Click here for the original link to the WashPlus Tool Kit

SPLASH, 2015. Menstrual Hygiene Management Toolkit. Washington D.C., USA. USAID/WASHplus Project. 

May 2015

Menstrual Hygiene Management TOOLKIT

About SPLASH:

SPLASH (Schools Promoting Learning Achievement through Sanitation and Hygiene) is a comprehensive school-based water supply, sanitation, and hygiene (WASH) project funded by USAID/Zambia through field support. SPLASH is implemented through the WASHplus project, which supports healthy households and communities by creating and delivering interventions that lead to improvements in WASH and household air pollution (HAP). This five-year project (2010-2015), funded through USAID’s Bureau for Global Health (AID-OAA-A-10-00040) and led by FHI 360 in partnership with CARE and Winrock International, uses at-scale programming approaches to reduce diarrheal diseases and acute respiratory infections, the two top killers of children under age 5 globally.

Recommended Citation:

SPLASH, 2015. Menstrual Hygiene Management Toolkit. Washington D.C., USA. USAID/WASHplus Project.

Contact Information:

Justin Lupele SPLASH Chief of Party Plot 2473 Farmers’ Village, ZNFU Complex Tiyende Pamodzi Rd, Off Nangwenya Rd Showgrounds Areas P.O. Box 51439 Ridgeway Lusaka, Zambia Cell: 0971252490 jlupele@fhi360.org

Sandra Callier WASHplus Project Director 1825 Connecticut Avenue, NW Washington, DC 20009-5721 Office tel.: 202-884-8960 scallier@fhi360.org

This toolkit is made possible by the generous support of the American people through the United States Agency for International Development (USAID) Bureau for Global Health under terms of Cooperative Agreement No. AID-OAA-A-10-00040. The contents are the responsibility of FHI 360, and do not necessarily reflect the views of USAID or the United States Government.

May 2015

ACKNOWLEDGMENT

WASHplus/SPLASH is indebted to USAID/Zambia for its financial and technical support to the SPLASH project and the Ministry of Education Science, Vocational Training and Early Education (MESVTEE), Eastern Province for supporting the development of this publication. This toolkit was originally developed during a series of workshops and consultative meetings involving MESVTEE staff in the Eastern Province of Zambia and stakeholders in the WASH sector. Special tribute goes to Sarah Fry, SPLASH Activity Manager under the WASHplus project, for her tireless efforts to finalize this toolkit; Margaret Mapata, District Resource Center Coordinator (Chipata), for her innovative games and learner-centered activities; and Kylie Saunders, an intern from Emory University who worked closely with Ms. Mapata on a menstrual hygiene management exhibition and activities.

Special thanks to the following people for their valuable efforts in developing this toolkit:

Bridget Kakuwa Kasongamulilo SPLASH Knowledge Management, Documentation, and Communication Advisor

Levyson Banda SPLASH Deputy Provincial Coordinator

Romakala Banda SPLASH Hygiene Behavior Change Technician, Mambwe

Mayombo Mandevu Mwanza SPLASH Hygiene Behavior Change Technician, Lundazi

Boyd Hakubeja SPLASH Hygiene Behavior Change Technician, Chadiza

James Nyirenda SPLASH Hygiene Behavior Change Technician, Chipata

Febby Busiku SPLASH Provincial Coordinator (former)

Davidson Phiri District Resource Center Coordinator, Mambwe

Bernard Kakumbi Provincial Standards Education Standards Officer Natural Sciences

Doris Kanyerere SPLASH Provincial Finance Officer/ Project Manager

Venus C. Thole Principal Education Officer Teacher Education, Chipata (retired)

May 2015

TABLE OF CONTENTS

ABOUT THIS TOOLKIT ..................................................................................................................................................................................................... ii

WHAT IS PUBERTY? ........................................................................................................................................................................................................ 1

WHEN DOES PUBERTY OCCUR? ..................................................................................................................................................................................... 2

WHAT IS MENSTRUATION? ............................................................................................................................................................................................ 3

MENSTRUAL HYGIENE MANAGEMENT .......................................................................................................................................................................... 5

MHM SCHOOL CHECKLIST ............................................................................................................................................................................................ 7

ACTIVITIES, GAMES, AND FUN ....................................................................................................................................................................................... 9

1. ROLE-PLAY: A Menstrual Hygiene Management Drama................................................................................................................................ 9

2. PATTERNS FOR MENSTRUAL PADS .............................................................................................................................................................. 17

3. ALL-IN-ONE “PANTYPOCKET” ....................................................................................................................................................................... 24

4. THE GAME OF LIFE ....................................................................................................................................................................................... 29

5. WORD SEARCH PUZZLE ................................................................................................................................................................................ 35

6. MATCHING GAME ........................................................................................................................................................................................ 38

7. SNAKES & LADDERS ...................................................................................................................................................................................... 42

MHM Toolkit i

ABOUT THIS TOOLKIT

Menstrual hygiene management (MHM) is an important component of a “WASH-Friendly School.” As a new concept in schools, the USAID-funded Schools Promoting Learning Achievement through Sanitation and Hygiene (SPLASH) project and Zambia’s Ministry of Education, Science, Vocational Training and Early Education (MESVTEE) are offering various kinds of support to teachers to establish MHM programs and facilities to keep girls and female teachers in school.

This toolkit was designed to help teachers, school health and nutrition (SHN) coordinators, and other school personnel in Zambian primary schools to carry out MHM programs or activities in their school. It is organized into three sections:

• basic information about puberty, menstruation, and MHM

• a checklist for schools to use to ensure that they have all the elements needed for a good MHM program

• interactive games and activities that will engage students to learn about MHM including an activity that shows students how they can make their own pads or sanitary towels

As MHM becomes more established in schools, better tools can be developed and integrated into this toolkit.

MHM Toolkit ii

WHAT IS PUBERTY?

Puberty is the process that boys or girls undergo to become adults and sexually mature; in essence, the period from childhood to adulthood. Puberty involves a series of physical changes in both boys and girls that lead to the development of secondary sex characteristics, the physical features associated with adult males and females (such as the growth of pubic hair). While puberty involves a series of biological or physical transformations, the process can also have an effect on the psychosocial and emotional development of adolescents.

Adolescents also increase their intellectual capacities and experience moral development during puberty. Social identity is supplemented by the search for a psychological identity. An important dimension of puberty is that young adolescents are able to integrate bodily changes into their self-identity, and to incorporate others’ responses to these changes into that self-identity. During the early stages of puberty friendships between same-sex peers become more important due to the shared social, physiological changes including a possible detached relationship with parents. The physical growth experienced during puberty is accompanied by new and complex emotions including sexual desire and gender identity. These changes, combined with peer pressure, may cause adolescents to behave in a certain way.

These changes may effect learning both positively and negatively. Positive changes include the ability to reason and understand complex processes and concepts. On the other hand, the negative effects associated with peer pressure, bullying and arrogance can be experienced by some boys and girls. Adolescents react differently to puberty education. Sometimes boys’ behavior enables them to assert their stereotypical masculinity and therefore their power and supposed superiority. In some cultures in Zambia, girls who reach puberty are tutored to present themselves in public—as women or young ladies. There are stereotypes of what behaviors are acceptable for young men and women.

MHM Toolkit 1

WHEN DOES PUBERTY OCCUR?

Puberty begins when extra amounts of chemicals called “hormones” are produced and lead to physical, emotional, and cognitive changes in the body. A growing adolescent may feel happy one moment, or sad, or confused the next moment. The onset of puberty varies among individuals. Puberty usually occurs in girls between the ages of 8 and 16, while in boys it generally occurs later, between the ages of 12 and 16. Most girls and boys begin to notice changes in their bodies between the ages of 10 and 14 which take place over a number of years. See Table 1 below:

Table 1: What are the changes that take place in girls and boys at puberty?

Changes in Boys Changes in Girls

• Breasts look like they're developing a bit

• Chest broadens

• Penis and testicles start to grow

• Ejaculations begin—boys start to experience “wet dreams” while sleeping

• Voice “breaks” and deepens

• Boys gain weight and grow taller

• Body and facial hair appears (armpits, pubic area, moustache, beard, or sideburns)

• Shoulders get wider, muscles start to get bigger and stronger

• Breasts start to develop

• Girls gain weight, particularly on the hips

• Menstruation starts

• Bodies become curvier and hip bones widen

• Hair grows in pubic area and armpits

• Muscles get bigger and stronger, but they do not show up as much as boys’ muscles

MHM Toolkit 2

WHAT IS MENSTRUATION?

Menstruation is the monthly flow of blood from the uterus through the vagina in girls and women from puberty to menopause.1. It is a normal process for women and girls, and it starts at puberty or adolescence. Girls tend to start their menstrual periods between the ages of 10 and 14, and this continues until they reach menopause usually between their late forties to mid-fifties. Menstruation is also sometimes known as menses or a menstrual period. During adolescence, a girl’s body starts to change. Along with physical changes (such as growing breasts, wider hips, and body hair) the girl will also experience emotional changes due to hormones.

The cycle for menses is usually around 28 days but can vary from 21 to 35 days. Each cycle involves the release of an egg (ovulation), which moves into the uterus through the fallopian tubes. The body’s tissues and blood start to line the walls of the girl’s uterus for fertilization. If the egg is not fertilized, the lining of a girl’s or woman’s uterus is shed through the vagina along with blood. The bleeding usually lasts between two to seven days each month, with some lighter flow and some heavier flow days. The menstrual cycle for girls during their first year or two is often irregular.2

1 Ministry of Health, Zambia Reproductive Health Glossary, 2013 page 2 2 House, Cavill, and Mahon. 2012. Menstrual Hygiene Matters. UK: WaterAid.

MHM Toolkit 3

Source: Kanyemba A. 2011. Growing Up at School, a Guide to Menstrual Management for School Girls. Zimbabwe: Water Research Commission, South Africa.

MHM Toolkit 4

MENSTRUAL HYGIENE MANAGEMENT

Menstruation has critical implications for girl’s educational outcomes. Menstrual hygiene materials must be made available; linkages to health services must be formed; and safe latrines with water and soap, adequate sanitation and disposal mechanisms must be provided. These objectives benefit all members of the school community, including learners and staff. Furthermore, failure to meet them puts girls at risk of not having a high-quality educational experience.

MHM in school includes the facilities, products, education, training, and support necessary for girls to manage their menstrual periods away from home. MHM is gaining recognition globally as a critical human rights and development problem, one that influences poverty levels and even a country’s GDP. Around the world, stigmas and taboos have defined how menstruation is viewed and experienced. Now, a movement is growing, bringing the topic into the open and addressing menstruation as a normal part of being female.

Let’s take a closer look:

What is menstruation?

Menstruation is:

• A natural biological function of all females worldwide

• A natural process where the female body sheds the lining of the uterus every month if a fertilized egg does not plant itself there and grow into a baby

• When the lining of the uterus, rich in blood and other matter ready to nourish a baby, flows out through the vagina every 28 days if conception has not occurred

• Sometimes painful because the uterus cramps up to shed the lining

Menstruation is NOT:

• An illness or a curse

• Shameful

• A reason to keep girls and women from school, household activities, or work

MHM Toolkit 5