Adolescence in girls has been recognized as a special period marked with the onset of menarche. Even though menstruation is a natural process and represents a key sign of reproductive well-being, it is associated with misconceptions, malpractices and challenges among girls in developing countries. Approximately 51% of the total population of Pakistan are females, among them 22.7% are girls in the age bracket of 10-19 years (PDHS 2017-18) implying that most of them have started menstruating.
A research on Menstrual Hygiene Management (MHM) conducted by AKU Pakistan has revealed major gaps in knowledge and practices and various factors causing poor management of menstrual hygiene such as dearth of awareness, taboo and beliefs, socio-cultural practices, poor access to water and sanitation at home,lack of access to affordable sanitary products, absence of private and hygienic facilities for washing and changing of sanitary napkins, as well as lack of facilities for proper disposal of used sanitary products.The study also shows that Majority of adolescent girls and women were not aware of menstruation before the onset of menarche, leading to feelings of anxiety, pain, fear, and shame. More than a third (39.8%) of menstruating women did not use an absorbent and had the misconception that using anything (cloth/pad) will stop their menses.There is no formal channel for providing information regarding menstruationto women, hence transferring information and perceived incorrect notions coupled with lack of access and affordability thus leading to various challenges to social, physical and psychological well-being of adolescent girls and women.
In this regard a working group has been formulated advocating for incorporation of MHM in the programmes and projects of the government departments and development sector organizations. The working group on MHM at the national level acts a strategic platform constituting of key development sector organizations as well as relevant ministries to come together and strategize policy directives to plan and budget for MHM activities to enhance its outreach to communities especially the vulnerable segment of our society.
The National MHM working group currently led by Ms. Tanya Khan of water supply & sanitation collaborative council (WSSCC) is striving to strengthen the provincial chapters of MHM working group in all four provinces and GB and AJK. These provincial chapters have strong representation of the 5-6 provincial government departments as well as of civil society organizations with common agenda of improving the lives of women and adolescent girls.
Capacity building initiatives have been initiated in all provinces led by WSSCC in collaboration with other development sector organizations and institutions. Series of Training of Trainers on imparting MHM sensitization skills is being conducted in all major cities of the country representing all the provinces and territories. A cadre of master trainers is being developed in all the relevant departments and development sector organizations with the objective of expanding outreach activities at the grass roots level. Adherence of strict SOPs in regard to COVID-19 is being maintained in the training events ensuring safety of the participants.
A nationwide movement is being triggered forging alliance amongst the sector stakeholders working towards the common goal of advocating and mainstreaming MHM for adolescent girls/women especially at the grass roots level and communities in vulnerable situation. Through this movement, front line workers from different government departments and development sector organizations (school teachers/community health workers/ community volunteers) are encouraged to come forward and initiate, incorporate, and advocate for menstrual health and hygiene in their respective regions.
Through the MHM Alliance, efforts are being made to implement three pronged approach in scaling MHM agenda in the country which constitutes capacity building and awareness raising initiatives and promotion of safe hygienic products and its disposal mechanism. A road map of training of trainers (ToT) under the leadership of Ms. Tanya Khan is planned in all the provinces in the last quarter of 2020. The first of such an event was held in Karachi for Sindh province followed by Balochistan, Punjab, Gilgit Baltistan amd AJ&K in the consecutive weeks.
The MHM Alliance is striving for enhancing engagement of parliamentarians, religious leaders, academia, CSOs, private sector and social/print media to work hands in hand with the government line departments ensuring accountability and addressing inequalities so that girls and women in Pakistan are able to manage their menstruation in a comfortable, safe and dignified way.
