Social Stigma and Taboos Related to Menstruation are Barriers for Change in the Community and School, Develop Logical Framework (LFA)

1. Social Stigma and Taboos Related to
Menstruation are Barriers for Change in the
Community and School,
Develop Logical Framework
Presented By:
Mohammad Aslam Shaiekh

2. Contents
• Background
• Social stigma and Taboos related to
Menstruation
• Social Stigma and Taboos: A Barrier for
Change
• Logical Framework for MHM
• Recommendations
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3. Background
• Menstruation is a natural biological process takes
place every month for girls and women begins in
between the age of 9-16 years and stops around 45-
55years of age.
• 52% of women worldwide are in reproductive age
and most of them are menstruating monthly.
• Every day, estimated 290,000 women and adolescent
girls in Nepal menstruate (Scoping review and
preliminary mapping of Menstrual health in Nepal)
• Still, the majority of them are not in conditions to
take care of their menstruation in a hygienic manner.
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4. Background Cont…
• The NDHS 2011 revealed that of the top ten SRH issues of
concern identified by teenage girls, seven were
menstruation-related
• One of the most extreme forms of menstrual seclusion
practice in Nepal is Chhaupadi.
• Strongholds of Chhaupadi culture exist in the far western
districts of Nepal, including Achham, Dailekh, Bajhang,
Bajura, and Doti. However, the practice persists throughout
the country
• 71.2% girls and women stay in Chhaupadi during
menstruation in the Mid western and 15.5% in far Western
(MICS-2014)
• Integrating MHM into programs for SRH and WASH is an
important step in achieving SDGs 3 (Good Health and Well-
Being), 4 (Quality Education), 5 (Gender Equality) and 6
(Clean Water and Sanitation).
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5. Social Stigma and Taboos
• Practice of Chhaupadi, isolating menstruating women
in poorly ventilated menstrual huts/cowshed.
• Treated as uncleaned, impure, shameful and
untouchables during menstruation period
• Restrictions on movement and normal life (like in
kitchen , temple, Religious gathering, communal tap,
water sources)
• Restriction in taking part in holy event and place,
religious festival.
• Not allowed to bath using water from communal taps.
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6. Social stigma and Taboos
• Discussion on menstruation at public as a matter of
shy
• Not touching plants or male members of the family,
purifying the bed on the fourth day of menstruation.
• Menstruation linked with sins
• Taboos associated with the food and nutrition
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7. Discriminating Practice During
Periods
Source: CBS 2015
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8. Major Barriers of Menstrual
Hygiene in Community and School
• Limited knowledge
• Negligible Communications
• Poor Menstrual Hygiene and Disposal Practices
• Prevailing Social Norms and Restrictions
(Temple)
• Lack of Social Supports.
• Myths and Misconceptions in the Society (Plant
dry)
• Lack of access to sanitation facilities
• Limited and unskilled/untrained frontline workers
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9. Barriers for Menstrual Hygiene :
Socio-Ecological Model
• Social stigma and taboos exist at all levels thus change
requires at all level:
a. Public Policy: Ineffective implementation of the
dignified menstruation policy, lack of multi-sectoral
collaborations
b. Community: Presence of social and Cultural taboos,
Socio-economic factors for maintaining MHM
c. Organizational: Non realization of absenteeism due to
menstruation as a problem, Gender unfriendly school
culture and infrastructure, representation of social and
cultural taboos in institution
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10. Barriers for Menstrual Hygiene :
Socio-Ecological Model
d. Interpersonal: less or no discussion on menstrual
hygiene in family, restriction practice at home (family
norms), Presence of social and cultural taboos,
socioeconomic factors for MHM products.
e. Intrapersonal (Individual): Scanty awareness about
menstruation, poor attitude to help women during
period, women unaware about MHHM, Link
menstruation with sins.
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11. Social Stigma and Taboos are
Barrier for Community Change
• Social Stigma and taboos may affect directly and
indirectly on following things which are basics of
community development/Change
 Physical, Psychological and emotional state
 Gender inequality and Social inclusion
 Community participation and Entrepreneurship.
 Violation of Human rights, integrity, dignity, privacy
and right to freedom abuse and violence
 Women and Girl Empowerment
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12. Social Stigma and Taboos are
Barrier for Community Change
 Regular and Continue education and other social
opportunities
 Lower Socioeconomic status
 Right to dignity and respect
 Decision making structure
 Feeling of Insecure (Rape, snake bite)
 Impact on school and job attendance, and thus affects
women’s economic
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13. 13

14. Framework for Overcoming the Social
Stigma and Taboos in Community for
MHM
Access to
knowledge and
Information on
MHM
Access to Safe
Menstrual
Absorbents
Access to
WASH
Infrastructures
Access to Safe
Disposal of
Absorbents
Results in:
• Acceptance of Menstruation as a matter of
natural biological process
• Dignity for girls and women
Supportive family,
community and
Society
Availability of trained
and informed support
for MHM
Supportive Policies,
guideline and
Behaviour changes
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15. Social Stigma and Taboos Related to Menstruation are Barriers for Change in the Community and School
Logical Framework
Goal: By 2022, Adolescent girls and women in Bajura district break away from the cultural of silence related to
Menstrual Hygiene and Practice and have consistent access of Knowledge on MHM and support to address myths
social stigma, taboos, restrictive perceptions and social norms
Activities Output Outcome Objectively Varifiable Indicators
Objective 1: Breaking the silence around Menstruation.
Conduct orientation
program for Sensitizing
the men, women and
adolescent about
menstruation and
triggereing them for
behavior Change around
taboos, stigma and myths
related to Mensturations
Men, families,
communities informed
and sensitive to
menstruation, needs of
women during
menstruation
Silence around
Menstruation is Broken
Reduced restrictions on girls and
women during Menstruation Girls
attending school during
menstruation
Arrange MHM stalls for
Information sharing in
school, college,
community during
different events, festivals
Questions/queries around
menstruation are
answered for all
Aware community on
Menstrual health and
hygiene, best practices
and Restrictions on
unhealth behaviours and
practices in the
community.
Decrease in boys teasing girls
during menstruation; Fathers willing
to discuss menstrual matters
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16. Objective 2: Easy access to appropriate knowledge about mensturation
Training for counsellors
Trained and informed
resource available at all
levels
Easy access to
information
Availability of registered counsellors
and depot holders
Establishing counselling
centres at all levels
Counselling centres
easily accessible at
school and community
level
Share/consult and
overcome / handle any
situation related to
menstruation without
feeling shy or being
ashamed
Number of people approaching
counselling centres; Entry in registers
of depot holders and counselling
centres
Objective 3: Establishing Community strengthening system for MHM
Formation of District Project
Advisory Committee
Functional DPAC and
identification of priority
areas
Improved Knowledge,
attitude and behavior
related to SRH
Increased coverage of SRH services
utilizations
Conduction of coordination
meetings with stakeholders
Proper coordination
with stakeholders and
resources identification
at local level
Improved health seeking
behavior
Relation an network building for
addressing the agenda of MHM in a
collaborative way
Formation of Child Clubs,
Girls student groups, etc
Platforms to discuss the
SRH and MHM related
issues
Improved capacity of
such groups to deal with
the issues of SRH and
MHM
Capacity building and development
Selection of Local facilitators
and orginize facilitator
training
Identified and trained
local facilitators
Improved capacity of
facilators
Skilledfull Human resources for
managing the SRH and MHM
Development of IEC/BCC
materials based on local
context
Disseminated health
messages and informed
decision making
Improved knowledge,
attitude, perception,
practices and behaviour
of people towards MHM
Behavior change and right practices
for MHM 16

17. Peer Group discussion
on social stigma and
taboos related with
menstruation
Identified MHM
relatedstigma and
taboos rooted in the
community, gaps and
areas for
improvement
Decrease in beliefs
upon the social taboos
and stigma.
Awareness about wrong
perception and beliefs of
people towards menstruation
Assessment of School,
public places with
gender friendly
infrastruture for
WASH
Identified functional
WASH facilities with
regular water supply
and gender friendly
structure.
Increase in school
enrollment and
decrease in
absentiesm in school.
Education achievemnt
Develop mobile apps
and incorporate health
messages
Objective 3: Girls and women make informed choice; providing access to wide range of MHM
material
procure menstrual
absorbents or material
(where pad production
units are established)
based on demand
Supply delivery
systems established/
Pad production units
established and
functional
Easy availability and
access to menstrual
material/absorbents
Material chosen are safe
absorbents as also safely
disposable
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18. Objective 3: Girls and women make informed choice; providing access to wide range of MHM
material
procure menstrual
absorbents or material
(where pad
production units are
established) based on
demand
Supply delivery
systems established/
Pad production units
established and
functional
Easy availability and
access to menstrual
material/absorbents
Material chosen are safe
absorbents as also safely
disposable
Objective 4: Enabling easy access to safe disposal of used absorbents /menstrual material
Installation of electric
incinerators at
schools, colleges and
girls’ hostels
Schools are equipped
with safe disposal
incinerators for used
menstrual material
Used menstrual
material across the
districts is safely
disposed off
Regular use of the incinerators
and their operation and
maintenance in schools and
colleges
Sensitizing
communities about
environmentally safe
options for disposal of
used menstrual
material
Communities use
environmentally safe
material and dispose
it off safely
Safe disposal of used
menstrual material
Absence of used menstrual
material in trash ; abstinence of
communities from disposing
off in open places
Setting up of sign
boards near water
bodies, fixing penalty
for defaulters
Sign boards
announcing
imposition of fines on
defaulters
People conform to
agreed rules of safe
disposal
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19. Recommendations
• Empower community people, girls and women
with knowledge about MHM through
addressing the social stigma and taboos related
menstruation.
• Increase parental/Family, community and
Institutional support for Menstruating girls and
women
• Ensure a supportive school environment for
MHM.
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20. References
• https://sanitationandwaterforall.org/news/lets-discuss-
menstrual-hygiene-management
• Menstrual Hygiene Matter, WaterAid Report-2012
• Central Bureau of Statistics Report-2015
• https://blogs.lse.ac.uk/southasia/2017/01/31/what-works-
breaking-silence-on-menstrual-stigma-and-taboos/
• Menstruation among Nepalese Adolescent girls: A Qualitative
Study, Priti Koirala, Sona G.C.
• Perception and practices of menstruation restrictions among
urban adolescent girls and women in Nepal: a cross-sectional
survey
• Multi-Indicators Cluster Survey-2014
• Scoping review and preliminary mapping of Menstrual health
in Nepal
• The Nepal Demography Health Survey-2011
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