Social Stigma and Taboos Related to Menstruation are Barriers for Change in the Community and School, Develop Logical Framework

Social Stigma and Taboos Related to Menstruation are Barriers for Change in the Community and School, Develop Logical Framework (LFA)

1. Social Stigma and Taboos Related to Menstruation are Barriers for Change in the Community and School, Develop Logical Framework Presented By: Mohammad Aslam Shaiekh

2. Contents Background Social stigma and Taboos related to Menstruation Social Stigma and Taboos: A Barrier for Change Logical Framework for MHM Recommendations 2

3. Background Menstruation is a natural biological process takes place every month for girls and women begins in between the age of 9-16 years and stops around 45-55years of age. 52% of women worldwide are in reproductive age and most of them are menstruating monthly. Every day, estimated 290,000 women and adolescent girls in Nepal menstruate (Scoping review and preliminary mapping of Menstrual health in Nepal) Still, the majority of them are not in conditions to take care of their menstruation in a hygienic manner . 3

4. Background Cont… The NDHS 2011 revealed that of the top ten SRH issues of concern identified by teenage girls, seven were menstruation-related One of the most extreme forms of menstrual seclusion practice in Nepal is Chhaupadi . Strongholds of Chhaupadi culture exist in the far western districts of Nepal, including Achham , Dailekh , Bajhang , Bajura , and Doti . However, the practice persists throughout the country 71.2% girls and women stay in Chhaupadi during menstruation in the Mid western and 15.5% in far Western (MICS-2014) Integrating MHM into programs for SRH and WASH is an important step in achieving SDGs 3 (Good Health and Well-Being), 4 (Quality Education), 5 (Gender Equality) and 6 (Clean Water and Sanitation). 4

5. Social Stigma and Taboos P ractice of Chhaupadi , isolating menstruating women in poorly ventilated menstrual huts/cowshed. Treated as uncleaned, impure , shameful and untouchables during menstruation period Restrictions on movement and normal life (like in kitchen , temple, Religious gathering, communal tap, water sources) Restriction in taking part in holy event and place, religious festival. Not allowed to bath using water from communal taps . 5

6. Social stigma and Taboos Discussion on menstruation at public as a matter of shy Not touching plants or male members of the family, purifying the bed on the fourth day of menstruation. Menstruation linked with sins Taboos associated with the food and nutrition 6

7. Discriminating Practice During Periods Source: CBS 2015 7

8. Major Barriers of Menstrual Hygiene in Community and School Limited knowledge Negligible Communications Poor Menstrual Hygiene and Disposal Practices Prevailing Social Norms and Restrictions (Temple) Lack of Social Supports. Myths and Misconceptions in the Society (Plant dry) Lack of access to sanitation facilities Limited and unskilled/untrained frontline workers 8

9. Barriers for Menstrual Hygiene : Socio-Ecological Model Social stigma and taboos exist at all levels thus change requires at all level: Public Policy: Ineffective implementation of the dignified menstruation policy, lack of multi-sectoral collaborations Community: Presence of social and Cultural taboos, Socio-economic factors for maintaining MHM Organizational: Non realization of absenteeism due to menstruation as a problem, Gender unfriendly school culture and infrastructure, representation of social and cultural taboos in institution 9

10. Barriers for Menstrual Hygiene : Socio-Ecological Model d. Interpersonal: less or no discussion on menstrual hygiene in family, restriction practice at home (family norms), Presence of social and cultural taboos, socioeconomic factors for MHM products. e. Intrapersonal (Individual): Scanty awareness about menstruation, poor attitude to help women during period, women unaware about MHHM, Link menstruation with sins. 10

11. Social Stigma and Taboos are Barrier for Community Change Social Stigma and taboos may affect directly and indirectly on following things which are basics of community development/Change Physical, Psychological and emotional state Gender inequality and Social inclusion Community participation and Entrepreneurship. Violation of Human rights, integrity, dignity, privacy and right to freedom abuse and violence Women and Girl Empowerment 11

12. Social Stigma and Taboos are Barrier for Community Change Regular and Continue education and other social opportunities Lower Socioeconomic status Right to dignity and respect Decision making structure Feeling of Insecure (Rape, snake bite) Impact on school and job attendance, and thus affects women’s economic 12

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14. Framework for Overcoming the Social Stigma and Taboos in Community for MHM Access to knowledge and Information on MHM Access to Safe Menstrual Absorbents Access to WASH Infrastructures Access to Safe Disposal of Absorbents Results in: Acceptance of Menstruation as a matter of natural biological process Dignity for girls and women Supportive family, community and Society Availability of trained and informed support for MHM Supportive Policies, guideline and Behaviour changes 14

15. Social Stigma and Taboos Related to Menstruation are Barriers for Change in the Community and School Logical Framework Goal: By 2022, Adolescent girls and women in Bajura district break away from the cultural of silence related to Menstrual Hygiene and Practice and have consistent access of Knowledge on MHM and support to address myths social stigma, taboos, restrictive perceptions and social norms Activities Output Outcome Objectively Varifiable Indicators Objective 1: Breaking the silence around Menstruation. Conduct orientation program for Sensitizing the men, women and adolescent about menstruation and triggereing them for behavior Change around taboos, stigma and myths related to Mensturations Men, families, communities informed and sensitive to menstruation, needs of women during menstruation Silence around Menstruation is Broken Reduced restrictions on girls and women during Menstruation Girls attending school during menstruation Arrange MHM stalls for Information sharing in school, college, community during different events, festivals Questions/queries around menstruation are answered for all Aware community on Menstrual health and hygiene, best practices and Restrictions on unhealth behaviours and practices in the community. Decrease in boys teasing girls during menstruation; Fathers willing to discuss menstrual matters 15

16. Objective 2: Easy access to appropriate knowledge about mensturation Training for counsellors Trained and informed resource available at all levels Easy access to information Availability of registered counsellors and depot holders Establishing counselling centres at all levels Counselling centres easily accessible at school and community level Share/consult and overcome / handle any situation related to menstruation without feeling shy or being ashamed Number of people approaching counselling centres; Entry in registers of depot holders and counselling centres Objective 3: Establishing Community strengthening system for MHM Formation of District Project Advisory Committee Functional DPAC and identification of priority areas Improved Knowledge, attitude and behavior related to SRH Increased coverage of SRH services utilizations Conduction of coordination meetings with stakeholders Proper coordination with stakeholders and resources identification at local level Improved health seeking behavior Relation an network building for addressing the agenda of MHM in a collaborative way Formation of Child Clubs, Girls student groups, etc Platforms to discuss the SRH and MHM related issues Improved capacity of such groups to deal with the issues of SRH and MHM Capacity building and development Selection of Local facilitators and orginize facilitator training Identified and trained local facilitators Improved capacity of facilators Skilledfull Human resources for managing the SRH and MHM Development of IEC/BCC materials based on local context Disseminated health messages and informed decision making Improved knowledge, attitude, perception, practices and behaviour of people towards MHM Behavior change and right practices for MHM 16

17. Peer Group discussion on social stigma and taboos related with menstruation Identified MHM relatedstigma and taboos rooted in the community, gaps and areas for improvement Decrease in beliefs upon the social taboos and stigma. Awareness about wrong perception and beliefs of people towards menstruation Assessment of School, public places with gender friendly infrastruture for WASH Identified functional WASH facilities with regular water supply and gender friendly structure. Increase in school enrollment and decrease in absentiesm in school. Education achievemnt Develop mobile apps and incorporate health messages       Objective 3: Girls and women make informed choice; providing access to wide range of MHM material procure menstrual absorbents or material (where pad production units are established) based on demand Supply delivery systems established/ Pad production units established and functional Easy availability and access to menstrual material/absorbents Material chosen are safe absorbents as also safely disposable 17

18. Objective 3: Girls and women make informed choice; providing access to wide range of MHM material procure menstrual absorbents or material (where pad production units are established) based on demand Supply delivery systems established/ Pad production units established and functional Easy availability and access to menstrual material/absorbents Material chosen are safe absorbents as also safely disposable Objective 4: Enabling easy access to safe disposal of used absorbents /menstrual material Installation of electric incinerators at schools, colleges and girls’ hostels Schools are equipped with safe disposal incinerators for used menstrual material Used menstrual material across the districts is safely disposed off Regular use of the incinerators and their operation and maintenance in schools and colleges Sensitizing communities about environmentally safe options for disposal of used menstrual material Communities use environmentally safe material and dispose it off safely Safe disposal of used menstrual material Absence of used menstrual material in trash ; abstinence of communities from disposing off in open places Setting up of sign boards near water bodies, fixing penalty for defaulters Sign boards announcing imposition of fines on defaulters People conform to agreed rules of safe disposal   18

19. Recommendations Empower community people, girls and women with knowledge about MHM through addressing the social stigma and taboos related menstruation. Increase parental/Family, community and Institutional support for Menstruating girls and women Ensure a supportive school environment for MHM. 19

20. References https :// sanitationandwaterforall.org/news/lets-discuss-menstrual-hygiene-management Menstrual Hygiene Matter, WaterAid Report-2012 Central Bureau of Statistics Report-2015 https://blogs.lse.ac.uk/southasia/2017/01/31/what-works-breaking-silence-on-menstrual-stigma-and-taboos/ Menstruation among Nepalese Adolescent girls: A Qualitative Study, Priti Koirala , Sona G.C . Perception and practices of menstruation restrictions among urban adolescent girls and women in Nepal: a cross-sectional survey Multi-Indicators Cluster Survey-2014 Scoping review and preliminary mapping of Menstrual health in Nepal The Nepal Demography Health Survey-2011 20