We were delighted that Cynthia Folarin a Public Health Nurse joined us in October to deliver reproductive health training, and to help us explore the level of Period Poverty within our community of sponsored students. With the support of Oliver and Learn she distributed 300 packs of washable sanitary packs to our girls. Who as you can see were very delighted!!

Her learning from talking to the girls and their teachers is outlined below.

Oliver ‘Live and Learn’ Charity in conjunction with Friends of Kianjai Kenya Washable Sanitary Wear Project Evaluation.

  1. Introduction:

Oliver & Learn was set up in 2014 as the charitable foundation of OLIVER, with the mission to alleviate poverty. The foundation supports educational projects in disadvantaged communities around the world. In particular, supporting education projects that lead to better lives.

Recent fundraising efforts have been focused on delivering key objectives to support the work of the Charity Friends of Kianjai Kenya, particularly as the local school community of Meru identified that the issue related to menses is having a significant impact on the educational achievement of young girls.

Both charities saw female empowerment as being a key tool in helping to address poverty in this region. This is alongside the growing body of evidence that suggests the education of girls has an impact at both local and national economies in the longer term. Thus, the following objectives were to be addressed by the Oliver team during the week-long trip to Meru: –

  1. Purchase washable sanitary wear in the form of Days for Girls Kits, to tackle the problems of missed days from school, and thus the negatively impacts on a girl’s education; menstrual management to maintain a young girl’s dignity and effective health and hygiene.
  2. Provide training and inspiration towards future career possibilities, by providing interactive learning materials to encourage the children to start thinking about the career possibilities that are out there for them and broaden their horizons to what could be possible.
  3. Pass on valuable knowledge about irrigation and crops they could grow to help benefit and sustain the community in years to come.
  4. Background

Menstruation is a healthy and natural process for women and adolescent girls. The management of menstruation has varied over time and differs with available resources, cultural traditions, and preferences. There is increasing recognition that in low-income contexts, women struggle to manage menstruation in effective and hygienic ways[1]. This has been linked to negative impacts on health, education and wellbeing[2] [3]. A lack of clean and reliable menstrual absorbents has received much of the attention, with interventions focussed on the provision of these products to improve poor menstrual hygiene and associated consequences[4] [5]. There has been a proliferation of programs and organisations providing girls with menstrual absorbents, most frequently reusable or disposable pads[6] [7] [8].

  1. Setting

Throughout the week 28th September to 5th October 2018 the team of seven staff working for and with Oliver Agency Charity, Oliver Live & Learn, were based at Kianjai Polytechnic where a series of workshop sessions covering art, sports, washable sanitary wear and careers guidance, were

delivered simultaneously to groups of young girls and boys from predominantly Grade 4-year groups.

Six secondary schools (Machaku Day Secondary; Nairiri Day School; Machahu High School; Kianjai Girls Secondary School; Mituntu Mixed Day Secondary School and Mituntu Youth Polytechnic) in the Meru province, Kenya took part. Approximately 300 Grade 4 girls attended the sessions, accompanied by their teachers.

Separate sessions for Grade 4 boys that focused on Sexual and Reproductive Health (SRH), Sexually Transmitted Diseases (STI) and teenage pregnancy were also held. In addition, a specific session on SRH and the Days For Girls washable sanitary wear was provided for teachers and parents from fourteen Special Needs Schools.

Oliver Foundation Charity provided resources, such as laptops, reusable – washable pads made by the Charity Days for Girls (Nairobi branch), to address the barrier that managing menstruation was presenting to girls’ dignity, health, education, and psychosocial wellbeing. Washing kits and underwear was also provided for the boys and the children in the Special Needs Schools.

  1. Aims and objectives of Sexual Health & Reproduction Health; Sexually Transmitted Infection and Days for Girls workshop session evaluation

To assess the impact of the session introducing and explaining the Days for Girls washable sanitary wear; sexual health and reproductive health; and sexually transmitted disease session attended by to young girls and boys of six secondary schools (Machaku Day Secondary; Nairiri Day School; Machahu High School; Kianjai Girls Secondary School; Mituntu Mixed Day Secondary School and Mituntu Youth Polytechnic ) in the Meru province of Kenya, and in addition, teachers and parents from fourteen Special Needs Schools.

  1. Evaluation Methodology
  2. The Summative method was used to assess the value of the workshop, content on Sexual and Reproductive Health; introduction and demonstration of the Days For Girls washable sanitary kit and Sexually Transmitted diseases.

Kirkpatrick’s Four Level Evaluation Model[9], in the form of four questions at the end of the workshop session looked specifically at: –

  1. Girl’s perception of what knowledge they gained
  2. The capability of the girls to use of the new sanitary wear
  3. What the girls wished to share with others, as well as eliciting if there was any additional information that they would wish to further increase their understanding and knowledge in the future.
  4. Lastly the girls were asked if they liked the session.

Table 1 below provides an overview of the key responses to the evaluation questions asked at the end of the workshop.

Table 1. Workshop Evaluation Questions and Responses

Question Response
  1. Most important things I have learnt today?
  • How to use and maintain washable sanitary pads to ensure they last 4 years
  • Significance of good hygiene particularly hand hygiene
  • Understanding own reproductive health organs
  • Avoiding early pregnancy
  • Feeling proud and confident to say no to sex
  • Not being afraid about changes to body during puberty
  • Age at which periods commence and cease
  • Overtime recognising when menstruation will happen because kept a diary
  • Avoiding early sexual intercourse to prevent teenage pregnancy
  • Body changes when you ovulate – body temperature rises
  • Pads must be handled carefully to ensure that they last 4 years
  • Washable pads are environmentally friendly
  • Washable pads are more cost effective
  • Learnt more about my body so I can be comfortable with the changes
  • A child’s sex can’t be determined by the day one has sexual intercourse
  • When a period stops it likely indicates that a girl is pregnant
  1. What will you be sharing or telling your friends about what you have learnt in today’s session?
  • The new technology – washable sanitary pads
  • How to use and maintain the washable sanitary pad
  • Understanding of the menstrual cycle and ovulation
  • The importance of periods in a woman’s life and it is nothing to be ashamed of
  • How easy it is to get pregnant when you are young
  • Changes that happen to your body in puberty
  1. What did today’s session teach you that you would want to know more about in the future?
  • Wanting to know more about ovulation
  • Knowing more about transmission of HIV
  • Increased knowledge about menstruation
  • Learn more about sexual and reproductive health
  • Would like to know how to counsel other young ladies in the future
  • Would like to know how to be a peer councillor role model for others
  • Would like to know more about relationships and marriage as I get older
  • Would like to know more about how to prevent infection as a result of menstruation
  • Would like to know how to make the ‘Shield’ and to teach other girls how to use the washable pads
  • Would like to make know how to make the washable sanitary pads so that more girls in need can access them
  • Would like to know more about STI
  • Would like to know about orgasms
  • How to help other girls who need Days for Girls Kit too
  • I would like to experience being a mother one day
  1. Did you enjoy today’s session, and why?
  • All participants enjoyed the session and felt that they had individually learnt something new about sexual and reproductive health, the importance of menstruation, maintaining good hygiene, feeling confident and proud of their bodies and able to say no to sexual intercourse until they are ready
  • Session has taught new things that was previously not discussed
  • Session inspired
  • I feel confident using the washable sanitary pads
  • Learning more about the changes to my body during puberty
  • More confident managing my period
  • How will the change in use of sanitary wear affect the economy? And what will the government do to the companies that continue to produce sanitary towels that harm the environment
  • There is a lot I didn’t know about periods
  1. RECOMMENDATIONS
  • Reusable Days for Girls sanitary pads were rated favourably
  • Puberty education sessions increased knowledge re body awareness and included strategies to address a wider range of practical menstrual challenges, including pain management
  • Responses were notably related to reproductive health and education
  • Valuable to train the special needs teachers in using these pads, as special needs girls managing their menstruation is hugely challenging and it causes the teachers a lot of problems.
  • The distribution of sanitary products to address current deficits in girls’ menstrual management needs to be significantly increased
  • Increased awareness and knowledge of STI particularly HIV required

REFERENCES

  1. Sommer M, Hirsch JS, Nathanson C, Parker RG. Comfortably, safely, and without shame: defining menstrual hygiene management as a public health issue. Am J Public Health. 2015;105(7):1302–1311. doi: 10.2105/AJPH.2014.302525. [PMC free article] [PubMed] [CrossRef]
  2. Winkler I, Roaf V. Bringing the Dirty Bloody Linen Out of its Closet—Menstrual Hygiene as a Priority for Achieving Gender Equality. Cardozo Journal of Law and Gender. 2015. Available at http://www.ssrn.com/abstract=2575250. Accessed Nov 2015.
  3. Das P, Baker KK, Dutta A, Swain T, Sahoo S, Das BS, et al. Menstrual hygiene practices, WASH access and the risk of urogenital infection in women from Odisha, India. Plos one. 2015;10(6):e0130777. doi: 10.1371/journal.pone.0130777. [PMC free article] [PubMed] [CrossRef]
  4. Sumpter C, Torondel B. A systematic review of the health and social effects of menstrual hygiene management. PLos one. 2013;8(4):e62004. doi: 10.1371/journal.pone.0062004. [PMC free article] [PubMed] [CrossRef]
  5. Hennegan J, Montgomery P. Do menstrual hygiene management interventions improve education and psychosocial outcomes for women and girls in Low and middle income countries? a systematic review. Plos one. 2016;11(2):e0146985. doi: 10.1371/journal.pone.0146985. [PMC free article] [PubMed] [CrossRef]
  6. Proctor & Gamble. Keeping girls in school: supporting girls health to promote their empowerment. 2010. Available at: http://www.pg.com/en_ZA/sustainability/social-responsibility/always-keeping-girls-in-school.shtml. Accessed Mar 2016.
  7. Garg R, Goyal S, Gupta S. India moves towards menstrual hygiene: subsidized sanitary napkins for rural adolescent girls—issues and challenges. Matern Child Health J. 2012;16(4):767–774. doi: 10.1007/s10995-011-0798-5. [PubMed] [CrossRef]
  8. Ameade EPK, Majeed SF. Improving girl child education and menstrual hygiene through free sanitary pad provision to secondary school girls-opinion of female university students in Ghana. J Health Educ Res Dev. 2015;3:143.
  9. I. Reaction – How well did the learners like the learning process?II. Learning – What did they learn? (the extent to which the learners gain knowledge and skills)III. Behaviour – Capability of the girl to adequately use the newly learned skills

    IV. Results – What are the tangible results of the learning process in terms of reduced cost, improved quality, increased efficiency, etc.?