Menstrual Management among school girls in Uganda
During menstruation girls and women face both practical and strategic gender problems. These have negative impacts for their personal lives and development opportunities: restrictions on work and mobility, increased fears and tensions, early marriage, early and premature childbirth and higher infant mortality, and potential vaginal infections resulting in the worst case in infertility.
In many cultures, the onset of menstruation means coming of age and therefore has big consequences for young girls. Apart from that there is the hygiene side which if not properly addressed can have horrific consequences. One of the impacts is the lower class attendance of girls during menstruation days and school drop-out at the onset of menstruation.
Based on the literature review, surveys show 33%-61% increase in absence due to lack of menstrual hygiene provisions. However, intervention studies show both insignificant and significant differences in class attendance. The reason behind this may be due to different means of recording intervening factors such as water, sanitation and privacy conditions in primary schools and at home, distance to school and attitudes of teachers and parents.
For many years now, the global education community, ranging from UNICEF, World Bank to local organisations, have noted the challenges of puberty for adolescent girls, and specifically the need for girl-friendly water and sanitation facilities in primary schools. Although anecdotal stories, from field projects, and articles in newsletters from local women’s groups express concern over the issue of schoolgirls and sanitation, still too little empirical data exists that captures girls’ actual experiences and concerns. Understanding the reality of girls’ experiences of sanitation and schooling is critical to addressing the continuing challenge to meet their specific needs in an effective and resource-feasible manner. A deeper understanding of girls’ daily struggles, and rationale behind proposed solutions, is essential to engaging policy makers who can enact legislation and make resources available at school level.
The implication of these findings is that menstrual hygiene affects the majority of adolescent girl pupils in school and this can potentially reflect that their ultimate educational performance will not be optimal. Girls express fear, shame, distraction and confusion, besides physical discomfort, as feelings associated with menstruation. These feelings are largely linked to a sense of embarrassment, concerns about being stigmatized by fellow pupils and as teachers explained, a perception that the onset of menstruation signals the advent of girl’s sexual status.
Around 3000 days of menstruation occurs in an average woman’s lifetime.
What can be done
District
Health inspectors should make menstrual hygiene management part of their periodic inspection and report to the District Water and Sanitation Coordination Committee on a quarterly basis.
subcounty
More focus is needed to include menstrual hygiene management as one of the assessable areas in the performance agreements signed by senior head teachers with sub county chiefs.
school
The primary schools should ensure the availability of water, soap, a basin, emergency material (e.g. menstrual pads), facilities for disposal of used pads and medication (e.g. pain killers)
girl child
Peer support should be available for the girls to help them understand menstrual hygiene management.
ngo and civil society
- There is a need to promote advocacy campaigns on the effects and coping mechanisms around MHM to policy makers.
- Building in budgets to support MHM at school level is of key importance.
- Involve cultural leaders and break the silence around MHM needs to get more attention.
- Advocate for further research around specific areas linked to menstrual hygiene management.
private sector
Explore further possibilities of manufacturing and marketing innovative low-cost sanitary towels e.g. working with village saving schemes and credit associations.
UGANDA:Teenage Pregnancy and Child Marriages
School closure has led to an increment in teenage pregnancies and early marriages in Uganda. Most school-going girls are becoming pregnant, and some of them are forced to get married at an early age because their parents cannot take care of them and the unborn baby. The United Nations Children Fund (UNICEF), defines teenage pregnancy as “a teenage girl, usually within the ages of 13-19, becoming pregnant and refers to girls who have not reached legal adulthood, which varies across the world. Although it is considered a serious public health and social problem globally, approximately, 95% occur in developing countries.Teenage girls aged 15–19 years are twice more likely to die during pregnancy and childbirth compared to women in their twenties, whereas those under the age of 15 years are five times more likely to die. According to the World Health Organisation (WHO), most of the pregnancies and childbirth are not planned and wanted, although a few are planned and wanted. Some of the complications associated with teenage pregnancy include: preterm labour, intrauterine growth retardation and low birth weight; neonatal death, obstructed labour, genital fistula and eclampsia. Furthermore, their reproductive health is affected by unsafe abortion, sexually transmitted infections, sexual violence and limited access to medical services.
The factors contributing to teenage pregnancy are multifactorial, ranging from individual-behaviour, traditional, and socio-cultural to religious in nature. Inarguably, low socioeconomic status, limited education, and early sexual activity can perpetuate teenage pregnancy. Additionally, weak implementation of the Penal Code Act (which criminalizes sexual intercourse with girls below 18 years) and the Uganda National Adolescent Reproductive Health Policy by government institutions and a lack of community, social support and poverty are some of the determinants of teenage pregnancy. Furthermore, increased accessibility to social media and pornographic sharing, cross cultural influences, and decreased supervision by adults, have led to early initiation of sexual activity by teenagers. Studies have shown substantial reduction in birth rates globally, with Adolescent Birth Rate (ABR) declining from 61.8 to 22.3% per 1000 female adolescents aged 15–19 years. However, sub-Saharan Africa continue to have the highest ABR. Uganda has one of the highest rates of teenage pregnancies in sub-Saharan Africa, estimated at about 25%. Socio-cultural and religious norms promote abstinence until marriage. However, as in many other societies, a double standard concerning sexuality is prevalent whereby girls are expected to be modest, tender, submissive and passive, while boys are encouraged to engage in behaviours that assert their masculinity, autonomy, and ambition. The Uganda national adolescent reproductive health policy (2004) pledges commitment to advocate for the review of existing legal, medical and social barriers to adolescents’ access to information and health services. In addition to ensuring protection of the rights of adolescents to health, provision of legal and social protection against all forms of abuse and harmful traditional practices, promotion of gender equality and provision of quality care for adolescent sexual and reproductive health issues. Uganda has committed to eliminate child, early and forced marriage by 2030 in line with target 5.3 of the Sustainable Development Goals. In its 2016 Voluntary National Review, Uganda provided baseline data on the situation for child marriage Uganda co-sponsored the 2013, 2014 and 2018 UN General Assembly resolutions on child, early and forced marriage, and also co-sponsored the 2013 Human Rights Council resolution on child, early and forced marriage. In 2014, Uganda signed a joint statement at the Human Rights Council calling for a resolution on child marriage.
In spite of the implementation of available policies and other related laws, teenage pregnancies remain quite high in Uganda.
What we ARE doING
KNOW YOUR BODY, KNOW YOUR RIGHTS
This is a youth-led advocacy model that targets adolescents and youth to empower them by delivering stigma-free and rights-affirming information on issues of health, sexuality and human rights. Young girls also receive information, supplies and facilities to manage their menstruation. The programme builds young people and adolescents’ capacity to advocate for their health and well-being at the personal, community and national levels.
GIRLS PARLIAMENT
The program advances girls’ leadership by facilitating PARLIAMENTS through which girls & women advocate with key stakeholders especially clan leaders, church leaders, parents and local leaders to design and implement strategies that are aimed at empowering communities to end gender inequalities and child marriages.
YOUTH VOICES
Youth Voice empowers and amplifies young people’s voices to advocate for policy reforms by engaging policy and decision makers at community, district and national level to prioritize young people’s access to quality Sexual and Reproductive Health services. The program has facilitated dialogues between young people and various decision makers at different levels.