1. Menstrual Hygiene Management in Schools
Meeting Girls’ Rights in Zambia
Sarah Fry, MPH, Sr. Hygiene Programming Advisor
USAID WASHplus/FHI360

2.  Access to WASH in schools
◦ No gender friendly WASH facilities or programs prevent girls
from managing menstruation with dignity
 Full education (minimum primary)
◦ Lack of MHM pushes girls out of school - missing classes or
dropping out
 Access to quality health (especially reproductive)
services and information
◦ Lack of knowledge about puberty can result in early
pregnancy
◦ Poor or no MHM can lead to health problems (infections)

3.  Equal treatment with boys
◦ Poor MHM puts girls at educational disadvantage
◦ Girls’ puberty often = marriageable age
 Psychosocial well-being
◦ Taboos and unhelpful beliefs cause shame
◦ Bullying and teasing by boys cause fear
◦ Violence can result from shaming of family (stains on skirt)
◦ Silence about MHM causes fear, shame, confusion, depression

5. SPLASH Zambia
• 4 year (2011 -2015) school WASH program
• Funded by USAID, managed by FHI360 and
CARE
• Reaching 370 schools and 250,000 pupils in
Eastern Province
• Construction of water and sanitation facilities
• Providing hygiene education to teachers and
pupils
• Advocating for WASH/MHM in all schools

6. • 4 districts
• 370 primary
schools

7. 2012 Baseline Facilities Survey shows
 70% of schools had access to water supply (but
functionality a big problem)
 Only 13% treated their drinking water
 28% had handwashing facilities, (but not used and
no soap)
 The average ratio of girl pupil to toilet was 207:1
 MHM was non existent and not discussed

8. How SPLASH does MHM
1. Awareness raising and advocacy
2. Improved access to facilities and products
3. Learning, teaching and training
4. Integration into MOE systems
5. Useful documents and teaching aids on MHM

9. Awareness raising and advocacy
• Visual brand and slogan for MHM – Let’s Talk About It!
• Qualitative research on MHM to understand cultural norms
• MHM exhibitions at central schools
• Celebration of MH Day with high ranking officials and media
• Inclusion of community and traditional leaders in MHM
programs

10. Special emphasis on including boys and men

11. Improving access to school sanitation
facilities
A school toilet before…. And after!

12. Female teachers
need safe clean toilets too

13. Improved access to MHM products
• Pad provision via PTAs and school budgets
• Local reusable pad production in schools
• PPP for reusable pad production and distribution to schools

14. Educational activities
• MHM included in national curriculum
• In-service teacher training on MHM and puberty topics
• Both male and female guidance and counseling
teachers trained in MHM
• After school WASH clubs have MHM activities for boys
and girls

15. Integration in Ministry of Education Systems
• MHM in provincial and district strategic
plans
• MHM indicators in school monitoring tool
• MHM module developed for provincial
teacher training college

16. 3. Menstrual Hygiene Management
a. Does the school have washrooms for girls?  Yes  No
b. Do washrooms have water?  Yes  No. Soap?  Yes  No
a. Do girls’ toilets have facilities for disposal of menstrual soiled sanitary towels?
(check one)  Yes  No
a. What method of disposal of soiled sanitary towels exist in the school? (check one)
 Burying  Burning (incinerator)  Other (Specify)
................................
a. Does the school provide sanitary towels for the girls? (check one)  Yes  No
a. Does the school offer Menstrual Hygiene Management education to the girls?
(check records)  Yes  No
a. If yes above, how often is this done?
 Beginning of each term
 Once in a term
 Twice in a term
 Three times in a term
REPUBLIC OF ZAMBIA
MINISTRY OF EDUCATION, SCIENCE, VOCATIONAL TRAINING AND EARLY EDUCATION
PROVINCIAL EDUCATION OFFICE
EASTERN PROVINCE
CONFIDENTIAL
SCHOOL INSPECTION INSTRUMENT

17. Useful documents and
teaching aids on MHM
• Toolkit for Teachers
• Pad pattern booklet
• In-service teacher training
module
• Games and other classroom
and WASH club resources

19. Successes and Lessons so far
• Silence and taboos can break down very fast if there is
something positive offered
• MHM can and should be integrated into the existing
school system through advocacy, training, materials,
activities and events
• MHM can and should be included in school performance
indicators and assessment tools
• Boys are very interested in MHM and love to make pads!

20. Challenges
• Pockets of resistance remain due to strong
taboo and ignorance
• Materials for making reusable pads are not
always available
• Lack of availability of pads in general
• Scaling up to national level

21. Early (anecdotal) evidence of impact
• Increased enrollment and reduced absenteeism
• strengthened school-home linkages
• Increased engagement by boys and men
• improved the psychosocial environment through
open discussions and innovative activities
SPLASH Longitudinal Outcome Survey ongoing now
is assessing the impact of WASH and MHM on girls’
attendance

23. Thank you!
Visit www.washplus.org/countries/zambia
Contact sfry@fhi360.org