Menstruation – the monthly genital bleeding experienced by women after reaching puberty – is a big problem among school girls in many parts of the world. Girls generally feel shame when the bleeding leaks on their school uniforms, get laughed at or teased by boys, lack soap, water or private places to change, clean or dry menstrual pads, or lack ways to reduce pains while at school. These problems have been reported to limit girl‘s participation in some school activities that require to stand or walk to the front of the class to answer a question or demonstrate something. They also cause girls to leave school early, miss some classes, stay at home during the days they are bleeding or leave school for good before the end of their school years.
MITU has received funds from the UK Medical Research Council (MRC) to carry out this study that will help address the problems related to menstruation and contribute in improved reproductive health.
Dr Elialilia Okello, a senior MITU research scientist, is leading this three-year study which will take place in eight secondary schools in Mwanza and Kilimanjaro regions. MITU will be implementing this study together with Femme International, a local non-governmental organisation working in Tanzania; the London School of Hygiene & Tropical Medicine, UK; and local government leaders in the two regions.
The study has three main stages. The first stage is the review of a health education programme implemented by Femme International and develop a plan to bring on board boys and local government leaders in the programme. This will help the boys and the leaders to understand issues related to menstruation and offer their support to girls during that period instead of laughing or teasing them. The study will recommend ways of giving out reusable sanitary pads at school and improving school water supply, toilet and hand washing facilities to help girls have the menstrual products, safe and private places to change or clean and dry the pads. The first stage will also include looking for ways to relief girls from pain during menstruation.
The second stage will involve researchers working with local government leaders and school teachers, to look at ways of including the improved health education programme in the routine school activities. The third stage will involve the assessment of the improved health education programme to see if it can be delivered in a long-term at lower cost, and is accepted by students, teachers and local government leaders. The programme will also be evaluated to see if it helps to change what girls do during their menstruation period and how they think about it.
Although the focus of this study is on problems related to menstruation among girls, it is expected that the boys will get a chance to understand issues related to menstruation as well as benefit from improved water supply, toilet and handwashing facilities at school. Apart from boys, the results are expected to benefit teachers, school officials and the general community. The study will also contribute in improved school participation and performance among school girls.
“During menstruation, girls are usually worried about the blood leaking into clothes while in class. A girl who stains her clothes in class is laughed at. Some girls experience severe pain and may need pain killers. Due to these problems girls may not be comfortable to attend a school with poor facilities or services to support them during this period” Dr Okello says. “Many times they miss attending school for several days each month and their performance may go down“
Dr Okello feels this study came at the right time. “In July 2017 I joined MITU to work in a research that was trying to assess if washing hands with soap every time school children used the toilet will help to reduce worm infection” she says. “The project gave me a chance to work within the schools. It is during this time that I realised that we needed to do more to help adolescent girls gain knowledge, skills and basic resources to manage their menstruation”