By NS Kaoma
Copper Rose, Lusaka, Zambia
Correspondence: Natasha Salifyanji Kaoma (nskaoma@yahoo.com)
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Citation style for this article: Kaoma NS. Menstrual hygiene management in Zambia.Health Press Zambia Bull. 2018;2(5); pp 1-3.
Menstruation is a natural and beneficial monthly occurrence in healthy adolescent girls and pre-menopausal adult women. It concerns women and men alike as it is among the key determinants of human reproduction and parenthood. The age of menarche varies by geographical region, race, ethnicity and other characteristics but ‘normally’ occurs in low income settings between the ages of 8 and 16 with a median of around 13 [1].
Globally women and girls have developed their own personal strategies to cope with menstruation. These vary greatly from country to country, and within countries, dependent on an individual’s personal preferences, available resources, economic status, local traditions and cultural beliefs and knowledge or education. Due to these restrictions women often manage menstruation with methods that could be unhygienic or inconvenient, particularly in poorer settings.[2]
In Zambia, with half the population as female and over 80% within reproductive age, menstrual hygiene management is an area that needs much closer attention, due to its ability to have cross cutting impacts on the social and economic wellbeing of citizens. Girls and women are using unimaginable products to deal with menstruation; for those in rural areas, their options are dirty pieces of cloth or blankets, or mattresses. While those in urban areas purchase baby diapers at 10cents each and cut them up into small pieces, to last them at least two days. These methods often result in reproductive tract infections which are of public health concern.
In order to deal with the menstrual hygiene crisis, Copper Rose Zambia developed two initiatives; Candid Pride Campaign and Zaane Women empowerment project both aimed at dealing with menstrual hygiene management in schools and communities. These projects have collectively benefitted over 10,000 women and girls in 20 schools in across 5districts in Zambia.
In August 2016, the Zaane project was piloted in Mazabuka district, southern province. In this model, young women of Lubombo village are trained in menstrual hygiene management and sanitary pad sewing. After this training, they then go on and teach the skill of hand sewing sanitary napkins to community women, adolescent girls in schools, sometimes including a few men who seem interested. This model has also engaged local seam stresses who sew sanitary napkins professionally, these napkins are distributed in the community and the proceeds from these sales are used to support their families.
With the Zaane Project, 1500 members of the community have been reached with the skill of pad making in Mazabuka District. These women and girls have gone on to teach others with the skill, potentially bringing the number of beneficiaries to 3000 people, if not more. The pros of this model are that it is sustainable, once a woman learns a pad making skill, she can replicate it and learn how to make pads with her own fabric, it eliminates dependency because the beneficiary initially learns the skill for life. The project is also income generating because the women that make the pads sell them and those community distributors also gain a commission from the sale of the sanitary napkins. Because both the community outreach programs and the sewing of sanitary napkins is done by the locals, this project has gained owner ship by the community.
Shortcomings of this model are that there is no guarantee that a woman will go back home and practice the new pad sewing skills learnt. Furthermore, with washable pads, there must be extensive education on caring for the sanitary napkins. The napkins must be washed with soap and dried in the sun to prevent infections, this is not always easy amidst the cultural expectation to keep menstruation a secret, it is even harder for people living in poverty, with little access to soap and clean water.
Over the past few months there has ben a lot of hype on menstrual hygiene management in Zambia, with government commitment and many corporate companies offering to donate disposable sanitary napkins. For how long can the beneficiaries rely on donations? Are hand outs sustainable in a country that is expected to have the population doubled by 2030? As it stands, there are very few companies, if any that produce menstrual hygiene products locally. There is need to set up measures the are sustainable and offer long term solutions to solving this matter.
There is very high potential for scale up of the Zaane project model, Copper Rose continues to work with stakeholders such as the ministry of education and other partners to support the rollout of this model in Zambia. The initial pilot stared with ActionAid as the sole sponsor, but during the course of the year 2017, Copper Rose has partnered with other members, including the DREAMS initiative to replicate this model so as to reach out to more women. For more information about Copper Rose Zambia, please visit www.copperrosezambia.org.
References
1. Jones LL, Griffiths PL, Norris SA, Pettifor JM, Cameron N (2009) Age at menarche and the evidence for a positive secular trend in urban South Africa. Am J Hum Biol 21: 130–132.
2. Sumpter C, Torondel B, A Systematic Review of the Health and Social Effects of Menstrual Hygiene Management, Plos One
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0062004#s1
3. Enu A, Jayakant S, Menstualhygene Practices and Abnormal Vaginal Discharge Among Women in India, Sexual and Reproductive Healthcare Journal, Volume 6 249-254, Elsevier [4].