Menstrual hygiene management in humanitarian situations

May 28, 2019 is Menstrual Hygiene Day and below are excerpts from the May 23, 2019 issue of Water Currents: Menstrual Hygiene Day 2019 on menstrual hygiene management in humanitarian situations.

Events
Menstrual Hygiene Day 2019 – This global advocacy platform for MH Day brings together the voices and actions of nonprofits, government agencies, individuals, the private sector, and the media to promote MHM for all women and girls. This website contains campaign materials for this year’s theme—It’s Time for Action—and a list of events and resources. mhday2019

WASH Innovation Challenge on Menstrual Hygiene Management (MHM) and Incontinence – Elrha’s Humanitarian Innovation Fund is launching a challenge May 23, 2019, and will be seeking innovative projects exploring how to design safe and dignified MHM spaces in emergency camp settings and how to better engage with and understand the needs of people with incontinence in emergencies. We will especially welcome applications from broad partnerships that include NGOs as well as designers, academic institutions and local organisations, and we expect that any approach would take a participatory and user-centred approach to developing the innovation. Additional information will soon be posted on the Elrha’s website. You can also get in touch with Cecilie Hestbaek, c.hestbaek@elrha.org, and Sophie Van Eetvelt, s.vaneetvelt@elrha.org, for more information and advice on how to prepare for the call.

MHM and Humanitarian Situations
Pilot Study Findings on the Provision of Hygiene Kits with Reusable Sanitary PadsUnited Nations Refugee Agency (UNHCR), December 2018. In collaboration with AFRIpads, UNHCR Sub-Office Mbarara implemented a three-month pilot intervention to test the acceptability of introducing reusable sanitary pads to schoolgirls in the refugee context.

Periods Don’t Stop in Emergencies: Addressing the Menstrual Hygiene Needs of Women and GirlsHumanitarian Innovation Fund, August 2018. This article discusses the challenges that women and girls face around menstrual hygiene in emergencies.

Exploring Menstrual Practices and Potential Acceptability of Reusable Menstrual Underwear among a Middle Eastern Population Living in a Refugee SettingInternational Journal of Women’s Health, July 2018. Primary data analysis of narratives around the beliefs, behaviors, and practices of menstrual hygiene in this population revealed key themes related to the physical environment; the social environment; cleanliness, comfort, and health; and adaptation and coping.

Pilot Testing and Evaluation of a Toolkit for Menstrual Hygiene Management in Emergencies in Three Refugee Camps in Northwest TanzaniaJournal for International Humanitarian Action, June 2018.  This paper describes the development and pilot testing of the Menstrual Hygiene Management in Emergencies Toolkit in three camps hosting Burundian and Congolese refugees in northwest Tanzania.

Improving Menstrual Hygiene Management in Emergency Contexts: Literature Review of Current PerspectivesInternational Journal of Women’s Health, April 2018. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts to understand the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations’ menstrual needs.

Menstrual Hygiene Management in Emergencies ToolkitColumbia University Mailman School of Public HealthInternational Rescue Committee, 2017. The toolkit provides streamlined guidance to support organizations and agencies seeking to rapidly integrate MHM into existing programming across sectors and phases.

MHM and Waste Disposal
Menstrual Hygiene Management and Waste Disposal in Low and Middle Income Countries—A Review of the LiteratureInternational Journal of Environmental Research and Public Health, November 2018. A literature review showed that MHM and sanitation value chains often neglect the disposal of menstrual waste, leading to improper disposal and negative impacts on users, sanitation systems, and the environment.

Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries. Journal of Environmental and Public Health, February 2018. At home, women dispose of menstrual products with other domestic waste. Outside of the home, they often flush them in public toilets without knowing the consequences of choking sewer pipelines.

Menstrual Waste Management: A Simple GuideMinistry of Drinking Water and Sanitation, Government of India, 2019. This guide discusses composting and small-scale incineration of disposed menstrual hygiene products.

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Water Currents: Menstrual Hygiene Day 2019

Menstrual Hygiene Day 2019. Water Currents, May 23, 2019.

Every May 28, Menstrual Hygiene Day (MH Day) raises awareness and combats taboos associated with menstrual hygiene with the goal of enabling women and girls to achieve their full potential. mhday2019

The theme of Menstrual Hygiene Day 2019—It’s Time for Action—not only emphasizes the urgency of this public health issue, but also highlights the transformative power of improved menstrual hygiene to unlock economic and educational opportunities for women and girls.

Empowering women and girls and promoting gender equality are core operating principles of the U.S. Government Global Water Strategy and USAID Water and Development Plan. To alleviate a major constraint to women’s and girls’ participation in education and public life, USAID seeks to integrate menstrual hygiene management (MHM) interventions where practical and improve MHM in key settings, including schools.

As a contribution to MH Day 2019, this issue contains links to recent studies on “period poverty,” MHM and its impact on schooling/education, MHM in humanitarian situations, and other MHM–related topics.

Events
Menstrual Hygiene Day 2019 – This global advocacy platform for MH Day brings together the voices and actions of nonprofits, government agencies, individuals, the private sector, and the media to promote MHM for all women and girls. This website contains campaign materials for this year’s theme—It’s Time for Action—and a list of events and resources.

WASH Innovation Challenge on Menstrual Hygiene Management (MHM) and Incontinence – Elrha’s Humanitarian Innovation Fund is launching a challenge May 23, 2019, and will be seeking innovative projects exploring how to design safe and dignified MHM spaces in emergency camp settings and how to better engage with and understand the needs of people with incontinence in emergencies. Additional information will soon be posted on the Elrha’s website.

MHM Overviews
What Is the Point of a Period? Scientific American, May 2019. Age-old taboos against menstruation have led to a lack of research on how women’s menstrual cycles work, with serious consequences for their health.

Period Poverty Impact on the Economic Empowerment of WomenKnowledge, Learning and Evidence for Knowledge, January 2019. Period poverty refers to a lack of access to sanitary products due to financial constraints. The problem exists in high as well as low- and middle-income countries.

Read the complete issue.

Burden of disease from inadequate WASH for selected adverse health outcomes: An updated analysis

Burden of disease from inadequate water, sanitation and hygiene for selected adverse health outcomes: An updated analysis with a focus on low- and middle-income countries. International Journal of Hygiene and Environmental Health, 12 May 2019.

Authors: Annette Prüss-Ustün; Jennyfer Wolf; Jamie Bartram; Thomas Clasen; OliverCumming; Matthew C. Freeman; Bruce Gordon; Paul R.Hunter; Kate Medlicott; Richard Johnston wateraid

Background – To develop updated estimates in response to new exposure and exposure-response data of the burden of diarrhoea, respiratory infections, malnutrition, schistosomiasis, malaria, soil-transmitted helminth infections and trachoma from exposure to inadequate drinking-water, sanitation and hygiene behaviours (WASH) with a focus on low- and middle-income countries.

Methods – For each of the analysed diseases, exposure levels with both sufficient global exposure data for 2016 and a matching exposure-response relationship were combined into population-attributable fractions. Attributable deaths and disability-adjusted life years (DALYs) were estimated for each disease and, for most of the diseases, by country, age and sex group separately for inadequate water, sanitation and hygiene behaviours and for the cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks.

Findings – An estimated 829,000 WASH-attributable deaths and 49.8 million DALYs occurred from diarrhoeal diseases in 2016, equivalent to 60% of all diarrhoeal deaths. In children under 5 years, 297,000 WASH-attributable diarrhoea deaths occurred, representing 5.3% of all deaths in this age group. If the global disease burden from different diseases and several counterfactual exposure distributions was combined it would amount to 1.6 million deaths, representing 2.8% of all deaths, and 104.6 million DALYs in 2016.

Conclusions – Despite recent declines in attributable mortality, inadequate WASH remains an important determinant of global disease burden, especially among young children. These estimates contribute to global monitoring such as for the Sustainable Development Goal indicator on mortality from inadequate WASH.

An Emergency WASH Update – May 15, 2019

NEWS

OFDA Meet Our Experts – Trevor White. OFDA, May 7, 2019. Trevor White is a Water, Sanitation, and Hygiene (WASH) Advisor at USAID/OFDA. As part of the USAID/OFDA WASH team, Trevor provides support at the country level during natural disasters and conflicts, but also at a global level to support efforts to improve the quality of future WASH responses. emergencies

BLOG POSTS

Cash transfers can help Yemen’s conflict-affected children. IFPRI Blog, May 6, 2019. As a result, the transfers helped preserve children’s dietary diversity in critical early developmental stages 6-23 months. The program also led to improved breastfeeding and water treatment practices, which further enhanced the nutritional environment.

JOURNAL ARTICLES

Efficacy of the SuperTowel: An Alternative Hand-washing Product for Humanitarian Emergencies. The American Journal of Tropical Medicine and Hygiene, May 2019. Given that the ST is more lightweight than soap and longer lasting, we envisage that the ST would also be beneficial to humanitarian actors working in areas where logistical and security issues make regular hygiene product distribution challenging. We recommend that further testing should be carried out to assess the efficacy of the ST under conditions that more closely mirror real-world hand-washing practices.

REPORTS

Urban WASH programming in Protracted Conflict Contexts: Aleppo’s Experience, Syria. UNICEF, March 2019. The focus of this Field Note is Syria’s urban WASH programme, documenting the experience in implementing WASH in a city which has endured years of protracted conflict, and is designed as a learning note for the organization as it strengthens its role in urban areas.

Private Sector & Refugees—Pathways to Scale. IFC, 2019. Multinational corporations like Mastercard, regional and national businesses such as Equity Bank and PowerGen, social enterprises like NaTakallam and Sanivation, and a range of others across industries, are demonstrating the potential roles of the private sector in supporting refugees and host communities.

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How to fill the non-sewered sanitation skills gap – IWA

How to fill the non-sewered sanitation skills gap. IWA, April 2019.

The Source asked a global panel of experts: ‘How can the water sector respond to the skills gap that must be filled if we are to make the most of opportunities presented by urban non-sewered sanitation?’ iwa.png

Professor Dr Damir Brdjanovic, Director, Global Sanitation Graduate School

The sector is in need of quality training and education, cooperation between academic and professional institutions, a recognised framework with assured quality, prestigious degrees and diplomas, platforms for alumni career development, and many other ingredients that will help people have healthier and productive lives.

In response to the growing need for leaders in developing countries and the implementation of non-sewered sanitation (NSS), the IHE Delft Institute for Water Education and partners – supported by the Bill & Melinda Gates Foundation – have launched the Global Sanitation Learning Alliance, to help develop and disseminate knowledge on sanitation.

Recently, IHE Delft has started a new MSc in sanitation – a unique interdisciplinary programme with a focus on the delivery of NSS services to urban communities. It is designed for people from diverse backgrounds, acknowledging the complexity of urban sanitation.

Read the complete article.

Building partnerships for change – WSUP

Building partnerships for change. WSUP, April 2019.

Our Chair, Lord Paul Boateng, recently visited Nairobi where he highlights the challenges caused by poor access to clean water and safe sanitation. wsup-logox2

Key to addressing this challenge is partnerships – at the local and national level – including city authorities tasked with delivering city-wide services, and community leaders who are a vital link between low-income residents and utilities.

Watch the video here:

Blog 3 of 3: Accelerating improved sanitation in Africa through market based approaches

This is the final blog in the series, which is being released after AfricaSan 5 where the African sanitation community came together to assess progress against the Ngor commitments on Sanitation and Hygiene. Learning gained from the side-session on Market-based Rural Sanitation held on February 22nd also shapes this final blog.

Introduction

Blog one in this series was about the opportunities for market shaping in West and Central Africa and blog two shared the experience of the SHAWN project in Nigeria. This third blog looks at how market based sanitation (MBS) might be a means to accelerate the scale of improved sanitation uptake in Africa including amongst the poorest and most marginalised households and communities. It draws upon both the regional sanitation industry consultation (see report here) and the Bill and Melinda Gates Foundation, UNICEF and USAID side-session on market based rural sanitation held as part of AfricaSan5. unicef

Recent reports have highlighted that neither MBS nor CLTS or other behaviour change approaches alone will be adequate for everyone, everywhere, all of the time (1, 2 and 3). It is increasingly recognised by practitioners that being effective calls for context-specific policies and practices that are less rigid or dogmatic about what approaches are used (4, 5 and 6). Interventions need to be flexible and adaptable and be designed with the priorities of target groups, including the products and services that they want, at the forefront. Furthermore, approaches need to be responsive to context and different stages of a programme both of which should inform decision-making (6).

Conducive contexts for MBS

With this in mind, which contexts are most conducive for MBS? Where and how can it be made more effective? Under what conditions are we most likely to find scenarios where the poorest and most vulnerable are climbing the sanitation ladder? And where is the market creating opportunities for people as consumers, entrepreneurs, and artisans?

A WaterAid-Plan-UNICEF joint rural sanitation guidance document (see document here) shared in Abuja and at AfricaSan5 recommends beginning with an analysis of the current sanitation situation, economic and social contexts, the physical environment and the enabling environment. Such an analysis forms the basis to determine what approaches will be appropriate for increasing basic sanitation in that particular context.

Read the complete article.