MENSTRUAL HEALTH MANAGEMENT
1. THE CHALLENGE
Menstrual Health Management (MHM) in underserved communities face two primary issues - stigmas surrounding MHM resources and the lack of resources overall. Through extensive literature review and preliminary field research, Project Kilimanjaro found that Menstrual Health Management is a growing concern in the field of women’s health and within underserved communities around the world. As commonality that connects many women across the world, we hope to target the biological process that is most prominently stigmatized. In a report on current conditions of Menstrual Health Management in East and Southern Africa by WoMena and the UNFP, a non-governmental organization, evidence displayed that “shame, stigma, and misinformation surrounding menstruation are contributing to serious human rights concerns for women and girls.” By understanding the differences and similarities between the methods that women currently use to address menstrual hygiene, we can work to increase accessibility to culturally catered resources and education programs.
According to the United Nations Population Fund, when girls hit puberty and begin menstruation, they stand by and watch as their opportunities disappear. Menstruation is unfortunately considered to mark the start of restrictions to their mobility and behavior.
“My aunty told me I should stay away from boys,” a 16-year-old girl in Zambia told UNFPA.
“I want to study but the boys started bothering me,” a 13-year-old in Madagascar said.
When young girls begin menstruating it is often misconstrued as a sign that they are ready for sexual activity or marriage, leaving them vulnerable to child marriage, sexual violence, an interrupted education, and being ostracized.
Through extensive literature review and preliminary research, our team noted four groups of women from underserved communities in Tanzania and India that faced issues with education, accessible resources, and sanitation surrounding menstrual health management.
Women from Indigenous Populations
Women in LMICs
Women that identify as trans/non-binary
Women with intellectual disabilities
Lack of MHM resources and education has been determined to be a human rights issue by UNICEF and can be exacerbated by limited clean water and WASH infrastructure that generally supports menstrual hygiene resources in public spaces. Social stigmas and taboos play a large role in the way that menstrual hygiene resources are received in a variety of different communities; however, were prominently seen in indigenous communities in Tanzania and India due to lack of accessible information surrounding proper menstrual health and hygiene management. The Tamil Nadu Urban Sanitation Support Programme (TNUSSP) reported that 84% of the young women interviewed were taken by surprise at their first period. It was reported that over 30% of the participants in North India dropped out of school after they start menstruating and women that were unable to maintain proper menstrual hygiene were 70% more likely to have reproductive tract infections. The concern of improper MHM encompasses an obstructed lifestyle through generationally propagated stereotypes and increased likelihood of debilitating healthcare conditions that young women in underserved communities face.
In low and middle income communities (LMICs) in Tanzania and India, menstrual health hygiene isn’t effectively communicated with prepubescent girls which results in large amounts of confusion coupled with fear. Generally, information surrounding menstrual health management is spread by word of mouth between family members and bolsters common social beliefs/practices, but any associated physical discomfort caused by menstrual cycles often goes unaddressed. As a result, there is a growing concern about unhygienic practices in menstrual health management.
In an article published by NBC News, Transgender men and non-binary persons that undergo the monthly occurrence of a menstrual cycle often feel isolated, undergo gender dysphoria, and fear for their safety. In 2015, a transgender survey reported that over 60% of transgender men and non-binary persons are too afraid to use public restrooms due to the fear of being confronted or abused. Given that men’s restrooms don’t have any disposal options for hygiene material, many are forced to dispose of sanitary napkins in the general trash in the middle of the restroom, thereby increasing this fear. There has been an increase in anti-trans hate crimes that is estimated to be about 34% between 2017-2018. Trans-men and non-binary people face the issue of the lack of accessible resources and proper education surrounding effective menstrual health management.
In a 2018 study of Menstrual Health Management of Adolescent Girls with Intellectual Disabilities, tests revealed that factors such as parents/guardians’ educational level, family income, and severity of menses were statistically significant and associated with awareness of parents/guardians on menstrual suppression in girls with intellectual disabilities. Most parents/guardians reported having limited information regarding the menstrual care of girls with intellectual disability. This results in shock, distress, and improper methods of menstrual health management among girls with intellectual disability when they attain menarche.
When the COVID-19 pandemic struck, the world closed down and healthcare inequities that women in underserved and vulnerable communities faced intensified. These communities include women in indigenous populations, women in low-income settings, women that identify as trans/non-binary, and women with intellectual disabilities - particularly young women. The pandemic has caused issues in access to menstrual hygiene resources due to the closing of many establishments, financial constraints, and quarantine.
“Poor menstrual hygiene is not a girls’ or women’s issue – it’s a human rights issue”
2. THE SOLUTION: A SUSTAINABLE DESIGN TOOLKIT
Using Project Kilimanjaro’s model of ethical program intervention, we aim to supplant menstrual hygiene kits with that of accurate menstrual health cycle management information that allows for young women to manage their menstrual cycles with dignity. Project Kilimanjaro has created MHM separate curriculums and will be implementing these curriculums alongside menstrual hygiene resources in groups of women with intellectual disabilities, women that identify as trans/non-binary, and women from culturally-sensitive populations.
We are working closely with regional grassroots organizations to create partnerships between local corporations and underserved communities in an effort to increase industry and accessibility to healthcare. Our approach uses a co-design process with communities and grassroots organizations to design solutions that are culturally sensitive and cater to the genuine need that each community faces. As we continue to iterate our solutions, we do so continuously learning from and collaborating with female participants and community members to ensure that any devised solution is catered sensitively to the culture of the region.
Menstrual Health Management Pilot at Olmoti Secondary School, Longido, Tanzania
By working closely with secondary schools in Tanzania and grassroots organization Elle Peut Naidim, we hosted a variety of programs on the topic of menstrual health management for women in low-income communities and indigenous populations. By implementing strict evaluation and monitoring protocols, and collecting feedback over the course of several months we have co-designed a curriculum for menstrual health management specifically for young girls in these communities. We work with local corporations to help boost regional industry and create a sustainable flow of information and finances - creating a B2B and B2C partnership between corporations, grassroots foundations, and community members.
Our project in India encompass the issues that women in rural regions face with clean water inaccessibility which leads to increased rates of infection due to improper disposal, reuse, or cleaning of sanitary products. By creating units in isolated communities that produce BananaPads, biodegradable sanitary napkins out of banana fibers which is a resource that is plentiful in the region, Project Kilimanjaro will help sustainably increase ownership and understanding of women’s health resources by community members while simultaneously increase employment of women within the community itself. Employed by affiliates of Project Kilimanjaro that are local to the area of impact, a portion of the product developed is sent to HQ to market and distribute to other communities. We hope to give women greater control over their own healthcare through this process.
To scale the impact, our design and innovation team will be creating an application with our pre-configured program evaluation and monitoring methods. This will assist in creating a database of the efficacy of impact on different communities both ethnically and geographically. This will allow further programming that is community specific and provides valuable insight about the problems that communities around the globe face.