dining for women (d4w) interim report 1. information...dining for women (d4w) interim report 1....
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Diningforwomen(D4W)InterimReport
1. Informationa. OrganizationName:SustainableHealthEnterprises(SHE)b. ProjectName:SHE28c. GrantAmount:$46,947d. ContactPerson:MelissaDriverBearde. Address:175VarickStreet,NewYork,NY10014
2. Outcomestheprogramwasdesignedtoachieve
Theprogramwasdesignedtoincreaseaccesstopadsandknowledgearoundmenstruation.Throughtheprogram,503,000go!padswillbedistributedtotenpublicschools,tenkiosks,andotherschoolsandinstitutionsthatserveyouthsuchasyouthvillages,orphanages,andNGOsimpactingover3,000girls’abilitytoaccessaffordablepads.Theschoolswherewedistributepadswillbeabletoprovidedoubletheamountofpadstheycanprovidetogirlsbecauseofourpads’affordability.Attheschoolswherewedistributepads,50targetedteachers/personnelhavebeentrainedinpubertyeducationandmenstrualhygienemanagement(MHM)inordertodeliverMHMafter-schoolprogrammodulestogirlsandboyswithconfidence.Girls,boys,parentsandteacherswillreceiveMHMeducationresourcematerials.
3. ChangesinFundingforthisProgram
Therewerenosignificantorunexpectedchangesinfundingforthisprogram.
4. ChangesinOrganizationorProgram
NadiaHitimana,ourHealthandHygieneManageratthetimeoftheapplication,hasleftSHEtopursueherMastersinPublicHealthattheLondonSchoolofHygieneandTropicalMedicine.
TherehavebeentwoadditionstotheSHEteam.MelissaDriverBeardhasjoinedtheorganizationasExecutiveDirectorandJeanetteMurekatetebeganworkinNovember2015asourHealthandHygieneManager.JeanettehasanMPHand14yearsofworkexperienceintheWASHSector.Shehasconductedtrainingsofbothtrainersandyouth,includingMHMeducationforgirlsinrefugeecamps.
5. Challenges
Ourfirstchallengewasovercomingteachers’perceptionsonMHM.SomeoftheparticipantsstronglybelievedthemythsaroundMHM.Afteranalyzingthefactsbehindmenstruationandcomparingthosefactswithmythsandbeliefsattachedtomenstruation,theteacherscametorealizethatthemythsandtaboosaroundmenstruationwererestrictionsonwomenandgirlsthatwererootedintheculturalcontextratherthangroundedinscientificfact.Evenwithascienceteacherinthecohort,thegroupattimesdidnotfullygrasptheanatomyandphysiologyofthefemalereproductivesystem.However,apersonalexchangeofinformationandexperiencescreatedanatmosphereinwhichalltheteacherswerehighlyengagedandhelpedsomeofthenewteachersbetterunderstandtheinformationpresented.Moretimethanplannedwasrequiredforthetrainerstoresolvemisconceptions.Thisresultedinlesstimebeingavailableforothersubjectsplannedbythetrainer,suchasthemenstrualcycleandchoosingfemininecareproducts.Wehavefacedanotherobstacleinconductingourmonitoring&evaluation.Wehadplannedtoconductourstudentknowledgeandbehaviorchangepost-teststowardstheendofthe2015schoolyearandbelievedthattheschoolyearendedinmid-tolateNovember2015.However,welearnedonshort
noticethattheschoolyearendedinmid-October2015,withtheremainingtimeservingasareadingandexaminationperiod.Conveningthestudentsduringreadingandexamperiodprovedtobeimpossible.Tothatend,wewillneedtoconductthepost-testsinJanuary2016andwillrequestanextension,tobediscussedinSection8belowThischangeinschedulewillenableustoaskmorerigorousquestionsinthepost-test,aswelearnedinthepre-testthatsomeofourquestionswerenotdetailedenough.Ontheproductionside,inordertoincreaseourthroughputandreach250,000ormoregirlsbytheendof2017,wehavekickedoffapartnershipwithamultinationalhealthcompany,whichisdesigningmachineryforusthatwillincreaseourthroughputbytenfold.Wehavealreadyimplementedproductimprovementssuggestedbythispartner,andwillcontinuetodoso.6. Revisionofobjectives
Inourproposal,westatedthatSHEwouldprovide180,000padsto3,000girlsin10schools.In2015-16,wewillactuallymanufactureatotalofover2milliongo!pads.40,000ofthesepads,ratherthantheestimated180,000,willbeprovidedfor3,000Rwandangirlsthroughthe10schoolsmentionedinourproposal.Given2015budgetallocations,thisisboththemaximumthatschoolscanbuyanddoubletheamountofcompetitors’padsthatschoolsbuyforgirlsatcurrentprices.Thisprovisionwillensurethatgirls’roomsarestockedwithpadsforgirlstouseincaseofemergencies.Becausewearecommittedtoincreasinggirls’accesstopads,another50,000padswillbesoldatkiosksnearthe10schools.Finally,413,000willbesoldtootherschoolsandinstitutionsthatserveyouthsuchasyouthvillages,orphanages,andNGOs,whichhavetheresourcestosupplygirlswithpadsforregularuseratherthanonlyforemergencies.Takenasawhole,throughthesechannels,wewillincreaseaccessfor6,803girlsthroughschoolgirls’roomsandbulkpurchasers.Wethinkthismakesforamoresustainablebusinessmodelinthelongtermandultimatelyincreasesgirls’accesstopads.
WecommunicatedthischangetoDiningforWomeninFebruary2015,andthischangewasapproved.Ourobjectiveshavenotchangedotherwise.
7. Progresstowardsachievingobjectives
SHEhasusedtheD4Wgrantforthreemainactivities;teachertraining(November2014)andrefreshertraining(March2015),M&Ewithstudents(March2015)andtocollectteachers’feedbackontheMHMimplementationwithstudents(August2015).Asafollowupstep,SHEwillconductfeedbacksessionswithstudentstolearnhowtheirteachersandSHEcouldservethembetter.
a.SHEMenstrualHygieneManagement(MHM)teachertraining,November2014
Thetrainingwasconductedfor51academicians(24malesand27females),from10schoolsintheEasternprovinceofRwanda,Kayonzadistrict.Amongtheteamwere3headteachers,2headmasters,1headmistressand3directorsofstudies.TheseteachersnowconductMHMtrainingsforstudents.ThegovernmentofRwandahasallocatedabudgetlineof$35,000forhygieneimprovementinschools,includingfor$267perschoolperyearthepurchaseofsanitarypads.Participantswereselectedbasedontheirinfluenceonmakingthegovernmentafterschoolprogramadvanceintheirrespectiveschools.ScienceteacherswillbecatalystsinhelpingunderstandthephysiologyandanatomyrelatedtoMHM.
Thetrainingswereconductedfrom10-13November2014attheMidlandHotelinKayonzadistrict.The51teachersweresplitintotwogroups.Eachgroupwasallocatedatotalof2daysforthewholetrainingsession,withapproximately13hoursofinstructionforeachgroup.
Thepurposeofthetrainingwastoincreaseteachers’knowledgeandskillsonmenstrualhygienemanagement(MHM)and,consequently,theirconfidenceintrainingtheirstudents.OurmaingoalistoprovidereliableinformationonMHMtoteachers,students,andtheRwandancommunity.Furtherdiscussionwillbreakthesilencearoundthetopic,thuskeepinggirlsinschoolsandempoweringwomentoparticipateandcontributetosustainabledevelopment.ThelanguageofinstructionwasKinyarwanda,thelocallanguage.
i. Generaloverviewoftheteachertraining.
Trainingsessionswentaccordingtoplan.Teachersappreciatedthegoalofthisinitiativebecausetheywereunfamiliarwithhowtoaddressthiscriticaltopic.AmongthesubjectstaughtwereMenstrualCycle,ChoosingFeminineCareProducts,andBeliefs,Norms,Myths,andTaboos.Onemaleteacheramongtheparticipants,afterhavingattendedthesessiononthemenstrualcycle,said,“Inowunderstandwhymywifebehavesthisandthatotherway.Iamsoshamefulforblaminghertonotbe
abletocontrolourbirths,butknowIseehowcriticalthisis.Icanonlyimaginehowconfusingandstressfulforayounggirlduringhermenstruation.” Anotherteacherexpressedabeliefinthemyththatmenstruatingwomencouldlowertheyieldofherfamily’scropsbywalkingthroughthefieldwheretheygrow.Thispersistenceofmisinformation,evenamongteachers,showshowfarwestillhavetogoindispellingmythsonmenstruation.
• Teacherslikedthemanuallayoutandteachingmethodologies.TheteachersagreedtogothroughtheSHEMHMmanualafterthetrainingandcomebacktothetrainersformoreclarificationsandimprovementsuggestionswhereneeded.
• Teachersdemonstratedsomeknowledgeofthephysiologyofmenstruation,butmanyonlyhadbasicinsightaboutthetopic.Ingeneral,thefacultyhadnottackledthetopicofMHMbecausetheybelievedthatitwasasubjectbestleftbetweengirlsandtheirmothersorotherfemalefamilymembers.However,manywomenthemselvesdonotknoworaresilentaboutMHMevenwithintheirfamilies,andmalesoftenneverlearnaboutMHM.
ii. Immediateimpactofthetraining
Basedonthepre-andpost-testsadministered,MHMknowledgeamongteachershasincreased.Pre-testgradesrangedfrom48%to84%.Post-testgradesrangedfrom61%-96%.Theaveragescoreinthepretestwas62.9%,increasingto74.1%inthepost-test.Additionally,thepretestmedianwasat66%andthepost-testmedianat78.5%.SHE’sobjectiveofincreasingteachers’knowledgeofMHMwasachieved.Femaleacademiciansscoredhigherthantheirmalecounterparts.Fromournon-scoredpartofthetest,morethan80%ofparticipantssaidtheywerenowconfidentaboutMHMasasubject.
iii. Recommendations
• Teachersindicatedthattwodaysoftrainingwerenotsufficienttocoverallthematerial
• TeacherssuggestedwehighlightthemodulesonMenstrualCycle,ChoosingFeminineCareProducts,andBeliefs,Norms,Myths&TaboosandspendlesstimeonthePuberty&Adolescence,Care&DisposalofMenstrualProducts,andHealthPracticesmodules.
• Teacherssuggestedthatmodulesbeadjustedfortheageofthestudents• Teachersproposedthatwehavevideoinstructionalmaterials
iv. StepsForward
• Bothparticipantsandtrainersagreedthatschoolvisitswillbecarriedouttofollowupontheimplementationplanforthestudents’trainingsandforWASHassessments.
• TheBusinessdevelopmentandproductionteamsneedtopayattentiontothegovernmentschoolpadsbudgetforitwasreportedfromvariousteachersthatthisamountisnotconsistent.
b.TheTeacherrefreshertrainingsoverview
Thetrainingshappenedfrom30January-5February2015.SHEstaffre-trainedtheteachersonlessonstheyhadmisunderstoodorforgotten,elaboratedanimplementationplanforstudents’trainingsandassessedtheschools’WASHfacilities.Onlyoneschoolfailedtoelaborateanimplementationplan.
i.RepeatedLessons
AllofthesmallgroupswantedtorepeatthelessonsonMenstruationandMenstrualCycle,andChoosingFeminineCareProducts.
ii.FeedbackandRecommendations
• Condensethemanualcontentandrearrangethemodules• Coupleourfinalmanualswithinstructionalmaterialsforstudents.Trainerssuggestedpelvicmodels
ordrawingsonpiecesoffabric,menstrualcups,andreusablepads.• Thefinalsoftcopyofthetranslatedmanualshouldbeproofreadbyoneoftheteacherstoensure
thatthecontentandlanguageappropriatetobothstudentsandteachers• DevelopbookletsorotherIECmaterialsforstudents• TrainerswillgenerateadataanalysisofWASHfacilitiesinthe10schools
c.TeacherTrainingEvaluationIn-Service
Thefinalteachertrainingin-servicetookplacefrom10-14AugustattheMidlandHotelinKayonzaDistrict.52teachersandheadmastersfrom10schoolsinKayonzaDistrict–thesameteacherswhoattendedthefirsttwotrainingsessionsandconductedstudentMHMtrainings–attended.Thepurposeofthisevaluationin-servicewasfortheteacherstoevaluatetheteachertrainingmanualandtheeffectivenessofthestudenttrainings.Keyfindingsinclude:
• Teachersfounditeasytoteachstudentsaboutpuberty,asstudentsarealreadyexperiencing,andcuriousabout,puberty-relatedchangesintheirownbodies.Teachersfounditdifficulttoteachstudentsaboutthemenstrualcycle,especiallythephysiologyaroundreleasingoftheegg,variablecyclelengths,andirregularcycles
• Teachersbelievetheyareopeningupasafespacetotalkaboutsensitivetopicsthatintereststudents.
• Toeffectivelydeliverstudenttrainings,teachersneedmorecolorpicturesinthemanualandmorevisualmaterialssuchaschartsandcalendarsforexplainingandtrackingmenstrualcycles,exercisesandcasestudies,samplesofmenstrualproducts,andvideos.AbiologyteacherwhohashadMHMtrainingshouldgiveinputonthedevelopmentofstudentIECmaterials.
• Teachersalsosuggestedusingparticipatory,student-centeredpedagogicalmethods,e.g.presentations,skits,roleplaysthatstudentsdothemselves
• TeachersaremorecomfortableteachingstudentsaboutMHMthantheywerebeforethetraining• Teachersneedtobepreparedtounderstandthemenstrualcycle,answerquestionsfromstudents,
talkopenlyaboutwhathadpreviouslybeenconsideredasensitivetopic,helpstudentsbreakdowntaboos,andadjustcontenttobeage-appropriateforstudents
• Teachersrankedthemostimportantmodulesas:1)Puberty;2)menstruationandmenstrualcycle;3)menstrualhygiene;4)challengesfacedbygirlsandwomen;and5)myths,beliefs,&taboosaroundmenstruation
• Teacherssuggestedthatallothermodulesbesummarizedandcondensed• Studentsneedabooklettofollowalongwiththetrainings• Studentshadagoodunderstandingofpubertybutlittleunderstandingofthemenstrualcycleand
howtousedifferenttypesofmenstrualproducts
• Bothboysandgirlsshowedinterestinandexpressedcuriosityaboutthetopic,thoughgirlsweremorecomfortableaskingquestionsingender-segregatedgroups
• Boysaremoresupportiveofmenstruatinggirlsaftertheygothroughthetrainings
• TeachersareeagertoteachMHMinnationallymandatedafter-schoolhealthclubsoncethoseclubsareimplemented.
• MHMteachertrainingneedstobereplicatedatthenationallevelasuntrainedteachersdon’tunderstandtheimportanceofMHM
• SchooladministratorsshouldrecognizetheimportanceofMHMandencourageteacherstotraintheiruntrainedcolleagues
• Itiscriticaltoconveyaccurateknowledgearoundpuberty,menstruation,andMHMtoparents,andstresstheimportanceofbreakingthesilencearoundthesetopics.
d.BaselinedatareportonstudentsM&E
SHEconductedapre-knowledgeandpre-behaviorchangebaselineassessmentamongmaleandfemalestudentsinthe10schools.Thegoalofthisassessmentwastodeterminethestudents’knowledge,attitudesandskillsaswellastheirbehavioraroundMHMpriortothestartoftheMHMclubs.Theassessmentscombinedbothqualitativeandquantitativemethodsandwereconductedfromthe9thtothe20thMarch2015.Thetotalnumberofstudentsreachedwas657usingavarietyofdatacollectionmethodologiestoinclude:surveys,focusgroupsanddiaries.
Keyfindingsinclude:• Acrossallschools,students(primaryandsecondarystudentswithapproximateagesof10to15
years)werecorrectintheirMHMknowledge74%ofthetime,incorrect18%ofthetimeandnotsure8%ofthetime.
• Secondaryschoolstudentsweremorelikelytogivecorrectanswersthanwereprimaryschoolstudents(77%versus71%ofthetimeforprimary)
• GirlswerecorrectintheirMHMknowledge76%ofthetimeversusboys69%ofthetime.• While34%ofboysadmittedtheywereembarrassedtotalkaboutmenstruation,86%ofbothboys
andgirlsthinkthatboysshouldbeincludedinconversationsaboutmenstruation.• 15%ofgirlsand21%ofboysconsideredmenstruatinggirlsunclean.• 42%ofgirlsand24%ofboysbelievedthatgirlscouldparticipateinsportsduringtheirperiod.• 12.6%ofgirlsreportedthattheyhadmissedapartialorfulldayofschoolduringtheirmostrecent
menstrualperiod.• Ofthosegirlswhomissedallorpartofadayofschool,menstrualpainwasthereasonformissing
school79%ofthetime;lackofproductwasthecause8%ofthetime.• 72%ofgirlsreportedusingthepitlatrineforpaddisposal.
• 81.6%ofgirlswhocompletedthebehaviorsurveyuseddisposablepadsastheirprimarymenstrualproductduringtheirmostrecentperiod.
• Tenofthe191respondents(5.2%)reportedusingmorethanoneproductduringtheirmostrecentmenstrualcycle.8ofthosewereacombinationofdisposablepadandcloth.1wasacombinationofclothandcottonwooland1wasacombinationofnothingandclothing.
• Everytime47%andSupa44%werethemostpopulardisposablepadbrands.• Themajorityofgirls(48%)went2-4hoursbetweenchangingproducts.Girlsweremorelikelyto
stretchthatto4-6hoursandlongerifwearingapadthaniftheywereusingcloth.• Thevastmajorityofgirlsacquiredthepadsfromthestore(49%)orhome(44%).Only3%saidthey
gotthemfromschool.• 34%ofgirlshadrequestedpadsfromschoolinthepastandreportedthattheywereavailable97%
ofthetime.• Whenchangingtheirmenstrualproductatschool45%changetheirproductinthelatrine,37%
changedtheirproductinthegirlsroom• 14%ofgirlssaidtheyhadfeltashamedatsomepointduringtheirlastperiodand2%reportedthat
theyhadbeenteasedduringtheirlastperiod.
e.TeacherfeedbackonMHMimplementationinschools.
FeedbackfromourfirstcohortofteacherswillhelpusdeliverMHMteachertraininginthemosteffectivemannerpossible.Thisinformationwillhelpustomodifythemanual,andtobetteradvocateforotherteacherstobetrainedinthissubjectandconsequentlysupportandtrainstudentseffectively.
8. Pictures
Seeattached
9. Messagefordonors&community
Thankstoyoursupport,SHEtrainedover50teachersin10schoolsinKayonzaDistrict,whothenwentontotrain657studentsinMHM.WehopethatyoucontinuetosupportSHE28andourworktokeepgirlsinschool,period.
10. Listofexpensesincurred
Seeattached
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