MENSTRUAL HYGIENE DAY 28TH OF MAY 2017  Menstrual Hygiene Day is a global platform for partners across all sectors to engage in action, adv...

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MENSTRUAL HYGIENE DAY 28TH OF MAY 2017  Menstrual Hygiene Day is a global platform for partners across all sectors to engage in action, advocacy and knowledge-sharing around menstrual hygiene management. For millions of girls in low income countries dealing with menstrual hygiene creates extreme difficulties, particularly when at school. Lack of money to buy sanitary products means they must rely on old cloth, bedding or paper and, in some settings, use organic matter like leaves, grass, animal hides, or nothing at all. These unhygienic and uncomfortable materials leak, cause embarrassment, and reduce their ability to concentrate on schoolwork, or results in them missing school during their period. Prior to starting a pilot study in western Kenya one parent told us of her daughter: ‘Sometimes she doesn’t go to school due to the bruises she got from using blanket’. The lack of sanitary materials may harm girls in other ways, as a mother noted: ‘She will go look for this money (to buy pads) from the men, and that’s how they can end up with the unwanted pregnancies’.  In western Kenya, partners from Liverpool School of Tropical Medicine, with the Kenyan Medical Research Institute, the US Centers for Disease Control and Prevention, and Safe Water and AIDS Project, Kisumu, collaborated with the local government ministries to conduct a pilot study, paid for by the British Department for International Development, Medical Research Council, and Wellcome Trust. The pilot looked at the use and acceptability of sanitary pads and menstrual cups for girls in rural primary schools in western Kenya. Before the project, a girl described her worry when using cloth ‘Some cloths might infect you… if you use damp cloths you might start itching then it turns to a wound’. The stress this causes was commonly discussed; another girl told us ‘You can develop a stench…when there is no soap you become stressed up because you don't know how you will wash them’. In the pilot, we checked with girls during the school year to see if provision of sanitary products affected their school-lives, and if cups could be used safely. Girls used and liked the cup because it did not leak or chafe, and they could keep and reuse it. Initial concerns about inserting the cup changed to joy as they familiarised themselves with use: ‘Yes, I’m feeling good…when I put that Mooncup inside I can run, I can do anything’. After the year, fewer girls using cups or pads had sexually transmitted infections compared with those continuing usual practice, and fewer girls using cups had reproductive tract infections. While no difference in absence was confirmed, girls’ attitude to school attendance during menstruation changed ‘So it is better if I do not go to school until the period stops. But since they brought us Mooncup … after bathing you insert it you just go to school’. A mother also noted ‘She has pads she will now concentrate more (and) in case she is a clever girl, she will be cleverer now’.  The study team is now looking to see if a large trial can show the benefits of menstrual cups for secondary schoolgirls, by improving their sexual and reproductive health and helping them reach their academic potential. Because girls have many competing challenges, as well as menstruation, the trial will also test if the provision of pocket money to girls will support their menstrual hygiene, as well as assist them to obtain other small necessities without risking their health or wellbeing. The trial, funded by the same British agencies, and supported by national, county and local ministry officials, has begun in Siaya County. The research field team, aiming to recruit ~3500 girls in 84 secondary schools, have met with positive support from schools, communities, parents and girls. Participating girls are now being trained on puberty hygiene and how to use the cup, and on financial literacy and safe use of pocket-money. Girls will then be followed up to the end of their final school year to assess outcomes, and programme materials developed with ministry, school and community partners.  Members of the team also support the Ministry of Health and many other experts across Kenya in developing the national policy and guidelines for menstrual hygiene management for girls and women in Kenya, to be launched on 28th May 2017 in Makueni County.

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