Nepal WASH Blog Water, Sanitation and Hygiene (WASH) & Development in Nepal

February 9, 2011

Menstrual Hygiene Management (MHM)

Filed under: Advocacy,Gender,Menstrual hygiene — Anita Pradhan @ 9:00 am

WaterAid with support from SHARE, a research consortium, brought together 16 practitioners and researchers with expertise in water, sanitation and health (WASH). The purpose of the roundtable was to assess the state MHM, address various policies and practice and lastly to build a community of practiced individuals and institutions passionate about MHM and who want to share, work, influence and respond to the practical challenges faced by women and girls.

On the first day participants reviewed their knowledge of MHM, understood the issues linked to MHM and learnt key policies in Asia region. They also learnt from experiences and initiatives from countries like Bangladesh, India and Tanzania. It was also concluded that MHM is a big issue for women, one which lacks awareness among both men and women. They also found out that patriarchal culture and tradition determine how MHM is addressed in different communities. While there are evidences of good MHM practice there are no user satisfaction surveys.  Sufficient research on the issue has not been done.

The second day, participants designed research methodology to assess the advantages-disadvantages of different methodological research approaches and developed it to combine quantitative and qualitative learning. They also discussed on the length of the study and if a longitudinal study would be helpful. It was discussed that a balance was needed among the qualitative and quantitative evidence. From this discussion it was suggested that the existing literature be synthesized and clear MHM related indicators be developed to monitor implementation and effectiveness. They also suggested that it would be important to understand the risks of current MHM practices and understand the impact of improved MHM.

Lastly they agreed on keeping in touch as   a group in order to articulate the issue and make it a priority among advocacy workers. They will also remain in contact in order to build a community that practices MHM and support research initiatives.

The post is written by Ms Therese Mahon, Regional Programme Officer - Asia, WaterAid in UK.

January 11, 2011

Photo of the week – 11 to 17 January 2011

Filed under: Gender,Photo of the week,Rural,Water — Anita Pradhan @ 9:00 am

Ram Rati Malik from Beli, Siraha district in Nepal showing the water source she used to collect for drinking purpose. Photo: WaterAid/ Marco Betti

January 7, 2011

What if the ‘pillars of Nepal’s public health programmes’ became pillars for WaSH?

Filed under: Gender,Health,Hygiene,Open defecation free,Sanitation,Women — Om Prasad Gautam @ 2:33 pm

Since female Community Health Volunteers (FCHVs) are the ‘pillars of Nepal’s public health programmes’, would it not be feasible for them to also become advocates for WaSH? With a reported total of 48,604 FCHVs working across the country as change agents for health within their communities, adding WaSH to their remit could make a lot of sense.

Female Community Health Volunteers

With support from health institutions, FCHVs actively work to promote safe motherhood, child health, including immunisation, family planning and several other basic health services. Their role is also a practical one; distributing items such as condoms, ORS packets, vitamin A capsules and oral polio vaccines, as well as administering iron tablets to pregnant women. In addition, FCHVs are responsible for treating pneumonia cases, (referring complex cases on to health institutions).

While WaSH related diseases remain the biggest cause of morbidity and mortality in Nepal, hygiene promotion at a local level is vital. Might these FCHVs, fully trained by the health sector, also offer great potential in the promotion and changing of hygiene behaviour at a local level?

An excellent example of involving FCHVs in WaSH social mobilisation is a project in Sindhuli, Kamalamai; a WaterAid in Nepal project, implemented by our partner CIUD. Since extending their remit to WaSH, these FCHVs have successfully influenced numerous positive hygiene related behaviour changes within their communities.

The benefits of involving FCHVs in WaSH are plentiful. FCHVs are often already known within their communities as effective mobilisers; they are also familiar with local social norms and values and as such are more easily able to influence changes in hygiene behaviour. Living within the community themselves, FCHVs are then able to monitor these new hygiene practices. Enabling and empowering these FCHVs in WaSH related projects then, would surely be a sustainable way of retaining trained personnel at local level.

Given this potential, how do we move forward strategically? I propose that those in the health and WaSH sector in Nepal ask ourselves the following questions:

1. Do we recruit volunteers to promote hygiene at a local level or do we make use of existing FCHVs in a community?

2. Do we use existing FCHVs as change agents in society by engaging them in the promotion of WaSH?

3. Can we strengthen the capacity of the FCHVs by providing them with WaSH related training so that they can become advocates for sanitation and hygiene promotion within each ward of the village/municipality?

4. Do we mobilise FCHVs in making their communities open-defecation-free?

Your thoughts?

Written by Om Prasad Gautam, Social Development Adviser, WaterAid in Nepal

December 29, 2010

Putting a social taboo on the development agenda

Filed under: Gender,MDG — Om Prasad Gautam @ 9:00 am

Several women’s rights issues have been receiving increased attention in the development arena in recent years. Issues such as the role of women in economic development, equal representation of women in different forums and platforms, early marriage, sexual abuse and the burden of domestic duties. One issue, however, remains a taboo for many – the issue of menstruation and the effects it can have on a girl’s education, dignity and quality of life. Neither women’s activist groups nor the Government have made adequate attempts at addressing these issues in Nepal.

Menstruation is a normal, natural process that occurs in all healthy adolescent and adult women yet to reach menopause. However, it has mostly been dealt with in secrecy since even discussing menstruation means breaking a social taboo.

As I write this, many adolescent girls are dropping-out of school because a lack of toilet on the school premises means nowhere to change their sanitary pads. A lack of water means nowhere to clean themselves and they undoubtedly fear leaking blood. Traditional beliefs and taboos associated with menstruation present further challenges. Many women will have been punished today for touching a member of the opposite sex, for going to worship or for using the same ponds as others for bathing or fetching water. A lack of proper menstrual hygiene management also means that many more are facing health related problems such as itching, vaginal discharge, severe headaches and abdominal pain. I am also sure that many women woke up this morning in the cow shed, having been banished from their usual bed.

The role of Menstrual management in achieving many of the Millennium Development Goals (MDGs) is rarely acknowledged. Yet it is clear that adequate measures to address menstrual hygiene will contribute directly to MDG-7 on environmental sustainability. Also, due to its indirect effects on school absenteeism and gender discrepancy, poor menstrual hygiene management may seriously hamper the realization of MDGs-2 on universal education and MDG-3 on gender equality and women empowerment. Unfortunately, there has been little recognition of this to date.

Issues surrounding menstrual hygiene and management have not received adequate attention in the Water, Sanitation & Hygiene (WASH) sector or in the reproductive health sector. It is surprising that even gender mainstreaming literature remains silent on the issues of menstrual hygiene management.

What do you think about these issues?

Written by Om Prasad Gautam, Social Development Advisor, WaterAid in Nepal

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