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Amar Mani Poudel | Mukesh Singh |3 August,2017
Day 3 Session 9:MENSTRUAL HYGIENE MANAGEMENT(MHM)
– MHM IN THE COMMUNITY
Australian Red CrossTHE POWER OF HUMANITY
SANITATION, HYGIENE AND WATERMANAGEMENT PROJECT
NEPAL
• 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
Overview of the project
• Considered unclean & impure
• Sleep outside of house
• Restricted in seeing relatives
• Restriction of various food
• Restriction in movement
(including attending school)
3
Taboos and Myths of Menstruation
• Chhaupadi is part of local
culture.
• Menstrual Hut (Chhau)
• Different for married and
unmarried women
• Cow pee for purity
4
Chhaupadi Practices in Nepal
5
BBC NEWSDec 2016
BBC NEWSDec 2016
CNN NEWSJuly 2017
CNN NEWSJuly 2017
• 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
MHM Challenges
7
Dolpa
Humla
Mugu
Dang
Kailali
DotiJumla
Bajhang
Mustang
Rukum
Ilam
Kaski
Taplejung
Bajura
Surkhet
Rolpa
Myagdi
Sindhuli
Banke
Manang
Jajarkot
Salyan
Bara
Darchula
Bardiya
Dolakha
Jhapa
Palpa
Kalikot
Chitawan
Parsa
Morang
Baitadi
Tanahu
Achham
Dailekh
Lamjung
Gulmi
Sarlahi
Saptari
Siraha
KapilbastuSolukhumbu
Udayapur
Baglung
Sankhuwasabha
Bhojpur
Makawanpur
Khotang
Rasuwa
Nawalparasi
Pyuthan
Sunsari
Kanchanpur
Dadeldhura
Ramechhap
Syangja
Panchthar
Rupandehi
Dhanusha
RautahatMahottari
Dhankuta
Arghakhanchi
Parbat
OkhaldhungaTerhathum
ChinaChina
IndiaIndia
IndiaIndia
IndiaIndia
Chhaupadi districts in NepalChhaupadi districts in Nepal
Bajhang
CSO WASHProject
• Unhygienic menstrual hut
• Unhygienic practices
• Lack of access to water
• Lack of Nutrients/food
• Lack of facilities in schools
• Shame and reduced schoolattendance duringmenstruation
• Poor results and school dropout
8
Problems seen within BajhangDistrict
9
Findings of MHM Survey
65%
32%
3%
Stay place during menstruation
Inside home and safe place
Menstruation shed/Differenthouse or roomRegular Place/Room
42%
58%
Usages of material/sanitarypads
NoYes
37%
2%
54%
1%6%
Yes - Types of Pads Used
Old Clothes
Reusable Old Clothes
Reusable Pads (Local)
Reusable Pads (Market)
Sanitary Pads
47%
10%
19%
4%
20%
No - Reasons for Not Using
Uncomfortable
No Idea
Never UsedTraditinally
No Access to Pads
Others
0
16
48
36
4
74
20
10
0
20
40
60
80
100
only chapati Plain food (rice) Meat products Dairy products
Main Food types consumed-normal vs menstruating days (% women)
Normally During
1. Social Awareness
2. Chaupadi Free Village Campaign
3. SaniShop
Approaches are supported by capacity building of
change agents and communities
12
APPROACH AND TOOLS
13
Male GroupMale Group
Interaction andDiscussion
Interaction andDiscussion
Women GroupWomen Group Traditional healer andPriest Group
Traditional healer andPriest Group
Mobiliser conducts ongoing home visits and monitoringMobiliser conducts ongoing home visits and monitoring
Social Awareness Approach
14
Chaupadi Free Village Campaign Approach
3Chaupadi Free
Indicators
No restriction of foodNo restriction touch to
other personsFree movement
Free from menstrualhouse
Use of pads andsanitary facilities
Personal sanitation
1Local Leadership
Communityleadership
Support fromgovernment and
NGO/CBOs
2Joint Monitoring
Signature andcommitment
campaign
Home visit
Decision for date toannounce
Chaupadi freevillage
ChaupadiFree
Village
MHM training towomen group
Selection ofwomen
entrepreneurfrom training
Supportentrepreneur
for SaniShop inremote place
15
SaniShop Approach
• 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
16
Progress in MHM
• Increased MHM knowledge
• Reduced use of menstrual huts
• Increase in women using re-
usable pads
• Reusable pads made and sold by
entrepreneurs
• Reduced school drop out among
menstrual girls
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
Lesson Learnt
MHM Training curricula
CGD Friendly WASH Facility guideline –Unicef
MHM survey 2017-CSO WASH Project Nepal
18
Resource recommendations
19
Different types Menstrual Huts
20