Improving menstrual health in Uganda beyond schools

Menstrual care is a major health and educational issue affecting girls across the globe. Communities often frame menstruation as a taboo or a belief of being impure and dirty, resulting in the segregation of girls and women. Not knowing how to manage their menstruation, or facing a lack of access to sanitary products, girls across the world seclude themselves. In Uganda for example, class attendance of girls during menstruation days is relatively low. Menstrual care issues result in girls lagging behind boys in terms of completion of primary education, sometimes resulting in school dropouts and very young marriages. Believing in a link between menstrual health, Sexual and Reproductive Health and Rights (SRHR) and Water, Sanitation and Hygiene (WASH), the Orange Knowledge Training ‘Bringing SRHR to Life in Menstrual Health Management in Uganda’ is battling taboos and spreading knowledge within Kampala and rural regions of Uganda.

The initiative in Uganda is a Tailor-Made Training Plus (TMT+) running between 2021 and 2023. It consists of a partnership between SHE Collaborates – Maastricht University, Simavi, SRHR Alliance Uganda, and Uganda WASH Alliance. Collaborating partners from the Netherlands and Uganda work together on enabling an environment for women and girls that are not able to go to school and their surrounding communities so that Menstrual Health issues can be openly discussed and they can receive support from men and boys. With a cascading model of sharing knowledge, and by bringing together civil society and government in achieving shared goals, the initiative is on a fast pace to achieving positive change for communities in Uganda. As a male participant confidently states:

“I have not only learned about menstruation, I have learned more about segregation. I have learned how men are going to be participative or and how we should be supportive to our mothers and girls who are experiencing this."

Collaborating on Menstrual Health
One of the goals of the initiative is to collect grassroot community-based experiences for updating the existing manual for Menstrual Health in Uganda. Linda Lilian from contribution NGO Simavi “The project is about integration. We are integrating SRHR rights, menstrual hygiene and WASH. Where this integration first was a grey zone, it’s now clear that these topics are interconnected. We believe that if the Menstrual Health manual is refreshed and the new manual is completed, it is going to contribute a lot to the local community.” Updating the manual, which is used by community trainers all over Uganda in order to make it better suited for local communities is vital to help the spread of knowledge on topics such as menstrual health. The initiative strongly includes views of different communities on a new Menstrual Health Manual, by using the experience of a diverse pool of master trainers working in different parts of Uganda.

Didactic skills
Besides creating a manual supported by and suited to the local context, the Orange Knowledge training initiative helps to better equip master trainers. Trainers from both alliances and community health workers in Uganda are strengthened with didactic skills and knowledge to use the manual, making training sessions more interactive and fruitful. Thanks to the initiative, trainers are now well-equipped to deliver comprehensive SRHR to women and girls out of school. To further increase positive change, the manual will be spread through local communities in which boys and men, local leaders and local government officials will also be involved. As one male participant stated:

“It is not for only women, men are involved. The key message is that it is our full responsibility for women and men to help others, it is not a responsibility for women only.”

Sustainable impact
Through the collaboration of partners in this initiative, 28 master trainers have been trained from 14 different organisations all across Uganda. These trainers have integrated newly acquired training skills and information into their organisational programmes through which each organisation reaches different community level trainers, local leaders, peer educators and village health teams. This way, a wide variety of communities, including women and girls outside the school environment, are reached by the manual. Master Trainer Dinah Elizabeth Akwii: “My goal for is to ensure that we equip the girls who are out of school with the right information, to be able to address issues of their SRHR, menstrual health management as well as WASH.” As a part of the initiative, collaborating partners together with the Ministry of Education and Sports in Uganda have recently organised five pilot trainings of the proposed menstrual health training manual to more than 100 community health workers. This is an important step in moving towards a formal approval of the manual by the Ministry of Education and Sports (MoES), through which the initiative aims to further institutionalise the new manual within Uganda. Yoka Cerfontaine from SHE Collaborates of Maastricht University. “We work together with an amazing team of Master Trainers from the SRHR Alliance Uganda and the Uganda WASH Alliance. Trainers show a lot of passion for the topics and have a lot of knowledge about the local context. It is great to see that the project really came to life in Uganda and that all pieces of the puzzle start fitting together. We have good hopes that the updated manual will be approved by the Ministry and that with the development of a solid cascading strategy many young people in Uganda will be reached with comprehensive and correct information on SRHR and Menstrual Health.”