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How an Innovative Communications Model is Enhancing Menstrual Health Management in Bauchi, Nigeria

By Sunday Oko and Onyinye Oranezi (Lead Writers)

Menstrual health and period poverty continue to be a major challenge affecting girls and women in Nigeria. Despite being a natural and necessary process in the female reproductive cycle, menstruation remains associated with secrecy and shame, with cultural and religious beliefs often dictating how women manage their periods. These cultural and religious attitudes have contributed to inadequate education about menstrual health and the use of menstrual products. Recently, a state in the United States is proposing legislation that would ban primary school pupils from learning about menstruation.

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Poverty often compounds this issue, as many low-income homes cannot afford menstrual health products like sanitary pads. According to a World Bank study, over 300 million women globally menstruate every day. An estimated 500 million do not have access to adequate facilities or products for managing their menstrual health. The inability to afford menstrual products causes one out of every ten girls in Africa to miss school while menstruating, which significantly impacts their education and may contribute to the dropout rates of girls from school.

Image credit: Nigeria Health Watch

In May 2021, PLAN International, a global organisation promoting girls’ rights, implemented the Kimberly-Clark Foundation (KCF) Menstrual Health Management (MHM) programme in 58 wards in three local government areas (LGAs) in Bauchi, Katagom, and Ningi — in Bauchi State. Funded by Kimberly-Clark Foundation and is supported by the Kotex brand, a menstrual health product brand, the project’s overall goal was to increase the individual and collective agency of women and adolescent girls to exercise their rights to gender-responsive, adolescent-friendly and inclusive menstrual health management.

Image credit: Nigeria Health Watch

The programme adopted several strategies including the setting up of ‘Pad Banks’ in schools, conducting intensive training for young men and women, and the establishment of a community peer educator system to increase access to menstrual health products, promote healthy menstrual practices and break down stigma and barriers that negatively impact the lives of girls and women.

Effective collaborations

According to Mr Afolabi Ahmed, Project Coordinator at PLAN International, the programme set up a ‘Pad Bank’ to encourage girls to stay in school as, through engagement with stakeholders, period poverty was identified as a fundamental issue that led to absenteeism from school. PLAN International established the banks in collaboration with Community Based Organisations (CBOs), the Bauchi State Ministries of Health, Education, Women Affairs and Child Development, and other community-based agencies.

Stakeholders during the activation of the Pad Bank project in Ningi LGA, Bauchi State. Photo credit: Plan International Nigeria

The Pad Bank supplied sanitary pads to 32 secondary schools across the three LGAs. Initially, cartons of menstrual pads — containing 16 packs each — were distributed to the schools. The number of cartons sent to each school was based on the population of the girls in that school. Subsequently, the pads were distributed in packs.

The sanitary pads were stored at the school clinic, if the school had one or in a storeroom, with a clinic nurse or teacher overseeing the distribution. If a girl’s period started in school or she needed to change her pad, she knew to quickly find the teacher in charge of the Pad Bank or visit the school clinic. They received one pad per visit but could return for more if necessary.

PLAN International also collaborated with Mata Dari, Muriya daya (100 women with one voice), a local advocacy group, training each member from the 58 wards where the project is being implemented on Menstrual Health Management (MHM) in the community. Following that, they conducted peer educator training on MHM across households and communities with young girls between 10 and 19 years old. After completing the training, the girls selected between eight to 10 of their peers within the community to cascade the training, thereby expanding the circle of knowledge and awareness around menstrual health and hygiene. Amina Yahaya, a peer educator, said that five training sessions took place in a quarter, and every peer educator received a pack of eight sanitary pads per session.

Allies and supporters

Another strategy the project adopted was “engaging with male champions from previous PLAN projects to educate and increase awareness on menstrual health among men and boys in the communities,” Mustapha said. He added that in many regions of northern Nigeria, educating boys about menstrual health is still regarded as a taboo subject. However, community buy-in, which was accomplished by gaining the support of religious leaders, traditional leaders, private school owners, and educators at the local government level, helped them overcome this limitation.

Male champion session at Ningi Local Governmnet Area, Bauchi State. Photo credit: Plan International Nigeria

The training was carried out using a curriculum developed by the PLAN International team. Although the training content differed for male and female participants, it focused on understanding menstrual health and dispelling myths and misconceptions regarding menstrual health management.

Mustapha Abubakar, a male champion, said that the project helped improve MHM awareness at the community level. He revealed that the sensitisation meetings were always well attended. The girls were not shy about sharing their MHM experiences on the radio. They also proudly wore the jackets provided to them by PLAN International because it caught the attention of community members which gave them an opportunity to discuss the programme.

Sensitisation on Menstrual Health Managment for male adults in Katagum Local Government Area, Bauchi State. Photo credit: Plan International Nigeria

Addressing the problem at its core

The KCF Menstrual Health Management (MHM) programme which is coming to a close in 2023, has trained 61 adolescent peer educators on Menstrual Health Management, with 1,525 adolescents reached with MHM messaging during peer sessions at the community level. Mustapha noted that the training has helped raise awareness among girls, leading to better menstrual health practices during their periods. Mallam Zailani Wakilin Dankade, a Traditional Ruler in Bauchi LGA who participated in the training, said another benefit of the training was clearly seen in the fact that “fathers now believe that it is not shameful if their daughters request for money to buy sanitary pads”.

Adolescent girls holding a peer education session at Ningi Local Government Area, Bauchi State. Photo credit: Plan International Nigeria

While these interventions are addressing menstrual health challenges in the targeted wards, a major obstacle remains the need for adequate data to assess the impact of interventions on the wider issue of access to affordable menstrual health and hygiene products. This can lead to fragmented and poorly targeted interventions, hindering progress in addressing period poverty.

A cross section of students during an awareness campaign on Menstrual Health Management, Government Girls Day Secondary School in Bauchi LGA, Bauchi State. Photo credit: Plan International Nigeria

Poverty is a significant driver of period poverty. It is a complex issue that requires a multifaceted approach. Girls and women who miss school or work due to their menstrual cycle may be less productive and earn less, lowering the country’s overall economic output. Furthermore, the stigma associated with menstruation can limit women and girls’ participation in social and economic activities, further perpetuating the cycle of poverty.

In addition to ensuring that women and girls in low-income communities have unlimited access to affordable menstrual health products, economic opportunities such as microfinance programmes, job training, and entrepreneurship opportunities should also be made available to them. These opportunities will provide girls and women with the resources and support to address the root cause of period poverty and create sustainable solutions that empower and enable them to manage their menstrual health with dignity and respect.

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