Presenter – Zahida Stanekzai –UNICEF Date: 23 Nov -2016 Islamic Republic of Afghanistan Afghanistan Conference on Sanitation 2016 Menstrual Hygiene Management -Experiences of Adolescent Girls in Afghanistan Presenter – Zahida Stanekzai –UNICEF Date: 23 Nov -2016

Presentation content Background information Fining of KAP study in 2010 MHM Formative Research- 2016 Key finding Determinants Challenges Potential Impact Potential Risk Way forward

Background information Challenge of understanding and managing menses. Discovering blood, feeling an uncomfortable crumping Finding themselves in need Cultural taboos and secrecy More the half of the schools lack facilities for girls and female teacher. lack of facility for disposal of used sanitary materials or pieces of clothes

Continue 3.5 million children, the majority of which are girls, remain out of school 79 % of girls didn’t complete primary education, largely due to cultural barriers, such as early marriage and a lack of female teachers.

Mensuration hygiene management KAP-Study -2010 Restrictions imposed on girls during menstruation 80% do not play sports, do not eat certain foods such as sour foods, vegetables, and also not take shower up to end of menstruation 30% girls stay at home in the menaces days Source: UNICEF –MHH KAP survey report 2010

Recommendation of KAP study 2010 Menstruation hygiene management/ puberty guideline developed Facility for management of menstruation in privacy

MHM Formative Research -2016 The formative research conducted in Aug -2016 to find the Knowledge, Perceptions, and Experiences of Adolescent Girls The MHM research identified the determinants, challenges , risk and impact of MHM in girls life

Functionality of WASH Facilities School latrines lack privacy, running water and cleaning materials (toilet papers and soap).

Conditions Latrines I do not use the school latrines because of the poor conditions and maintenance. I live near-by school and often goes home to use the latrine at home. This wasn’t the case for other teachers, particularly those who do not live in proximity to schools.” -KII Teacher-  

Continue Availability of Disposal Sites There is no proper place for girls to change and dispose of their used napkins

Continue Water is often located far away from the toilet, making it impossible for girls to privately wash before rejoining their classmates

Continue….. Knowledge of Menstruation before Menarche No structured content present in the school curricula Teachers avoid to talk as the topic is sensitive and linked with shame and taboos Visit clinic gynecologist doctor Cultural Beliefs and Practices

Challenges Coping with stress Overcoming shame Managing daily school activities despite of discomfort Communicating menstrual issues and seeking right guidance in this matter Limiting from socialization Access, management and disposal of sanitary waste

Participation in school activities Potential Impacts Social Isolation Prefer to be alone Participation in school activities School absenteeism

Potential Risks 1. Health Consequences Infection Infertility 2. Education consequences School drop out Early marriage

Way Foreword Advocacy at high level Capacity development Curriculum revision Dissemination Workshops Coordination at all level ( preventing early marriage, avoid school drop out, promote health ) Prioritization Provision sufficient water, sanitation and hygiene facilities in school.

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