From “Traditional Menstrual Absorbents” to “Modern Menstrual Products”?

“Walk of Pride”, Girls and advocates march to parliament.

6 Jun 2018

The recently concluded ‘Walk of Pride” on Menstrual Hygiene Day (28 May) brought put a spotlight on MHM in Malawi.  Dr. Christabel Kambala (University of Malawi) and Dr. Tracy Morse (University of Strathclyde/University of Malawi) reflect on the ‘Walk of Pride” what this means for women and girls in Malawi.

Menstrual Hygiene Management (MHM) and the burden it has on women and specifically for school going girls, has sparked a discussion across the globe. Malawi has joined the community of countries that have made MHM a focal point of discussion.

Walk of Pride?
The recent Menstrual Hygiene Day which was commemorated on 28th May, 2018 saw thousands of girls and advocates march to parliament in what was called the “Walk of Pride” in Malawi. The marchers presented a petition which highlighted the stigma women and girls face due to menstruation and the inadequacies in facilities for menstrual hygiene management and disposal which in turn affect adolescent girl’s access to quality education. They urged government to support the design and promote construction of innovative MHM facilities and absorbent materials that cater for the needs of  girls  and  women,  and  in  particular,  girls  and  women  with  disabilities, including the disposal of sanitary materials in institutions.

What does the walk of pride mean?
This initiative demonstrates the representation of MHM within the context of Malawi. The involvement of policy makers via parliament signifies a strong commitment towards the plight of women and girls and reminds parliament of one of their professional mandates. Consequently, the petitioners have urged government to, among other things, establish a National Menstrual Hygiene Steering Committee that will comprise the Ministries of Health, Agriculture, Irrigation and Water Development, Education, Science and Technology, Gender and Social Welfare and Labour and Social Development and other Non-State Actors, and be responsible for effective co-ordination of MHM policies and programs. We hope that, as a first step, the Steering Committee’s will develop a “Roadmap” that will guide the MHM processes in Malawi. We anticipate that the structure and contents of the roadmap will be based on research evidence and that relevant policies will be instituted. Therefore, the scientific community must join the band wagon to conduct relevant research in diversified areas of MHM that will guide the steering committee and the executives in decision making and policy development. This is appropriate given the fact we need to understand the context in which we are operating.

Absorbent products?
Since Malawi became involved in MHM discussions from early 2012, there has been a sudden and huge proliferation of MHM interventions in the country. Specifically, organizations with both long and short history working in WASH together with the private sector are implementing various MHM absorbent interventions. This is a good development given that we started talking about menstruation management only recently. Various providers are freely distributing absorbent products, or selling them at an affordable price, so that women and girls can upgrade from the “use of old clothes” to the “use of modern absorbents” (e.g. reusable and disposable sanitary pads, menstrual cups, etc.). There has been a lack of knowledge among women and girls that pads even existed, or they thought pads were only for the elite.These perceptions still exist, particularly among the poor.

It is a known fact that MHM disproportionately affects the poor and old cloths are commonly used during menstruation. Nevertheless, in recent years, more and more women have become aware of the health related dangers of using old cloths and strive to use dedicated sanitary pads where possible (i.e. if they have money they buy or will receive if given, and others are making their own reusable pads).

What about quality of the products?
However, we need to think of the quality of the absorbent products, do we know what kind of absorbents are given and/or sold out there? While these products may be produced in good faith, some may be unsafe for use and could be a source of infection and become detrimental to health - the very thing that we are trying to prevent. Sometimes pads are given to women and girls who have no underwear, and therefore nothing to place the pads on, ( which defeats the purpose.

Who is there to regulate the quality? Lack of guidance and/or standards on absorbents is a cause for concern. We need to examine broader dimensions on how these products should be regulated. These questions should also stimulate research ideas, and research priorities should be compiled and supported. MHM research will also form a basis for engaging implementers, modifying interventions and fostering collaboration among organizations so as to mitigate the impact of poor MHM among women and girls in Malawi.

So what are we doing?
As researchers, the first step that we have taken is to conduct a nationwide mapping exercise where we are documenting what absorbent interventions are available and where they are based (i.e. specific districts, schools and communities). The “Walk of Pride” activity provided us with additional information on who is actively involved in MHM in Malawi. As a second step, we have sampled three different types of absorbents that are being distributed / sold in selected schools and communities through several organisations, and we are assessing their efficacy from the perspectives of the users (i.e. girls and women). Through this nationwide process, clarification, engagement and more detailed specifications will be established. This research will guide policy making, regulations and development of standards of quality especially on what should be categorized not only as safe absorbent interventions but also as acceptable to the users. We hope that this will support the future task force in ensuring that successful interventions are led by local organizations with the necessary credentials and expertise.

BUILDING KNOWLEDGE. IMPROVING THE WASH SECTOR.

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