On any given day, 300 million people around the world will be menstruating. This normal and natural biological process is a fact of – and fundamental to – life. Everyone who menstruates, including girls, women and non-binary people, has the right to a supportive environment in which to manage their menstruation.
The Human Rights Council formally recognised this in 2018 when they adopted a resolution on menstruation as part of the universal human rights to water and sanitation. This resolution calls on states to tackle menstruation-related stigma and negative social norms, lack of information, and poor access to products and facilities.
Efforts to break down these barriers to improved menstrual health and hygiene (MHH) are gradually gaining momentum, and visibility of MHH issues is starting to rise. In the global water, sanitation and hygiene (WASH) sector, for example, menstrual health and hygiene is becoming an increasingly mainstream component of WASH programmes around the world, with a wealth of guidance and learning now available to support policy makers and practitioners in this area.
However, much remains to be done to ensure these efforts are translated into tangible change for all those who menstruate. Whilst Kenya abolished value added tax on sanitary products in 2004, progress in other countries has been much slower.
In the UK, for example, longstanding campaigns to eliminate these ‘tampon taxes’ as well as to introduce education on menstruation in schools have only recently come to fruition. Other countries, including India, Australia, Colombia and Germany, have also only recently approved changes.
Menstruation is still hidden and shrouded in shame in societies everywhere, and a lack of access to the information, materials and facilities needed to manage menstruation safely continues to impact the physical and mental health of people menstruating.
Menstruation also limits people’s mobility, both as a result of practical constrains such as pain, lack of absorbents or facilities to change them in, and social barriers tied to harmful beliefs, norms and behaviours rooted in gender inequality.
In many societies, people who are menstruating are believed to be impure and their movements may be restricted to limit contact with others accordingly. This has implications on their school attendance and productivity, as well as health and wellbeing. In extreme cases, menstruation-related practices can even lead to death.
The lockdowns many of us are facing as a result of COVID-19 exacerbate these existing challenges and inequalities. For people living in crowded accommodation, managing menstruation privately is extremely difficult, particularly for those dependent on shared or external toilets or washing facilities to which access may be restricted. With many unable to work, shops and schools closed, and supply chains interrupted or overwhelmed, people are also finding it harder to find affordable menstrual products.
And getting enough water for bathing and washing reusable menstrual products may be an additional challenge, as utilities struggle to meet demand and maintain services; queuing at shared water points is restricted and potentially dangerous; and water consumption (and associated cost) increases with more people at home and conscious of the need to wash their hands more frequently. Whilst increased handwashing with soap and other hygiene behaviours are to be encouraged, this may limit the amount of water available for menstrual hygiene.
The world’s focus is rightly on tackling this pandemic but as we do so we must not forget issues that were important before it hit. Millions faced menstrual health and hygiene challenges every day previously and that has not gone away. In fact, for many they have been exacerbated.
Whilst principles of gender equality and human rights should be enough to drive improvements to menstrual health and hygiene, perhaps the fact that women make up 70% of workers in the health and social care sector globally will be a stronger incentive for change.
Unless these people are able to realise their right to a supportive environment in which to manage their menstruation, they will not be able to perform their vital work effectively. In these times of crisis and moving forward, we simply cannot afford not to address the inequalities associated with menstruation.
]]>This blog was written by Elaine Mercer for the CLTS Knowledge Hub and originally appeared on their website.
It has been partly adapted from the workshop ‘Gender Transformative WASH’ (April 2019) that the Institute of Development Studies (IDS) co-facilitated with Dr Sue Cavill for Plan International. The workshop was for Plan country-office staff from Ethiopia, Indonesia, Nepal, Uganda and Zambia implementing the ‘WASH SDG Programme’.
As a sector we are still gathering evidence on what makes up effective gender transformative programming approaches. In this newsletter we suggest nine ideas for criteria.
Gender transformative approaches to programming aim to transform the power structures that underlie unequal gender relations and norms. Empowering marginalised women and girls to come into the public domain, share their perspectives, take on leadership roles, set political agendas and form movements is central to this approach. Working with men and boys as allies and champions of change is also vital in order to challenge and transform dominant social, economic and political structures that perpetuate gender inequality. Transformative approaches also aim to understand how gender inequalities intersect with and compound other inequalities, striving for more complex and nuanced programming.
Gender issues and dynamics affect everyone individually, every day. Our judgements and decisions around gender and sexuality issues are often so deeply ingrained that we make them unconsciously. To avoid ‘unconscious bias’, it is good to have a clear personal/organisational position on these issues as this will affect your own personal and organisational practice. Don’t forget that programme staff and partners also need space and capacity building to explore and understand their own values, attitudes, beliefs and experiences of gender and sexuality.
Here is an interesting short video about ‘Understanding Unconscious Bias’ which encourages you to think about the unconscious decisions you might make around gender and other issues. (The Royal Society, 2015)
WaterAid’s ‘Heroes of Change’ present some good examples of how individual’s stories of transformation around gender norms and WASH practices, can be a source of inspiration for others.
Gender transformation in programming is a process rather than an end goal, which can make it difficult to monitor. However, there are a few tools available, for example, the Gender and WASH Monitoring Tool enables users to explore and monitor gendered relations through facilitated community dialogue. (Plan International Australia and Plan Vietnam (2014))
A central part of gender transformation is women’s empowerment, which is also a set of complex, diverse and multi-layered processes. This short article, ‘Women’s empowerment: Sharpening our focus’ suggests the need for long-term contextual qualitative research in WASH programming (in addition to quantitative approaches) that monitors small incremental changes around empowerment, which over time can add up to a bigger shift. It also requires intersectional analysis to understand the differences between women’s lived experiences, which can be extremely varied. (Institute for Sustainable Futures, University of Technology Sydney, 2019)
This short ‘primer’ introduces Plan International Canada’s (CNO) architecture for gender transformative programming and measurement. The architecture consists of a rights-based theory of change model followed by two useful tools for measuring transformation: 1) ‘A Women and Girls Empowerment Index (WGEI)’ that measures changes directly associated with the root causes of gender inequality across five gender equality domains (roles and responsibilities, resource access and control, participation and decision making, social norms, institutional change). 2) The five domains are also built into ‘The Scoring Tool’ that assesses and ranks projects based on three specific areas: a) Project Design, b )Gender Equality Analysis Domains; c)Resources for gender equality programming.
Key gender issues that intersect with WASH include:
In this short video interview Dr Alison Parker, Cranfield Water Science Institute, talks about the importance of researching both men’s and women’s sanitation and hygiene needs separately when designing toilets.
This short article ‘Intersectionality: ask the other question’ looks at the WASH sector’s engagement with, and use of, the concept of intersectionality, so as to ensure the voice of those “multiply disadvantaged” individuals and groups are placed at the centre of research and programming, and that the structural factors that give rise to inequality and oppression are effectively challenged. (Institute for Sustainable Futures, University of Technology Sydney, 2019)
The discussion paper ‘Gender Equality and Disability Inclusion within Water, Sanitation and Hygiene: exploring integrated approaches to addressing inequalities’ is intended as a conversation starter for WASH programme managers and practitioners looking to strengthen their conceptual and practical understanding of challenges and successes in integrating gender and disability in WASH (WaterAid, CBM Australia and Di Kilsby Consulting, 2018).
Our recent edition of Frontiers ‘Engaging Men and Boys in Sanitation Programming’ looks at the practices and needs of men and boys. It reviews approaches and tools that facilitate men to support women’s leaderships, voice and participation in WASH. It takes a look at how programming can support more positive masculine norms and relations between men and women, and how to bring equality into the division of responsibility between men and women, boys and girls.
A key recommendation is for WASH professionals to collaborate and learn from gender specialists and campaigns that have successfully promoted gender-transformative change by challenging instead of reinforcing gender norms/stereotypes.
If women are not attending, speaking up, being listened to/taken seriously, facilitating and organising WASH meetings (at any level community/organisational/policy), then the barriers to their participation and engagement need to be critically examined, addressed and transformed.
This short article ‘Leadership and voice: more than add women and stir’ looks at the need for women’s leadership and voice in the WASH sector to inspire younger generations, shift gender norms and deliver more inclusive policies and development. (Institute for Sustainable Futures, University of Technology Sydney, 2019)
It is also essential to work with women’s organisations and other intersecting civil society organisations to build momentum and pressure to generate transformation. In her video interview, Hanh Nguyen Hong (Thrive Networks/East Meets West) talks about how the Women-Led Output Based Aid (WOBA) programme in Vietnam partnered with the Vietnam Women’s Union, a fantastic and well-connected mobilising force with over 17 million members across the country at all levels, including village level.
Water, sanitation and gender equality are fundamental human rights and integral to a human rights-based approach to development that recognises the importance and indivisibility of all rights. Women and girls are empowered when they have control over their WASH needs as rights-holders and participate in the planning and provision of WASH services. This position paper Water, Sanitation and Hygiene: A Pathway to Realizing Gender Equality and the Empowerment of Women and Girls draws on examples from the WASH sector and demonstrates how the sector can take an evidence-based, innovative, gendered and rights-based approach to transforming the lives of women and girls, and the communities in which they live.
There are not many resources focused on working with policymakers to address gender norms to make WASH programmes more gender transformative. However, the materials for ‘Making Rights Real’ are designed to show local government officials how human rights in general can improve the way water and sanitation services are planned, delivered and maintained. (WASH United, WaterAid, Institute for Sustainable Futures – University of Technology Sydney, End Water Poverty, UNICEF and RWSN, in partnership with C3.(2016))
Traditional leaders hold a great amount of power in many communities especially when it comes to influencing social norms. They are important ‘gatekeepers’ who play a vital role in passing on ideas and information to communities. Social norms around gender can be very ‘sticky’ and difficult to change so finding a way to work with traditional leaders can be valuable. This blog ‘Practitioner Tips: Transforming Harmful Gender Norms in WASH with Traditional Leaders’ offers some thoughts on working with traditional leaders in implementing gender transformative approaches.
In this short video interview Helen Lungu a gender specialist working for Plan International Zambia shares her thoughts on why a gender transformative approach is so valuable to WASH programming especially in challenging restrictive gender norms, practices and policies.
Working on gender issues, especially using an approach that aims to transform harmful power dynamics will always be welcomed by some more than others. These presentation slides list some potential challenges and unplanned consequences of using a gender transformative approach and ideas for how to overcome these.
It is also important to acknowledge that WASH programmes alone cannot solve existing social inequalities and structural problems, but that they can be implemented in a way that supports significant change in gender relations and norms.
It is also vital to highlight questions that we are still grappling within this relatively new area, for example:
Are you working on gender transformative WASH programming? Or maybe thinking about it? We would love to hear from you! Tell us about the issues you face, approaches you’ve used (or plan to use), successes you’ve had and the questions that you are grappling with. It would be great to open up a discussion! Email us at CLTS@ids.ac.uk
]]>The review indicates that menstrual cups are a safe option for menstruation management and are being used internationally. Good quality studies in this field are needed. Further studies are needed on cost-effectiveness and environmental effect comparing different menstrual products.
]]>Given the shortage of information on period poverty globally, the expected sensitivities around the topic, and the lack of standardised tools and methods (Phillips-Howard et al., 2016), evidence is predominantly provided from qualitative, participatory, and descriptive methods. It is difficult from the qualitative studies to determine the extent to which period poverty impacts any of these outcomes or economic empowerment, or how influential period poverty contrasts with other challenges facing women and girls in the contexts studied.
]]>The WASH programme provides up to £164.8 million over a seven-year period (2013 – 2020) to increase the availability of sustainable WASH services in the DRC. The programme consists of four pillars that together aim to deliver quality, scale and sustainability of WASH sector results in DRC:
1. Creating community incentives to deliver individual lasting behaviour change;
2. Increasing affordable access to WASH education;
3. Strengthening systems of empowerment and accountability between the communities, service providers and local and provincial government structures; and
4. Improving the capacity of service providers, institutions, and communities to monitor, operate, maintain, and deliver WASH services, and improving the capacity of national government to coordinate, monitor, and set appropriate priorities in the WASH sector.
Based on the overall progress summarised in the main report, the details described in the subsequent sections and the project score calculator, the overall score for this annual review is an “A”.
]]>This document may be accessible through your organisation or institution. If not, you may have to purchase access. Alternatively, the British Library for Development Studies provides a document delivery service.
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This document may be accessible through your organisation or institution. If not, you may have to purchase access. Alternatively, the British Library for Development Studies provides a document delivery service.
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