Menstrual hygiene management firmly on the agenda of regional workshops

The third bi-annual Asia Sanitation and Hygiene Practitioners' workshop was held in Dhaka, Bangladesh, from 31 January to 2 February 2012. As with the previous events in 2008 and 2010, some fifty Water Sanitation and Hygiene (WASH) practitioners and researchers came together to share their diverse experience. Once again co-organised by BRAC, WaterAid, IRC and the WSSCC, the event provided a platform for sharing a rich collection of field evidence and experience. Workshop papers and photo essays illustrated the range of progress that has been made, whilst also pointing towards the challenges that remain.

In 2008, menstrual hygiene management was signalled as a neglected area in WASH programmes. In 2010 the workshop participants pushed ahead and discussed necessary provisions for menstrual hygiene management in toilet design (washing facilities, sufficient space, incinerators) as well as issues of availability and affordability of menstrual hygiene materials.

This year, notable progress was reported in implementing menstrual hygiene into WASH programmes. There is still a lot to do, but now both male and female participants felt comfortable to discuss this topic, which for many is shrouded in taboo. A major hurdle remains the lack of awareness and lack of recognition that menstrual hygiene is a human right and health issue. Participants also concluded that menstrual hygiene programmes are now usually linked to school WASH, but efforts are needed to reach girls who are not in schools. Advocacy and hygiene promotion have to improve the awareness of both men and women about menstruation and menstrual hygiene management.

Progress on menstrual hygiene management since 2008
WaterAid is developing a resource guide on menstrual hygiene management. BRAC has integrated Menstrual Hygiene Management (MHM) in their WASH programme, especially in schools. At schools activities include: construction, hygiene promotion, formation of udent brigades, teachers' orientation, providing dumping facilities in school latrines and educating girls on better managing their personal hygiene. At community level, BRAC have encouraged student clubs, a school WASH committee and specially trained teachers. In communities, activities include peer cluster meetings of adolescent girls and the production of low cost sanitary napkins which are sold by the local health volunteers. Challenges including ability of girls to buy pads and inadequacy of toilets. WaterAid is working on a comprehensive guide on menstrual hygiene management as an integral part of WASH programming. The draft guide was presented by Therese Mahon.

Menstrual hygiene has been taken up by IRSP in Pakistan as part of their post-emergency response and conducts hygiene sessions for men and for women on menstrual hygiene management. Wickramasinghe (2012) provides a checklist of necessary inputs, which could form the basis for programming in post-emergency situations.

Next steps in menstrual hygiene management (MHM):

• We need to understand current indigenous MHM practices and issues before we move to the design of a menstrual hygiene management programme.
• Capacity building and promotion/ awareness raising materials for menstrual hygiene management are needed.
• Menstrual hygiene management needs to be included in monitoring frameworks.
• Advocacy is needed for inclusion of MHM in national educational curricula.
• Creative approaches are needed for targeting girls who are not in school.
• Low cost sanitary napkins are an urgent area for further innovation.