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