1. Rosemary James National University of Ireland, Galway
Menstrual Hygiene Health in Uganda’s refugee settlements: including boys and health education
Rosemary James
National University of Ireland, Galway

2. Major MHM problems in Ugandan refugee settlements
Lack of WASH
Poor accessibility of menstrual products
Limited reproductive health knowledge
Over 60% of the girl pupils absent themselves from school during their menstruation
BV, candida, PID risk using cloth/toilet paper

3. Humanitarian setting
‘The provision of sanitary materials to all women and girls of concern will become standard practice in all UNHCR assistance programs. This is central to women’s dignity and health’ -UNHCR, 2005
The commitment is to provide:
Either absorbent cotton material (4 sqm/year) OR disposable napkins (12/month)
Underwear (6/year)
Soap (250g/month) – in addition to the general soap distributions
250g/month
6/year
12/month
(UNHCR’s Strategic Objectives (SO) Expected Accomplishments and Indicators of Achievement 3.2, 3.3, 4.1, 4.3, 4.5, 9.1)

5. UNHCR Working Group on MHM
Collaborative: 10+ organizations involved
Distribution into schools and communities, coupled with sensitization and education
Difficult due to constant influx of new refugees
Fragmented approach
Coupled with SRHR education

6. Innovative solutions Reusable Pads Reusable Afripads (1 pack/year)
Single-use MakaPads (95% biodegradable papyrus leaves)
Menstrual Cups
Womena -81% satisfaction rate
there appears to be a trade-off between wanting to respond quickly and with urgency, and assuring that whatever the MHM response encompasses, it is culturally and socially appropriate so as no to prove useless and disempowering to girls and women
Paul holds a B.Sc. in Biology from McGill University in Montréal, Canada. He and his wife, Sophia, founded AFRIpads in 2010 while living in a remote village in Uganda, where they saw the direct need for an affordable sanitary pad in these parts of the world.

7. Involving boys & men is key
India found that peer-education for males decreased myths and stigmatization1
WHY SO IMPORTANT?
To encourage them to help collect the supplies
To avoid them selling off the distributed supplies
To reduce gender-based violence
To discourage transactional sex
To educate about reproduction and the menstrual cycle, which can decrease unwanted pregnancy rates
1. Country presentation at the International Technical Consultation on Menstrual Hygiene Management (MHM) and the Education Sector, 10–12 July 2013, Nairobi, Kenya. For further information please

8. Follow-up surveys are key to sustainability

9. Sources & Acknowledgements
Katego clinic, Reproductive Health Uganda
Midwives, Yumbe Health Center IV
Focus groups: Uganda Red Cross, Yumbe and Arua branches
Nakalema Shamirah, Womena Uganda
Sommer, M., Schmitt, M., Clatworthy, D. (2017). A toolkit for integrating Menstrual Hygiene Management (MHM) into humanitarian response. (First edit). New York: Columbia University, Mailman School of Public Health and International Rescue Committee.