By Jane Bevan and Kalkidan Gugsa
ADDIS ABABA, 30 May 2017 – Daniel Worku, a 12-year-old from Sheno Primary School in Oromia region, admits he did not know much about menstruation and thought it only an issue for girls and women to discuss. “The [menstrual hygiene management (MHM)] education in the school helped me to know more about it and how to be supportive of girls. I am a member of the MHM club, motivating my peers, particularly boys to be part of it too.”
Daniel and three courageous female students were telling their MHM experiences to a crowded room of health sector and development partners in Ethiopia. The advocacy event was held on global Menstrual Hygiene Day and organised by the Ministry of Health, in partnership with UNICEF and other MHM partners – Splash, WaterAid, SNV, Care and World Vision.
While menstruation is biologically a female issue, UNICEF’s recent knowledge, attitudes and practice (KAP) baseline survey of MHM in Ethiopia found that teasing from boys was a major reason that girls often skip school while menstruating, sometimes resulting in dropping out of school altogether. Thus, the involvement of boys in education about menstrual hygiene is key to improve understanding and reduce teasing, and thereby the retention of girls in school.
The KAP study found that over half of schoolgirls in Ethiopia knew nothing about menstruation prior to menarche, leaving them shocked and frightened and less than half of the girls in the county are taught about menstrual hygiene in school. The majority of adolescent girls never discuss menstruation with another person. On average, 11 per cent of girls miss school for reasons related to their periods – this is as high as 46 per cent in some regions. The main reasons for missing school were cited as pain/discomfort and teasing.
The study found there is a common misconception in Ethiopia that girls are no longer virgins because they begin menstruating and have been at times punished by parents who blame them for having sex or being raped if blood is seen on their clothes. These misunderstandings, in addition to teasing and bullying, cause girls to feel shame and isolate themselves.
“The girl who menstruates stays in a corner of the classroom or stays at desk until all classmates are gone because she does not want to be bothered by anyone,” said Hiwot Werka, grade 7.
Breaking the silence around menstruation and educating boys and men about this natural bodily function is seen as key by UNICEF to reduce harmful teasing. In schools, this includes male teachers’ awareness and sensitivity about MHM to ensure girls receive the support they need in school.
UNICEF Ethiopia’s MHM programme, funded by the Netherlands Government, began in 2016 and is piloting girl-friendly water, sanitation and hygiene (WASH) facilities in 96 schools across six regions. The facilities include more privacy, water for washing, safe spaces for girls to rest and change pads or clothes as necessary. The programme also developed and adapted educational material such as the Grow and Know booklet, a social and behavioural change tool which is being translated into local languages. The booklet targets girls, ages 10-14 years old and contains information on their changing bodies, including MHM.
A community-level component of the programme supports local women’s groups to produce reusable sanitary pads, which are sold to women and girls at an affordable price.
At the national level, UNICEF and partner agencies have worked closely with the Ministry of Health and Ministries such as Education and Women and Children’s Affairs to develop a national MHM guideline, which was also launched at the 30 May event. The guideline provides detailed guidance about the role of stakeholders in supporting women and girls with MHM. It also provides standards, for example regarding MHM kits for schools. The WASH Facilities in Schools construction manual is also being revised by the Ministry of Education to incorporate MHM facilities.
Through the initiatives described above, the aim of the UNICEF MHM programme is to improve girls’ attendance and retention in schools. By promoting understanding of MHM and finding solutions to the challenges faced by girls in schools, the unnecessary silence surrounding menstruation may be lifted. Including men and boys in the discussion is a vital aspect of equalizing opportunities and improving the future for girls.