Five working groups discuss recommendations for a Plan of Action on menstrual health issues for 2019/20 to be presented to the Nepali Government.
The Summit divided into technical working groups to discuss and add to the recommendations drawn up at a preparatory meeting of MHM Alliance members held on 3rd December. These recommendations will inform further discussions for a Plan of Action for 2019/20 to be presented to the Nepali Government and four key ministries for women and children, health, education and water and sanitation.
Working group 1: Education, awareness and learning
Moderator: Ganga Gautam, Associate Professor, Tribhuwan University
International Speaker: Marianne Tellier, Executive Director, WoMena
National Speakers: Sandhya Chaulagain, WaterAid Nepal; Shreelata Rana, Nepal Red Cross Society Community Eye and Health Promotion Programme; Nabin Shahi, Karnali Integrated Rural Development and Research Centre.
- The MHM Alliance should work with the government to develop more age-appropriate messages for girls and women.
- The MHM Alliance is currently working at government level, but should be expanded to local and provincial levels too.
- The Alliance should run a workshop for curriculum and text book writers so that there is a comprehensive approach to addressing not just hygiene issues, but also social norms.
- The Alliance should publish a calendar of events and information about initiatives, so that all members are kept informed about what everyone is doing.
Working group 2: Water, sanitation and health
Moderator: Bibek Balla, Hygiene Promotion Officer, Dan Church Aid
International Speaker: Jan-Christoph Schlenk, WASH Policy Adviser, GIZ
National Speakers: Subeksha Poudel, Senior Manager, Possible Health; Phurba Moktan, Sanitation and Hygiene Specialist,CARE Nepal.
- There should be an allocation for MHM issues in the annual budget.
- All facilities should be made user-friendly.
- Restrictions should be treated as a serious threat to women’s health and wellbeing.
- There needs to be more evidence-based planning.
- Community-based health workers are key to holistic planning and delivery of MHM at local levels.
Working group 3: Innovation and sustainability
Moderator: Susma Thapa, Freelancer
International Speaker: Janie Hampton, Author and activist, World Menstrual Network
National Speakers: Rajesh Bhagat – CRS social marketing company in Nepal.
- Menstrual pads need to be made more affordable
- Compared to menstrual cups, manufacturing pads requires considerable energy and transport costs.
- Since every woman using disposable pads produces at least two mini-buses of waste during her reproductive life, menstrual pads should also be biodegradable and menstrual cups encouraged, to address the growing environmental waste issues.
- Menstrual products need to be exempt from import duty and sales tax.
- Toilet facilities need to be gender-friendly, clean, private and appropriate.
- Education should start earlier (from class four) for both genders, parents and be age-appropriate.
Working group 4: Policy and advocacy
Moderator: Guna Raj Shrestha, National Co-ordinator for Nepal, Water Supply and Sanitation Collaborative Council
International Speaker: Gloria Liehmo, UNICEF Pakistan
National Speaker: Uddhav Khakurel, Nepal Fertility Care Centre.
- A co-ordinated MHM policy needs to be formulated with a Plan of Action drawn up to translate intentions into reality.
- There is a need for multi-stakeholder discussions, including all the government ministries concerned (women and children education, health and water and sanitation).
- Government policy should be cascaded down to provincial and local levels.
- Tax exemptions for menstrual products.
- In order to address the environmental challenge of safe disposal of menstrual products, there is a need to map products being used and then decide what is best, especially in rural areas.
Working group 5: Research and analysis
Moderator: Bisheshta Shrestha, Co-lead Researcher, Roosterlogic
International Speaker: Marni Sommers, Associate Professor, Mailman School of Public Health, Columbia University.
National Speakers: Sanila Gurung, Programme Co-ordinator, Beyond Beijing Committee; Hari Shova Gurung, SNV Nepal.
- Menstruation should not just be considered a women’s issue – it is everyone’s issue.
- The major gaps in research and knowledge about target groups need to be addressed. The focus so far has largely been on adolescents, but this needs to be broadened to look at working women, people with disabilities and other groups, all of which will have their different needs.
- It is important to address both the start and end of menstruation (menarche and menopause).
- Research projects need to be broader and consider the impact and duplication of centralised projects, which often focus on the same gender, age or ethnicity.
Summaries of these key recommendations were presented by the working groups to the Summit Plenary meeting and the recommendations as a whole will be developed into a MHM Plan of Action for 2019/20 for further discussion with the Government of Nepal in the coming weeks.