Hygiene Management requirements for women.ppt

this presentation covers a vast aspects of female health hygiene including with emphasis to all the related taboos around the world related to feminine hygiene

1. Menstrual Hygiene Management
Menstrual Hygiene Management
1
Naomi Radke, seecon international GmbH

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Contents
1.Introduction
2.Beliefs, Myths and Taboos
3.Menstrual Hygiene, Human Rights and MDGs
4.Health Risks of Poor Menstrual Hygiene Management
5.Menstrual Hygiene Management: Hardware
6.Menstrual Hygiene Management: Software
3

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Menstruation
52% of women worldwide are in reproductive age and most of them
thus are menstruating monthly.
Still, the majority of them are not in conditions to take care of their
menstruation in a hygienic manner or are impaired by it.
Menstruation is supposed to be invisible and silent.
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1. Introduction
Source: KJELLEN ET AL. (2012)
Source: http://www.mcmaster.ca/museum/Exhibitions_Fierce.html[Accessed:
07.08.2013]

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Harmful restrictions
In some cultures, women and girls are told that
•During their menstrual cycle they should not bathe (or they will
become infertile)
•Touch a cow (or it will become infertile)
•Look in a mirror (or it will lose its brightness)
•Touch a plant (or it will die)
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2. Beliefs, Myths and Taboos
Young women chatting
about menstrual issues.
Source: UNICEF (2008)

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Other restrictions
6
2. Beliefs, Myths and Taboos
Restrictions on girls during their menstrual
period in Afghanistan, India, Iran and
Nepal. Source: (HOUSE et al. 2012).

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Relieving restrictions
Women may appreciate the ‘banishment’ to menstrual huts as
they are given a rest period from the normal intensity of daily
chores.
7
2. Beliefs, Myths and Taboos
Zulu menstruation hut.
Source: RINDSTAD (2013)

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Parental Education
Education by parents about reproductive health, sexuality and
related issues is often a no-go area leading to a low knowledge and
understanding on these issue
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2. Beliefs, Myths and Taboos
Source: http://phil2100dsu12a.wordpress.com/2012/07/10/abortion-the-solution-is-viability/[Accessed: 07.08.2013]

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Lack of facilities and sanitary products (1/2)
... Can push many girls out of school.
Relationship between menstrual hygiene and school drop-out of girls
from the higher forms due to lack of facilities, affordable sanitary
products, fear of bloodstains and more.
Millenium Development Goal (MDG) 2: Achieve universal primary
education
Participation of girls especially in Africa and Asia lags far behind
the boys’ in higher forms of primary education
Millenium Development Goal (MDG) 3: Promote gender equality and
promote women
The lacking behind in primary education to not providing
adequate facilities and sanitary products infringes gender equality
and the promotion of women
9
3. Menstrual Hygiene, Human Rights and MDGs

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Lack of facilities and sanitary products (2/2)
Stigma around menstruation hurts human rights, especially human
dignitybut also the right to non-discrimination, equality, bodily
integrity, health, privacyand the right to freedom from inhumane
and degrading treatmentfrom abuse and violence.
10
3. Menstrual Hygiene, Human Rights and MDGs

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Health risks
•Poor protection and inadequate washing facilities may increase
susceptibility to infection
•In case of female genital cutting: blockage and build-up of blood
clots is created behind the infibulated area: pain, additional
infection risk
•Risk of infection higher than normal during period as the blood
forms a pathway into the uterus
11
4. Health Risks of Poor Menstrual Hygiene Management

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Inappropriate hygiene practices (1/3)
Certain practices are more likely to increase the risk of infection
e.g. using unclean rags. Inappropriate practices often due to the
non-affordability of sanitary products for poor women.
Findings from Bangladesh:
•80% of factory workers are women
•60% of them were using highly chemically charged rags from the
factory floor for menstrual cloths
•Infections are common, leading to 73% of women missing work for on
average six days a month
•Women had no safe place either to purchase cloth or pads or to
change/dispose of them
•When women are paid by piece, those six days away present a huge
economic damage to them but also to the business supply chain
12
4. Health Risks of Poor Menstrual Hygiene Management

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Inappropriate hygiene practices (2/3)
13
4. Health Risks of Poor Menstrual Hygiene Management
Source: HOUSE ET AL. (2012)
•Unclean sanitary pad materials (local infections/bacteria can
travel up the vagina and enter uterine cavity)
•Changing pads infrequently (skin irritation by wet pads)
•Insertion of unclean material into vagina (easier infection , also
of uterine cavity)
•Using highly absorbent tampons during light blood lossor no
menstruation (toxic shock syndrome, vaginal irritation)

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Inappropriate hygiene practices (2/2)
14
4. Health Risks of Poor Menstrual Hygiene Management
Source: HOUSE ET AL. (2012)
•Wiping from back to front following urination or defecation
(bacteria can travel easier into vagina)
•Unprotected sex (increased risk of sexually transmitted
diseases)
•Unsafe disposal of used sanitary materials or blood (risk of
infecting others with diseases)
•Frequent douching (forcing liquid into vagina can introduce
bacteria into uterine cavity)
•Lack of hand-washing after changing a sanitary towel (can
spread infections)

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Sanitary protection materials (1/4)
It is critical that any programme aiming to support women or girls
with sanitary protection materials involves them in the planning
discussions and decisions about the options to be supported.
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5. Menstrual Hygiene Management: Hardware
Schoolgirls participating in a
menstrual cup project.
Source: APHRC (2010)

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Sanitary protection materials (2/4)
Disposable sanitary towels
•In resource-poor settings often
very expensive and hard to
dispose of
•Often difficulty of proper
disposal (generates solid waste)
•But reduce barriers of girls
staying at school
16
5. Menstrual Hygiene Management: Hardware
Source: HOUSE ET AL. (2012)

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Sanitary protection materials (3/4)
Cloth or cloth pads
•A sustainable sanitary option,
but it must be hygienically
washed and dried in the
sunlight (natural steriliser)
•But shame of drying the clothes
outside, so often hide them in
damp unhygienic places
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5. Menstrual Hygiene Management: Hardware
Locally made reusable cloth
pads and cloth in Kenya.
Source: HOUSE ET AL. (2012)

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Sanitary protection materials (4/4)
Menstrual cup
•New technology appropriate for poor women and girls
•Cup made of medical silicone rubber that is inserted into the
vagina to collect menstrual blood
•Removed and emptied less frequently than sanitary pads
•Needs to maintain a high standard of hygiene especially during
insertion, removal and general cleaning
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5. Menstrual Hygiene Management: Hardware
Menstrual Cup by The
Moon Cup (UK).
Source:
http://www.mooncup.com/photographs.
html[Accessed: 07.08.2013]
Instructions for menstrual cups.
Source: RUBYCUP (2013)

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Sanitary protection materials –advantages/disadvantages (1/2)
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5. Menstrual Hygiene Management: Hardware
Sanitary protection
option
Advantages Disadvantages
Naturalmaterials(e.g.
mud,cowdung,leaves)
Free
Locallyavailable
Highriskofcontamination
Difficultanduncomfortabletouse
Stripsofclothes Easilyavailableinthe
localmarket
Re-usable
If old cloths are not cleaned well they
can become unhygienic.
Usersneedsomewhereprivate,witha
watersupplyandsoap,towashand
drythecloths.
ToiletpaperortissuesEasilyavailableinthe
localmarket
Loses strength when wet and can fall
apart.
• Difficult to hold in place.
•Maybetooexpensiveforthepoorest
users
Re-usablepads Available locally or on the
internet
Income generation
opportunity, if locally
made
Costeffectiveasarere-
usable
More environmentally-
friendlythandisposable
pads
Users need somewhere private, with a
water
supply and soap, to wash and dry the
pads.
Cost is prohibitive to many potential
users, if commercially produced
Source: HOUSE ET AL. (2012)

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Sanitary protection materials –advantages/disadvantages (2/2)
20
5. Menstrual Hygiene Management: Hardware
Sanitary protection
option
Advantages Disadvantages
Tampons Convenientandcomfortable
touse
Not available in many contexts.
Cost is prohibitive to any potential users.
Generates a lot of waste to dispose, not
environmentally-friendly.
May not be culturally appropriate,
particularly for adolescent girls, as need to
be inserted into the vagina.
Hygiene and availability of water and soap
for hand-washing are particularly important,
as need to be inserted into the vagina.
Menstrualcups Re-usable
Onlyneedemptying,washing
anddrying
May not be culturally appropriate for use,
particularly for adolescent girls, as need to
be inserted into the vagina.
Hygiene and availability of water and soap
are particularly important, for washing
hands and menstrual cup, as need to be
inserted into the vagina.
Expensive first investment outlay.
Panties/Underwear Useful for keeping a sanitary
product in place.
•Goodforkeepingthevaginal
areahygienic.
Costmaybeprohibitivetopotentialusers.
Cheapelasticcanwearoutrelatively
quickly.
Source: HOUSE ET AL. (2012)

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Sanitary infrastructure
Absence of cleanand private sanitation facilities that allow for
menstrual hygiene may discourage girls from attending
school when they menstruate.
•Menstrual hygiene: e.g. lockable toilets, closed bin for
sanitary item disposal, sink for hand washing and cleaning of
clothes (both inside toilets)
•1 in 10 school-age African girls do not attend school during
menstruation or drop out, due to this absence
•Teachers’ instruction time in school will be reduced by 10-
20%
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5. Menstrual Hygiene Management: Hardware
To manage menstruation
hygienically, it is essential
that women and girls have
access to water and
sanitation
Source: HOUSE ET AL. (2012)

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Disposal
•If lack of opportunities, dispose secretly and easily: thus on
defecation field, river or garbage dump
•Blocking toilets/filling up pits
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5. Menstrual Hygiene Management: Hardware
Disposing of non-biodegradable sanitary pads in
pit latrines leads to quick filling and thus
shortened service of the pit. Source: HOUSE ET AL. (2012)

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Education
•Education and information (in combination with hygiene and sex
education) empowers women and girls with factual information
about their bodies and how to look after them
•Teachers are rarely trained in teaching menstrual hygiene and
consequently rarely teach it; male teachers may feel cultural
norms forbid them
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6. Menstrual Hygiene Management: Software

24. Menstrual Hygiene Management
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Further software. Awareness Raising
•Promoting good practices for Menstrual Hygiene Management:
-How to capture the blood
-How to dispose of the cloth, pad, cotton
-How to keep yourself clean during the period
-How to manage the stomach pain from your period
-For an overview see Table 1.6 (p. 39, HOUSE et al. 2012)
•Community-wide approaches that include boys and men
(Physical barriers are often connected to social barriers. Social
barriers have to be overcome!)
•Integrate Menstrual Hygiene Management into a wider hygiene
promotion approach on Water, Sanitation and Hygiene including
risks and good practices
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6. Menstrual Hygiene Management: Software

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Example of promoting menstrual hygiene management:
Mother’s Day -Zambia
Mother’s day: one day off work per month.
Silent belief that this day was thought for a day of relief whilst
having menstruation.
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6. Menstrual Hygiene Management: Software

26. Menstrual Hygiene Management
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KJELLEN, M., PENSULO, C., NORDQVIST, P., FOGDE, M. (2012):Global Review of Sanitation System Trends and
Interactions with Menstrual Management Practices. Report for the Menstrual Management and Sanitation Systems
Project. Stockholm: EcoSanRes, Stockholm Environmental Institute (SEI). URL:
http://www.irc.nl/docsearch/title/180836[Accessed:05.08.2013]
HOUSE, S.; MAHON, T.; CAVILL, S. (2012): Menstrual hygiene matters. A resource for improving menstrual hygiene
around the world. London: WaterAid. URL:
http://www.wateraid.org/what%20we%20do/our%20approach/research%20and%20publications/view%20publication?id=0
2309d73-8e41-4d04-b2ef-6641f6616a4f[Accessed:05.08.2013]
RINDSTAD, S. (2013): Symbolic Meaning of Menstruation. Available at:
http://pub209healthcultureandsociety.wikispaces.com/Symbolic+meaning+of+menstruation+across+different+cultures+
and+perspectives[Accessed:07.08.2013]
RUBY CUP (2013): http://www.ruby-cup.com[Accessed: 08.03.2013]
UNICEF (2008): Sharing simple facts. Useful information about menstrual health and hygiene. New York: United Nations
Children's Fund (UNICEF). URL: http://www.unicefiec.org/document/sharing-simple-facts-useful-information-about-
menstrual-health-and-hygiene-booklet-english[Accessed: 08.03.2013]
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References

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