Menstrual Hygiene Management - Simavi
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photo: Jerry de Mars
Menstrual Hygiene Management
Simavi is an international non-profit Background
organisation working towards a world Simavi considers menstrual hygiene to be an important
in which basic health is accessible to aspect of its “basic health for all” goal. While menstruation
all. Our goal is to structurally improve issues and menstrual hygiene management have recently
gained attention in the global development agenda, there is
the basic health of 10 million people
a need to increase efforts to ensure that all girls and women
in marginalised communities in Africa
have comprehensive knowledge of menstrual hygiene and
and Asia by 2020. By doing so, we appropriate methods to manage their cycle.
enable them to build a better existence
and break the cycle of poverty. Our Around 26% of the world population consists of women
experience over the past ninety years of reproductive age (12-49). The majority of these women
has shown us that investing in water, menstruate between two and seven days every month.
sanitation and hygiene (WASH) and On average, a woman spends seven years of her life
in sexual and reproductive health and menstruating: menstruation is a natural and essential part of
rights (SRHR) is vital for people to be the reproductive cycle.
able to lead a healthy life. Therefore
we concentrate our efforts in these two However, in most parts of the world it remains a taboo
subject that is rarely discussed. These taboos and social
areas.
norms restrict the participation of women and girls in
All our programmes are based on society during menstruation. For example, in some cultures
women and girls are told that they should not bathe during
three integrated pillars: 1) Empower
their menstrual cycle (or they will become infertile), touch
communities to demand quality
a cow (or it will become infertile), look in a mirror (or it will
services and to practice healthy lose its brightness), or touch a plant (or it will die). These
behaviour; 2) Create a supportive, taboos result in women and girls being unaware of what
enabling environment in which all happens in their bodies during menstruation (and the rest
stakeholders are aware of their roles of the reproductive cycle), leading to ignorance, shame and
and responsibilities, work together and distress.
can be held accountable; 3) Ensure that
people use affordable, suitable and In addition, limited access to clean water, proper sanitation
sustainable WASH and SRHR services. facilities and sanitary napkins make it difficult for women to
This is the core of our Theory of manage their menstruation hygienically. As a result, many
Change – it’s designed to ensure that (young) women around the world face considerable physical
and social challenges during their menstruation period.
everyone involved, from community
to governmental level, works
together towards realising sustainable
improvement of basic health.
E. info@simavi.nl
www.simavi.org
The Simavi Approach
Simavi believes that solutions for menstruation Simavi therefore sees Menstrual Hygiene
issues are vital in ensuring basic health for women Management (MHM) as relevant to both
and girls around the world. Challenges faced by its WASH and SRHR programmes. Existing
MHM programmes often focus on WASH,
girls and women during menstruation are related meaning that interventions are targeted
to: 1) lack of proper (use of) water, sanitation towards improved access to water and
and hygiene facilities; 2) limited knowledge of sanitation facilities for girls and women (at
menstrual hygiene and appropriate solutions to schools and in the community) and increasing
awareness on hygiene during menstruation
cope; and 3) taboos which stigmatise women (timely change of cloths and pads, (hand)
during menstruation. washing, and proper washing and drying
of reusable pads or cloth). The impact of
these interventions can be strengthened by
integrating a SRHR approach and including
activities focused on raising awareness and
addressing taboos and existing gender
norms.
Theory of Change
By addressing Menstrual Hygiene, Simavi
contributes to improving the health
and rights of women and girls. In our
programmes we work on the three pillars of
our theory of change:
1. Create awareness on sexuality,
reproductive cycle and menstrual hygiene
among girls, women and men in order
to empower women to take care of
themselves during their menstruation, self-
develop and live a healthy life.
Girls and women often have a limited
understanding of menstruation and hygiene
management. Due to a lack of education or
information, most girls are not prepared for
their first menstruation therefore struggle to
manage bleeding. Empowering women and
girls to better understand menstruation and
hygiene management is therefore crucial to
improving their health and wellbeing during
menstruation.
2. Create a supportive environment, in
which menstruation is socially accepted and
photo: Jerry de Mars
women are not excluded or discriminated
against because of their monthly periods.
It is not only women who lack understanding
on the issue of menstrual hygiene. In many
E. info@simavi.nl
www.simavi.org
countries menstruation is not seen as a sign of reproductive Case Making periods normal
health and womanhood rather bodily excretions are India, 2014 - 2017
regarded as pollutants. Traditional values associate
menstrual blood with impurity and menstruation is seen as Together with Rutgers WPF and Women
taboo and is not openly discussed. Particularly problematic on Wings, Simavi designed a programme
is the fact that men lack understanding of menstruation, but to improve the health and dignity of Indian
as the traditional decision makers in both households and women and girls. 600,000 women will
the wider community, are mostly responsible for household be educated on menstruation and the
importance of proper hygiene, In addition,
finances. Creating an enabling environment for women in the
200,000 men and boys who will also be
household, community and social environment at large, is
educated about the subject. These education
therefore crucial in tackling menstrual hygiene issues. sessions are integrated in broader awareness
raising on sexual and reproductive health.
3. Improve access to services, such as sanitary pads and This way we will work on breaking down
SRHR services, as well as sanitation facilities and clean taboos on menstruation.
water.
Furthermore, we work on producing
Essential services for managing menstrual bleeding are often disposable sanitary pads for rural girls and
poor or non existent. The lack of proper sanitary facilities, women. By setting up a locally run production
including clean water and the necessary provisions for the line using simple, easy to operate machines,
sanitary pads are made available to 165,000
management of bleeding, influences women’s hygiene
women and girls. In total 10 production
during menstruation. Poor hygiene management can cause
units will provide jobs to 800 women. Local
infection and jeopardise women’s sexual and reproductive women are trained to sell the pads in their
health. Instead of sanitary pads, the majority of women in own communities. This way, our approach
Africa and Asia use old cloth or other absorbent materials does not only breakdown taboos and make
to manage their bleeding. These cloths can leak and thus women’s lives healthier, it also empowers
create discomfort. It is essential that the cloths are clean, women as they are able to work and earn
washed with soap and dried in the sun to prevent bacterial an income. This programme also lobbies for
growth. However, women feel ashamed and are taught not the construction and maintenance of sanitary
to hang their cloths to dry in public spaces. Consequently, facilities in schools.
many women use dirty, wet, cloths that seriously increase
the occurrence of vaginal rashes and urinary tract infections.
Affordable, suitable and sustainable sanitary services, Case Unite for Body Right
including sanitary pads or other solutions, are essential in programme
overcoming issues around menstruation. Bangladesh, 2011 - 2015
photo: Jerry de Mars
This programme, implemented by Simavi
and RutgersWPF, has three main pillars:
comprehensive sexuality education; delivery
of health services; and the creation of an
enabling environment. Over the course of 5
years, the programme will reach out to more
than 1,500,000 young people.
Menstrual hygiene is an integrated part of
the comprehensive sexuality education that
is implemented in local schools. A booklet
on menstrual hygiene was developed for
both boys and girls. Our five local partners
also cover health issues related to menstrual
hygiene in the services they offer from clinics
and hospitals. In addition, we lobby for the
implementation of comprehensive sexuality
education in the school curriculum.
Several of our partners are also piloting
different ways to distribute sanitary napkins.
One partner teaches women to make and
sell re-usable napkins. Other partners have
photo: Jerry de Mars
agreements with existing sanitary napkin
producers to deliver napkins at a reduced
price. These napkins are distributed through
schools and clinics.
E. info@simavi.nl
www.simavi.org
Important characteristics
Having access to reusable and/or disposable sanitary pads is Case Creating an enabling
important for women to feel comfortable during their period. Environment for WASH
Although the use of reusable and/or disposable pads is
Bangladesh, 2011-2015
preferable, not every woman is able to access these options.
The main aim of this programme,
Therefore, Simavi not only promotes the use of pads, but also implemented by Simavi and Wateraid
focuses on awareness and education on hygienic practices Bangladesh, is to create an enabling
when using traditional methods such as cloth (i.e. washing environment in regards to local WASH
with soap and drying in sunlight and disposal). Depending policies, with a focus on making menstrual
on the social and cultural context and availability, the use of hygiene management an integrated part of
other solutions such as the moon cup can be explored as well. these policies.
In addition, Simavi seeks innovative solutions and Lack of awareness and social taboos appeared
partnerships with the private sector to make disposable are significant factors contributing to health
complications in young girls when they reach
sanitary pads available to Bottom of the Pyramid (BoP)
puberty. Therefore the programme stresses
women. We strive for sustainability in our programmes, e.g. the need for open, in-depth discussions
social business models that can are sustainable without (long on menstruation. These break the silence
term) funding. surrounding the issue, raise awareness
amongst adolescent girls and avert health
We also take environmental impact into consideration when hazards.
implementing menstrual hygiene management; we are
looking into the creation of a biodegradable napkin and Besides raising awareness, the programme
trying to find solutions for discreet and sustainable waste emphasizes the importance of arranging
management. separate toilets for women at all educational
institutions, health centres, workplaces and
public places. These must have soap, a bin
Impact with a lid, and other necessary materials for
With our combined WASH and SRHR approach on MHM women. The programme creates an enabling
we improve access to WASH facilities and sanitary napkins, environment for local girls and women to
increase, knowledge and build an enabling (social and demand these services from the government,
cultural) environment. This leads to a sustainable change private sector and NGOs.
in health and overall wellbeing of women and girls of
reproductive age – an important step towards basic health.
Case Rwenzori WASH Alliance,
Integrated School WASH
programme
Uganda, 2011 - 2014
This programme aims to improve the
hygiene and sanitation situation for 17,940
beneficiaries in 24 primary schools by
promoting desirable hygiene practices
and appropriate sustainable sanitation
technologies in a gender responsive manner.
Menstrual hygiene management is an
integrated aspect of the WASH programme
and is addressed through training and
awareness raising activities. Women are
trained to raise awareness on menstrual
hygiene among women in their communities.
Awareness raising sessions are held in
health centers and schools. Messages on
menstrual hygiene management are also
broadcasted through radio plays. In addition,
the programme invests in local production
photo: Jerry de Mars
and distribution of re-usable sanitary napkins
called RUMPS. Women and girls are trained
to make the napkins to create a livelihood for
themselves.
E. info@simavi.nl
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