groups increased social awareness community, schools, males and females 4. Discussions on CGD friendly infrastructures has helped communities engage and understand issues 5. Developing opportunities such as Sanishops through existing community groups strengthens ownership and demand 17
Resource recommendations MHM Training curricula CGD Friendly WASH Facility guideline Unicef MHM survey 2017-CSO WASH Project Nepal 18
Different types Menstrual Huts 19
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