#MHD 2019: time for action. What does action look like?

Menstruation hygiene Day is held on the 28th May. This is the 5th year that it is running. It was first started by a German WASH (water, sanitation and hygiene) non-government organization (NGO). The 28th is used to symbolize the average 28 days of a woman’s menstrual cycle. This day is particularly important as it is a day that stakeholders in menstrual health and hygiene sector focus to highlight the importance on menstrual hygiene management.

This year’s theme is time to take action. What does that look like? For many of us, we will gather up our friends and family for a small fundraising and get enough pads to donate to a school near you. For some it is to rally up like minded individuals to change the way policy is written in their country. For some shouting at the top of their voices that they menstruate and it is normal is their contribution. All these in their own way help get to the aim of the day; to highlight the importance of menstrual health. However, what actions can we take to make it more sustainable?

Apart from been female, my interaction with the menstrual hygiene and health is from private sector. I run an organization that started off by providing private access to sanitary pads in emergency situations through my organization Ari now we focus on providing accountability and monitoring services of donated sanitary pads in Kenya.  I have 6 years in designing and implementing a sustainable health innovation specifically for adolescent girls.

We all know this static: “ 1 out of 10 girls in sub Saharan Africa is out of school because of lack of menstrual hygiene products.” Images of cotton wool, pieces of mattresses, clothes, cow hide are etched in our brains. For some of us that was and is still a reality we live with every cycle. For some of us a biological occurrence is a life sentence that we cannot opt out of.  Despite of this common knowledge menstruation has stagnated as a very personal experience that one must carry its burden alone.  How can we change this?

• Teach menstrual health hygiene to both sexes comprehensively

Menstruation has a nature of “private club” element where it could only be women who understand women’s plight.The education both genders get is that menstruation is exclusive to women therefore men understandably find it difficult to not only understand the magnitude of the issues surrounding menstrual health and hygiene but even to empathize because they do not have any reference point.

Basic biological classes need to be taught before sexual reproduction. The aim was to make scientific biological processes palatable for 13 year old boys and girls. The purpose is to introduce teenagers to the inner workings of their bodies the same way they could study the brain or the different bones. Through my organization Ari,we taught teenagers what is a menstrual cycle, the biological occurrences that happen in their bodies and why it happens we saw a better understanding of their bodies which resulted to confident boys and girls. There is empowerment in knowledge.

Teachers should not teach menstrual hygiene or sexual reproductive education

It takes a village to raise a child. Teacher- student relationship is a very dynamic one. Factors such as age difference and their interaction with each other greatly affect the communication between the two parties. Topics sensitive to a teenager’s body is best addressed with someone closer to their age.More peer to peer education or “big sister” or “big brother” programs yields better results than having the traditional teacher-student relationship or parent-child relationship.

• A shift from the solution is more sanitary pads.

I cannot stress this point enough. If the solution was as simple as just providing sanitary pads to those who do not have the problem would have been solved a long time. It is a multi-faceted monster. Providing sanitary pads to a community without adequate menstrual hygiene education puts them at risk of contracting reproductive tract infections (RTI). If you do not educate a community on the importance of sanitary pads to their menstrual hygiene then you have created another currency that they can buy food with. If you do not provide a safe and private access area for women and girls to access sanitary pads then you have skewed the power in favor of the custodian of the sanitary pads.

• Formalize donated sanitary pad in schools.

Donations of sanitary pads when handled by individuals, chamas and corporate is very informal. Informal means it is very reliant on goodwill. Because of menstrual hygiene day one might feel a need to give back therefore, donate a few packets of pads. The effect of that is that it is not sustainable. Why? The cost of donating, transportation to the school and handover is not taken into consideration. Also, more often than not there is no sustainability model with these donations. After doing a drive this month what happens next month, next year, or the year after that?

• Shifting donations from physical to monetary equivalent

One of the greatest breakdowns in donation as an intervention is that there is lack of trust. People and organizations donate physically because the product is easier to track than money. That is why donations are handed to the beneficiaries themselves or their school representatives. However, because of the economic constraints with informal donations the biggest been the need to do physically handovers hinders impact. Instead we need to shift the focus to donation implementers who are tasked with report generation and accountability measures.

• Break down Silos

As an owner of an accountability system that I can bet is the game changer for the way menstruation is addressed in the country I struggle with connecting with partners, influencers, financiers, policy makers who would provide a community to catalyze changes that have already been implemented. Different stakeholders in the value chain from Policy, media, government, private sector, impact investors, Community based organizations (CBOs), Non-government organizations (NGOs), work in Silos. All want to solve menstrual hygiene situations within their spaces.As a result there are clusters of activities that are not harmonious. If there is a push to change police where are CBOs,NGOs and private sector as co-authors to eradicate the issues facing women and girls due to a predictable, biological occurrence cannot be done alone? We are seeing very many people championing the same cause when the impact would be profound if there was synergy.

• Account, Account, Account

At Ari we believe this is where our biggest value addition to the menstrual health and hygiene arena is. There is no way to known if the sanitary pads donated by government, NGOs, corporates individuals like yourself ever reach the girls. Accountability and monitoring is expensive there is no infrastructure to support openness of donated sanitary pads. Where someone could simply log in at any time of the day to see where and who are using the sanitary pads. If as a community we cannot account how then can we know if we are succeeding or not? Easily accessible studies or evidence based information is difficult to acquire therefore, it is difficult to know what is working or not.Again, because of this there are a lot of players doing localized research that is not shared to advance the understanding in menstrual hygiene management.

I urge those with clout, those with high impact portfolios, those who hold the technology to make the systems more efficient, those who have community support, those who have technical understanding let us all come together and take action. It is time.