Applied Menstrual Hygiene Management through the Context of Rural Nepal

Applied Menstrual Hygiene Management through the Context of Rural Nepal Research Proposal

By Jaleigh Jensen

Overview of global understanding of MHM The importance of Menstrual Hygiene Management (MHM) is evident not only in a woman’s physical health but also her psychological and emotional well-being. Likewise, inability to effectively manage menstruation affects her overall quality of life.

According to UNICEF, basic Menstrual Hygiene Management is lacking in nearly half of the global population. And as reported by the Ministry of Health in Nepal, less than half of adolescent girls have adequate knowledge about menstruation and only one in ten practices improved menstrual hygiene.

So, it is either half of the population that has to change or services for half of the population have to change. And if we cannot change women’s bodies, we must be working towards changing services.

Because while much has been done to research the importance of MHM in Water Sanitation and Hygiene (WASH) programs in the global south, I have found that the biggest gap is making these services applicable and actionable.

This is a proposal for a project that encompasses the lack of understanding of MHM but explores the practicality of applying this in the context of rural Nepal.

Nepal’s existing gaps and challenges in applying MHM Sustainable Development Goal 6.2 outlines MHM as an “advanced� service in Hygiene and Sanitation education, as if menstruation is a choice not a naturally occurring process. This shows that women and their stories are not at the forefront of the policy being shaped in this issue that only affects women. Women should absolutely be the leading voice in these conversations, telling their own stories and creating change for themselves. And above everything, this is the fundamental gap in understanding and application of MHM. And with this, poor sanitation facilities and a lack of adequate water supply have exacerbated poor menstrual hygiene among adolescent girls. Because without an improved water source and access to safely managed water, people cannot effectively apply MHM in their daily lives.

And this challenge is alive and well in Nepal. According to WaterAid, 38% of households in Nepal did not have a toilet in 2011. In 2015, only 46% of the population had access to improved sanitation facilities. (Galli, 2017). And currently, only 28% of public schools in Nepal have separate facilities with toilets for girls (Galli, 2017). This means that two million adolescent girl students do not have access to a toilet at school. Subsequently, without an improved water source or locks on toilet doors to maintain privacy, girls in rural Nepal usually do not go to the toilet while at school and most do not even go to school during menstruation (Galli, 2017).

The lack of affordable hygienic products and facilities is often compounded by cultural attitudes that view menstruation as shameful or dirty. As a result, many women and girls are excluded from aspects of social and cultural life, including religious activities. Data shows that nine out of ten girls face some restriction during menstruation (Galli, 2017).

Chaupadi, for example, is the traditional Hindu practice of banning women from entering their households during menstruation primarily in rural, western Nepal. This leaves women to stay in animal sheds, vulnerable to disease and violence. And while this practice was outlawed by the Nepali government in 2004, the long-lasting effects are still present (Pulitzer, 2018).

So how do we remain culturally sensitive to the taboos around menstruation while also promoting behavior change? How do we put women at the forefront of this research? What can be done to promote personal MHM? How do we implement better strategies in schools and communities?

How I will continue current work and research to minimize gaps in understanding I am currently living in Nepal working with Wine To Water, a non-profit organization operating with a commitment to support life and dignity for all people through the power of clean water.

Our work began in Nepal in response to the 2015 earthquake. While this tragedy destroyed so much of this beautiful country, it awakened something powerful in us. Thousands of filters were implemented and thousands more gained access to clean water in a major time of crisis.

This large-scale relief effort was a massive step for Wine To Water—but more importantly-- we learned that through the connections we made in communities here, we could implement lifechanging systems that would put our programs in an entirely new trajectory.

Since, we have implemented a holistic WASH program in numerous communities in the Chitwan District through collaboration with the Madi Municipality. By focusing on building relationships, we’ve sustainably impacted 40,000 people with clean water-- but we know that our work goes deeper than any well ever could.

In researching WASH initiatives to continue bettering our program, a passion for Menstrual Health and Hygiene Management surfaced inside of me. With this research, I want to continue working with the people of Madi to implement programs that will truly revolutionize this water crisis, this female crisis—this human crisis.

I want to partner with Roshani Karki Sapkota, Wine To Water National Program Manager in Nepal, to shape an applicable program that promotes cultural interventions in promoting mental, physical and psychological empowerment for women of all ages in Nepal. Like my existing role in the W|W fellowship, want to support her as a leading agent in creating this applied program.

In building off Wine To Water’s current initiatives of improved water sources and safely managed water, this research will work in conjunction of Wine To Water’s current WASH consortium partnership with the Madi Municipality to provide improved water sources and WASH resources to 33 schools. And through working actively in the existing relationships we have with these communities, we will encompass participatory research in this Through participatory research in communities that have access to an improved water source, I will seek to promote dignity and respect along with education with this applicable program.

And above all, I will empower women to tell their stories and keep them at the heart of this research of applied menstrual health management in rural Nepal.

Sources Galli, K. (2017). Scoping Review and Preliminary Mapping of Menstrual Health in Nepal. Maverick Collective. Retrieved from http://maverickcollective.org/wpcontent/uploads/2017/06/Scoping-Review-and-Preliminary-Mapping-of-Menstrual-Health-inNepal.pdf Primary resource—most comprehensive analysis of the need for MHM Government of Nepal. (2011). Sanitation and Hygiene Master Plan. STEERING COMMITTEE FOR NATIONAL SANITATION ACTION. Retrieved from http://washinschoolsmapping.com/wengine/wp-content/uploads/2015/10/NepalGovernment-Sanitation-and-Hygiene-Master-Plan.pdf Pulitzer, Joseph. “Chaupadi: Nepali Women's Monthly Exile.” Pulitzer Center, 19 Aug. 2015, https://pulitzercenter.org/projects/nepal-cultural-practice-women-childbirth-maternalmortality-chaupadi WaterAid (2018). Menstrual hygiene matters | WASH Matters. Retrieved from https://washmatters.wateraid.org/publications/menstrual-hygiene-matters WSSCC. (2017). Master Training of Trainers on Menstrual Hygiene Management Nepal & Pakistan. WSSCC. Retrieved from https://www.wsscc.org/wp-content/uploads/2017/04/Nepal-MHMToT-Report-Final-2017.pdf.