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Breaking the bias around menstruation on International Women’s Day

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Female teacher appointed to lead and support the gender club at Dube primary school in the Dalocha woreda.

A new water, sanitation and hygiene project tackles challenges facing girls and woman in rural Ethiopia

March 8, 2022

This story was written by Bret McSpadden, Publications and Knowledge Manager at IRCWASH with whom NIRAS-LTS is partnering on this project.

According to a 2017 UNICEF study, 52% of adolescent girls in Ethiopia have never received any information about menstrual hygiene, and only 37% report ever freely discussing menstruation and not feeling ashamed of revealing their menstrual status. According to PMA2020 data in 2017, only 28% of women in Ethiopia report having everything they need to manage their menstruation.

As we celebrate this year’s International Women’s Day under the theme #BreakTheBias, the UK-funded ‘Strengthening Climate-Resilient WASH Systems Technical Assistance Programme’ (SCRS WASH TAP) is thinking about ways to address the stigma Ethiopian girls and women experience around menstruation. One component of SCRS WASH TAP is piloting innovative private sector approaches to improve access to and affordability of menstrual hygiene products while supporting behavioural change activities to improve healthy menstrual hygiene management (MHM) practices.

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Girls' club, menstrual hygiene management room at Dube primary school in Dalocha woreda.

Breaking down taboos around menstruation in schools

As the SCRS WASH TAP project gets underway, task teams are beginning to test data collection methods and gather early data to inform their research approach and pilot intervention. Recently the MHM team visited two woredas in the Silti Zone in the Southern Nations, Nationalities, and Peoples' Region of Ethiopia. Despite lack of water and menstrual hygiene products, schools and teachers are working hard to support their female students and break down taboos around menstruation. Still, facilities are not up to standard, MHM products are not available outside of school, and more can be done to support schools and their students.

The most positive finding during the field visit was the presence of girls’ clubs in every school. These clubs meet regularly to discuss MHM issues and members contribute 1‒20 birr per month (USD 0.02 and 0.39) to purchase MHM products. Out of 68 schools across two woredas, 44% have a designated MHM room where materials are stored and other support can be privately provided. These clubs may be contributing to increased attendance as one girl interviewed noted: “I always like to come to school whenever I am having period because I get a menstrual pad from the school. My family does not think it is worth to buy pads, and they have never bought any for me.” Some schools are also facilitating discussions outside the school between girls and their mothers over coffee, a tradition in Ethiopia, which is reported to help change the perception of taboos.

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Girls-only toilet in Tach Kemo primary school, Sankura woreda

Inadequate facilities, information, and supply

Although 100% of schools have latrines, only 56% have access to water. For schools without water, students must fetch water from nearby communal community water sources, but handwashing and other hygiene is still a challenge. Additionally, most of the MHM rooms do not meet the designed government standard due to lack of funding and clubs are only able to provide one pad per day for girls, who then wear them for many hours, a potentially dangerous practice. Finally, there are no support materials such as pamphlets or books to educate girls and boys, with the former reporting the information they receive through clubs to be inadequate.

Despite schools’ efforts, fully meeting women’s and girls’ needs is a long way off in rural areas. The majority of girls cannot afford to buy MHM products. Even for those able to afford them, availability is limited, as the team found when visiting the local shops. This is likely due to lack of affordable products and, in turn, lack of demand. This lack of supplies reduces girls’ quality of life and increases fear of stigma with one girl saying, “I usually restrict myself from playing or doing any physical activity at home and in the community whenever I have my period because I am afraid that people will see my clothes soaked with blood.”

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Dr. Fikralem Alemu (left) with the Director of Tach Kemo primary school in Sankura woreda

I was expecting stigma and a poor environment, but things are changing, and girls report not being bullied or having negative comments. On the other hand, I didn’t expect to see no supply of menstrual hygiene products in shops. This is something that needs improvement.

Dr. Fikralem Alemu, MHM expert following her field visit to a few school.

Way forward

Though there are challenges, it was exciting to see positive, community-driven developments during the field visit and SCRS WASH TAP is looking forward to building on these efforts. Upon returning from the field, MHM expert, Dr. Fikralem Alemu, reflected, “Going to the field, seeing what is going on, and interviewing the girls gave a real impression on MHM practices, awareness, social challenges, and school services. There are good initiatives, and we are not starting from scratch.” She went on to say, “Stakeholders take MHM seriously. Students, teachers, and government are contributing what they can, so this is a positive.”

More research is needed to understand the barriers to access affordable and quality menstrual hygiene products, effectiveness of school clubs, how they impact students’ attendance and health, and how they can be supported. And in line with the project goals, finding ways to address gaps in MHM through education and improving MHM product access using the private sector has much room for growth. But knowing this work has begun locally and is supported locally is positive and something to build up as the project designs and pilots next steps.

Jai Shende

Jai Shende

Analyst

Edinburgh, United Kingdom