Essential human right: Access to basic menstrual health and hygiene services

This post originally appeared on: GANM Blogs

Partnership, Not Aid: Haiti, Part 3

In this 5-part series we have been sharing critical issues faced by the women and girls we work with following disasters. Our flagship program in Haiti addresses an essential human right – access to basic menstrual health and hygiene services.

 Need for Data

 While there has been a more recent emphasis with respect to gender mainstreaming and water and sanitation, there is far too little research and specific strategies for addressing needs regarding menstruation. We need solutions that not only provide for immediate needs but also long-term sustainability in a post-disaster and development setting.

Using survey data to inform solutions

There has been some information suggesting links between poor menstrual hygiene and urinary and reproductive infections. However, this is not currently supported by sound medical analysis making it difficult to prove. Nonetheless, our fieldwork and other anecdotal evidence support a connection. In one example, respondents in a survey by WaterAid in Bangladesh reported health problems such as vaginal scabies, abnormal discharge, and urinary infections, associated with menstrual hygiene challenges (Ahmed and Yesmin 2008).

As discussed in our first blog, the women with whom we work have limited or no access to clean water or sanitary pads, which often forces them to modify daily activities such as going to school or work.

To address this, we worked with partner Haiti Projects to launch our Health & Hygiene Program in Fond des Blancs, Haiti.

As we prepared for the second year of our program, we used the data gathered from interviews with participating women to measure their personal experience during the project. This allowed us to hear straight from those we are helping to ensure they actually receive what they need.

 The field surveys provide us a better understanding of issues faced by women in rural Haiti. The surveys also provide us with a better understanding of cultural and societal practices around menstruation, as well as any pre-existing myths. For example, some rural women think that if they don’t get their periods, the menstrual blood will build up inside their bodies, which will result in an infection. This was an important discovery, as it allowed Haiti Projects, which also provides family planning services through their mobile clinics, to better educate women about the effects of birth control on women’s bodies.

What we’ve learned

Molly Klarman, Country Director for Haiti Projects recently explained that, “the menstrual health education is actually helping women stay on their birth control because they now understand the link between menstruation and birth control.” Beyond just addressing this need by providing sanitary pads (sewn by local women employed by the Haiti Projects Artisana), our program provides basic hygiene education, as we learned that nearly 25% of women surveyed did not know why they had their period.

 Our program nurse, Ms. Joseph surveyed approximately 30 women in 2 villages prior to the menstrual health education. Upon returning to the mobile clinic a few months later, she conducted a follow up survey to capture the experiences of each of the women.

We were delighted to learn that 100% of the women who used the pads liked them. Given the income of the women ranged from an estimated $1 – $3/day, “Kotex” (local term for disposable sanitary pads) are often too expensive. Therefore, more than 80% of the women regularly used folded cloth sheets or old T-shirts to absorb menstrual blood. They preferred the new pads and found them to be soft and easy to wash. The fact that the pads are washable reduces waste. Disposable pads are not a sustainable solution for menstruation in areas where safe disposal is not available.

One challenge our project faces is lack of clean water. In areas where access to clean water is difficult, washing pads is difficult. However, even the women who lack clean, running water in their homes still walk to retrieve clean water daily, making the washing of the pads possible.

Our program continues to grow. Drawing from what we’ve learned, we are implementing similar programs in communities where we’ve worked for several years in both India and Nepal.

We will discuss in the final two blog posts in this series why Menstrual Health Management cannot simply be addressed as a single issue, but as part of a WASH integration strategy.

 [It is important to note that these are not intending to be statistically relevant studies. Our intent is to capture information directly from the women we serve so that we can continue to learn from them, improve the services we provide and share this information with others.]