Improve Menstrual Hygiene and Eliminate Myths, Taboo, Beliefs and Social Restriction related to Menstrual Cycle.

Project location: India, Sagar
Project start date: May 2017 - Project end date: April 2018
Project number: 2017-015
Beneficiary: Manav Vikas Seva Sangh

The project is mainly introduced in the remotest area of Sagar district of Madhya Pradesh State in India. It is an intervention to improve mentrual hygiene and eliminate myths, taboos related to menstrual cycle in the targeted area. Menstruation is a natural and regular occurrence experienced by nearly all women of reproductive age.

They lack access to information, products and infrastructure needed to comfortably manage menstruation. Girls’s and women’s health, well-being, and rights are compromised when they must isolate themselves from their families: avoid work, community activities, or school: and face risk to their physical safety because of their basic biology. Adolescent girls are especially vulnerable to negative outcomes related to menstruation, including effects on their overall self-esteem and confidence.

In India even mere mention of the topic has been a taboo in the past and even to this date the cultural and social influences appear to be a hurdle for advancement of knowledge on the subject. Culturally in many parts of India, menstruation is still considered to be dirty and impure.
It is pertinent to follow a strategic approach for combating the myths and social taboos associated with menstruation in order to improve the reproductive health of adolescent girls and women. The first and foremost strategy in this regard is raising the awareness among the adolescent girls related to menstrual health and hygiene.
Low cost sanitary napkins can be locally made and distributed particularly in rural and slum areas as these are the areas where access to the product is difficult.
Thus, it is becoming clear that multi-sectoral approaches are needed.

General study towards MHM: Attainment of menstrual hygiene always remained challenging; there are certain obstacles in attaining the same; absolutely cultural taboos and restrictions, practices, limited access to information and supplies and related myths and infrastructure are of those and this myths, restrictions, taboos and information differ place to place, area to area, culture to culture and society to society which needs to be studied to tackle down effectively. In this regard we would take a study of target population to get the deep insights and formulate strategy in accordance to handle the local beliefs. This would also help us in preparing the IEC material and attainment of the project goal effectively.

Awareness on MHM: To combat weak menstrual hygiene practices and battle RTIs, UTIs and other women related issues, women and adolescent girls has to be educated on menstrual hygiene management practices in order to confine the infections and ensure healthy women’s life. The awareness camps would comprise of general dialog with women and girls, instruction by resource person (Gynaecologist) and audio/visual presentation on how RTIs, UTIs and other diseases take place due to unhygienic practices and how it affect women’s personal routine and social life. The awareness sessions would include role pays and some recreational activities to take women into faith and confidence.

Addressing myths, taboos and social restrictions: Research studies and our general studies of the project area show that several myths, taboos and social restriction such as not to cook, not to enter into kitchen, not to do religious activity, not to attend school, not to attend social and cultural events, not to work, not to go before male, not to bath and many more differs place to place, region to region, society to society which disable women and adolescent girls for socialization and live a restricted life, that all the issues will be studied and addressed in a logical way through awareness camp, counselling, IEC and print media etc.
Exposure of production units: Women SHG members whoever involved in production process would be taken to the place where the production and distribution of sanitary napkins are already going on. This would assist women in confidence building and learning production processing.

Production of SNs: Production of the Sanitary Napkins would only be done by the women SHG members both of the selected villages. The selection of the women SHG would be done on the basis of following parameter.

• Central village; means production village has to be central village in terms of connecting or has maximum number of adjoining villages.
• Priority would be given to village having maximum population.
• Well functioning SHG and members having close coordination.
• SHG members should agree on terms and conditions.

Supply of SNs: To supply sanitary napkins to the end user, existing SHG would be employed as the authorized sells unit on marginal commission basis. This margin incurred by SHG would be treated as the additional income of the group. A school level selling point will also be set up with the help of Kishori groups and female teacher and margin incurred through selling of the SNs would be for the welfare of school going girls only.
Referral linkages: To hold up problem facing women and adolescent girl, referral linkages will be done so that women and girls could get timely treatment and counseling. For this we would sign a contract of services on yearly basis with a Gynecologist.

SPECIAL COMPONENT OF THE PROJECT

Preparation and Distribution of IEC material kits: For better reach and impact of the project, we will prepare IEC material kit with the help of specialists consisting of menstruation biology, menarche, MHM practices, Introductions of RTIs, UTIs, Anemia and other related issues their causes and preventive actions with suitable pictures. These IEC materials will defiantly individuals in understanding the concern in detail, IEC kits will also be given to local health worker it would add value to their knowledge. We will also add Myths, taboos and social restriction existing in the society and how that customs affect badly to the women’s social and personal life.
24*7 assistance service: Sensing the lack of information and sources of information on menstrual hygiene among the rural girls and women a 24*7 telephonic service may help rural women and girls greatly. We may arrange a 24*7 (telephone/mobile) service, handled by female member only. This would help women and girls appropriate and timely solution to their problem.

4.3 METHODOLOGY:

Project village entry: The village entry consists of a multiple activities which will go hand in hand; first step in village entry will be informal contact to the local health worker, existing women CBOs, active village women and girls and school teachers for first formal meeting. This first formal meeting would be a way of future communication. In this meeting we will convey the objectives and activities of project to participants so that assistance of them could be right placed. With the help of the participants MVSS will prepare village wise action plane and activity schedule meanwhile through this meeting we will gather village level information so that available resources could be utilized.

Partnering the with district/block level health and education department: Respective health and school education department will formally briefed about our intervention and we together look up on the possible cross functional coordination for greater impact. Through this collaboration we will be able to exchange knowledge and best practices to bring the desired change among the community women.
Project staffing: Skilled, competent, suitable and experienced female staff will be employed through recruitment and selection process. A required manual for individual roles and responsibility will be prepared so that work allocation could be done effectively. This team will be responsible to implementation of entire project under the supervision of MVSS project manager and constituted PIMC. Before the field level intervention staff will be trained along with project orientation and goal setting.

Appointing resource person: MVSS will be appointing a female resource person (gynaecologist) to address biological aspects of the menstruation. This would also be encouraging for the rural women and girls in accepting the change. We would also appoint the same person as the chief counsellor for problem facing women and adolescent girls.

Field operations: Field operations include addressing the poor menstrual hygiene practices, existing social restrictions, taboos and myths related to MCs which disables women and adolescent girls for socialization and discourage them and to do this community and school level awareness and training camps will be organized.

Strengthening community/health workers: Strengthening community/health worker will go simultaneously to field operations. Gaps will be identified while the field operations and would be addressed with the help of health department and MVSS itself. Different kind of trainings and workshops for capacity building will be arranged on women health issues.

Production of SN: The production and operation will include selection of SHG for SN production, setting up production units, training of SHG members on production, packaging, inventory control, account keeping and cash flow etc.

Distribution of SN: Sanitary pads will be distributed through SHG and at village level and through schools at school level. For this we will follow a SHG selection process and train them on inventory control, placing order to production unit account management and cash flow etc. we will also teach them promotion strategies for safe disposal and effective MHM practices.