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Dining for women (D4W) Interim Report 1. Information...Dining for women (D4W) Interim Report 1....
Transcript of Dining for women (D4W) Interim Report 1. Information...Dining for women (D4W) Interim Report 1....
Diningforwomen(D4W)InterimReport
1. Informationa. OrganizationName:SustainableHealthEnterprises(SHE)b. ProjectName:SHE28c. GrantAmount:$46,947d. ContactPerson:MelissaDriverBearde. Address:175VarickStreet,NewYork,NY10014
2. Outcomestheprogramwasdesignedtoachieve
Theprogramwasdesignedtoincreaseaccesstopadsandknowledgearoundmenstruation.Throughtheprogram,503,000go!padswillbedistributedtotenpublicschools,tenkiosks,andotherschoolsandinstitutionsthatserveyouthsuchasyouthvillages,orphanages,andNGOsimpactingover3,000girls’abilitytoaccessaffordablepads.Theschoolswherewedistributepadswillbeabletoprovidedoubletheamountofpadstheycanprovidetogirlsbecauseofourpads’affordability.Attheschoolswherewedistributepads,50targetedteachers/personnelhavebeentrainedinpubertyeducationandmenstrualhygienemanagement(MHM)inordertodeliverMHMafter-schoolprogrammodulestogirlsandboyswithconfidence.Girls,boys,parentsandteacherswillreceiveMHMeducationresourcematerials.
3. ChangesinFundingforthisProgram
Therewerenosignificantorunexpectedchangesinfundingforthisprogram.
4. ChangesinOrganizationorProgram
NadiaHitimana,ourHealthandHygieneManageratthetimeoftheapplication,hasleftSHEtopursueherMastersinPublicHealthattheLondonSchoolofHygieneandTropicalMedicine.
TherehavebeentwoadditionstotheSHEteam.MelissaDriverBeardhasjoinedtheorganizationasExecutiveDirectorandJeanetteMurekatetebeganworkinNovember2015asourHealthandHygieneManager.JeanettehasanMPHand14yearsofworkexperienceintheWASHSector.Shehasconductedtrainingsofbothtrainersandyouth,includingMHMeducationforgirlsinrefugeecamps.
5. Challenges
Ourfirstchallengewasovercomingteachers’perceptionsonMHM.SomeoftheparticipantsstronglybelievedthemythsaroundMHM.Afteranalyzingthefactsbehindmenstruationandcomparingthosefactswithmythsandbeliefsattachedtomenstruation,theteacherscametorealizethatthemythsandtaboosaroundmenstruationwererestrictionsonwomenandgirlsthatwererootedintheculturalcontextratherthangroundedinscientificfact.Evenwithascienceteacherinthecohort,thegroupattimesdidnotfullygrasptheanatomyandphysiologyofthefemalereproductivesystem.However,apersonalexchangeofinformationandexperiencescreatedanatmosphereinwhichalltheteacherswerehighlyengagedandhelpedsomeofthenewteachersbetterunderstandtheinformationpresented.Moretimethanplannedwasrequiredforthetrainerstoresolvemisconceptions.Thisresultedinlesstimebeingavailableforothersubjectsplannedbythetrainer,suchasthemenstrualcycleandchoosingfemininecareproducts.Wehavefacedanotherobstacleinconductingourmonitoring&evaluation.Wehadplannedtoconductourstudentknowledgeandbehaviorchangepost-teststowardstheendofthe2015schoolyearandbelievedthattheschoolyearendedinmid-tolateNovember2015.However,welearnedonshort
noticethattheschoolyearendedinmid-October2015,withtheremainingtimeservingasareadingandexaminationperiod.Conveningthestudentsduringreadingandexamperiodprovedtobeimpossible.Tothatend,wewillneedtoconductthepost-testsinJanuary2016andwillrequestanextension,tobediscussedinSection8belowThischangeinschedulewillenableustoaskmorerigorousquestionsinthepost-test,aswelearnedinthepre-testthatsomeofourquestionswerenotdetailedenough.Ontheproductionside,inordertoincreaseourthroughputandreach250,000ormoregirlsbytheendof2017,wehavekickedoffapartnershipwithamultinationalhealthcompany,whichisdesigningmachineryforusthatwillincreaseourthroughputbytenfold.Wehavealreadyimplementedproductimprovementssuggestedbythispartner,andwillcontinuetodoso.6. Revisionofobjectives
Inourproposal,westatedthatSHEwouldprovide180,000padsto3,000girlsin10schools.In2015-16,wewillactuallymanufactureatotalofover2milliongo!pads.40,000ofthesepads,ratherthantheestimated180,000,willbeprovidedfor3,000Rwandangirlsthroughthe10schoolsmentionedinourproposal.Given2015budgetallocations,thisisboththemaximumthatschoolscanbuyanddoubletheamountofcompetitors’padsthatschoolsbuyforgirlsatcurrentprices.Thisprovisionwillensurethatgirls’roomsarestockedwithpadsforgirlstouseincaseofemergencies.Becausewearecommittedtoincreasinggirls’accesstopads,another50,000padswillbesoldatkiosksnearthe10schools.Finally,413,000willbesoldtootherschoolsandinstitutionsthatserveyouthsuchasyouthvillages,orphanages,andNGOs,whichhavetheresourcestosupplygirlswithpadsforregularuseratherthanonlyforemergencies.Takenasawhole,throughthesechannels,wewillincreaseaccessfor6,803girlsthroughschoolgirls’roomsandbulkpurchasers.Wethinkthismakesforamoresustainablebusinessmodelinthelongtermandultimatelyincreasesgirls’accesstopads.
WecommunicatedthischangetoDiningforWomeninFebruary2015,andthischangewasapproved.Ourobjectiveshavenotchangedotherwise.
7. Progresstowardsachievingobjectives
SHEhasusedtheD4Wgrantforthreemainactivities;teachertraining(November2014)andrefreshertraining(March2015),M&Ewithstudents(March2015)andtocollectteachers’feedbackontheMHMimplementationwithstudents(August2015).Asafollowupstep,SHEwillconductfeedbacksessionswithstudentstolearnhowtheirteachersandSHEcouldservethembetter.
a.SHEMenstrualHygieneManagement(MHM)teachertraining,November2014
Thetrainingwasconductedfor51academicians(24malesand27females),from10schoolsintheEasternprovinceofRwanda,Kayonzadistrict.Amongtheteamwere3headteachers,2headmasters,1headmistressand3directorsofstudies.TheseteachersnowconductMHMtrainingsforstudents.ThegovernmentofRwandahasallocatedabudgetlineof$35,000forhygieneimprovementinschools,includingfor$267perschoolperyearthepurchaseofsanitarypads.Participantswereselectedbasedontheirinfluenceonmakingthegovernmentafterschoolprogramadvanceintheirrespectiveschools.ScienceteacherswillbecatalystsinhelpingunderstandthephysiologyandanatomyrelatedtoMHM.
Thetrainingswereconductedfrom10-13November2014attheMidlandHotelinKayonzadistrict.The51teachersweresplitintotwogroups.Eachgroupwasallocatedatotalof2daysforthewholetrainingsession,withapproximately13hoursofinstructionforeachgroup.
Thepurposeofthetrainingwastoincreaseteachers’knowledgeandskillsonmenstrualhygienemanagement(MHM)and,consequently,theirconfidenceintrainingtheirstudents.OurmaingoalistoprovidereliableinformationonMHMtoteachers,students,andtheRwandancommunity.Furtherdiscussionwillbreakthesilencearoundthetopic,thuskeepinggirlsinschoolsandempoweringwomentoparticipateandcontributetosustainabledevelopment.ThelanguageofinstructionwasKinyarwanda,thelocallanguage.
i. Generaloverviewoftheteachertraining.
Trainingsessionswentaccordingtoplan.Teachersappreciatedthegoalofthisinitiativebecausetheywereunfamiliarwithhowtoaddressthiscriticaltopic.AmongthesubjectstaughtwereMenstrualCycle,ChoosingFeminineCareProducts,andBeliefs,Norms,Myths,andTaboos.Onemaleteacheramongtheparticipants,afterhavingattendedthesessiononthemenstrualcycle,said,“Inowunderstandwhymywifebehavesthisandthatotherway.Iamsoshamefulforblaminghertonotbe
abletocontrolourbirths,butknowIseehowcriticalthisis.Icanonlyimaginehowconfusingandstressfulforayounggirlduringhermenstruation.” Anotherteacherexpressedabeliefinthemyththatmenstruatingwomencouldlowertheyieldofherfamily’scropsbywalkingthroughthefieldwheretheygrow.Thispersistenceofmisinformation,evenamongteachers,showshowfarwestillhavetogoindispellingmythsonmenstruation.
• Teacherslikedthemanuallayoutandteachingmethodologies.TheteachersagreedtogothroughtheSHEMHMmanualafterthetrainingandcomebacktothetrainersformoreclarificationsandimprovementsuggestionswhereneeded.
• Teachersdemonstratedsomeknowledgeofthephysiologyofmenstruation,butmanyonlyhadbasicinsightaboutthetopic.Ingeneral,thefacultyhadnottackledthetopicofMHMbecausetheybelievedthatitwasasubjectbestleftbetweengirlsandtheirmothersorotherfemalefamilymembers.However,manywomenthemselvesdonotknoworaresilentaboutMHMevenwithintheirfamilies,andmalesoftenneverlearnaboutMHM.
ii. Immediateimpactofthetraining
Basedonthepre-andpost-testsadministered,MHMknowledgeamongteachershasincreased.Pre-testgradesrangedfrom48%to84%.Post-testgradesrangedfrom61%-96%.Theaveragescoreinthepretestwas62.9%,increasingto74.1%inthepost-test.Additionally,thepretestmedianwasat66%andthepost-testmedianat78.5%.SHE’sobjectiveofincreasingteachers’knowledgeofMHMwasachieved.Femaleacademiciansscoredhigherthantheirmalecounterparts.Fromournon-scoredpartofthetest,morethan80%ofparticipantssaidtheywerenowconfidentaboutMHMasasubject.
iii. Recommendations
• Teachersindicatedthattwodaysoftrainingwerenotsufficienttocoverallthematerial
• TeacherssuggestedwehighlightthemodulesonMenstrualCycle,ChoosingFeminineCareProducts,andBeliefs,Norms,Myths&TaboosandspendlesstimeonthePuberty&Adolescence,Care&DisposalofMenstrualProducts,andHealthPracticesmodules.
• Teacherssuggestedthatmodulesbeadjustedfortheageofthestudents• Teachersproposedthatwehavevideoinstructionalmaterials
iv. StepsForward
• Bothparticipantsandtrainersagreedthatschoolvisitswillbecarriedouttofollowupontheimplementationplanforthestudents’trainingsandforWASHassessments.
• TheBusinessdevelopmentandproductionteamsneedtopayattentiontothegovernmentschoolpadsbudgetforitwasreportedfromvariousteachersthatthisamountisnotconsistent.
b.TheTeacherrefreshertrainingsoverview
Thetrainingshappenedfrom30January-5February2015.SHEstaffre-trainedtheteachersonlessonstheyhadmisunderstoodorforgotten,elaboratedanimplementationplanforstudents’trainingsandassessedtheschools’WASHfacilities.Onlyoneschoolfailedtoelaborateanimplementationplan.
i.RepeatedLessons
AllofthesmallgroupswantedtorepeatthelessonsonMenstruationandMenstrualCycle,andChoosingFeminineCareProducts.
ii.FeedbackandRecommendations
• Condensethemanualcontentandrearrangethemodules• Coupleourfinalmanualswithinstructionalmaterialsforstudents.Trainerssuggestedpelvicmodels
ordrawingsonpiecesoffabric,menstrualcups,andreusablepads.• Thefinalsoftcopyofthetranslatedmanualshouldbeproofreadbyoneoftheteacherstoensure
thatthecontentandlanguageappropriatetobothstudentsandteachers• DevelopbookletsorotherIECmaterialsforstudents• TrainerswillgenerateadataanalysisofWASHfacilitiesinthe10schools
c.TeacherTrainingEvaluationIn-Service
Thefinalteachertrainingin-servicetookplacefrom10-14AugustattheMidlandHotelinKayonzaDistrict.52teachersandheadmastersfrom10schoolsinKayonzaDistrict–thesameteacherswhoattendedthefirsttwotrainingsessionsandconductedstudentMHMtrainings–attended.Thepurposeofthisevaluationin-servicewasfortheteacherstoevaluatetheteachertrainingmanualandtheeffectivenessofthestudenttrainings.Keyfindingsinclude:
• Teachersfounditeasytoteachstudentsaboutpuberty,asstudentsarealreadyexperiencing,andcuriousabout,puberty-relatedchangesintheirownbodies.Teachersfounditdifficulttoteachstudentsaboutthemenstrualcycle,especiallythephysiologyaroundreleasingoftheegg,variablecyclelengths,andirregularcycles
• Teachersbelievetheyareopeningupasafespacetotalkaboutsensitivetopicsthatintereststudents.
• Toeffectivelydeliverstudenttrainings,teachersneedmorecolorpicturesinthemanualandmorevisualmaterialssuchaschartsandcalendarsforexplainingandtrackingmenstrualcycles,exercisesandcasestudies,samplesofmenstrualproducts,andvideos.AbiologyteacherwhohashadMHMtrainingshouldgiveinputonthedevelopmentofstudentIECmaterials.
• Teachersalsosuggestedusingparticipatory,student-centeredpedagogicalmethods,e.g.presentations,skits,roleplaysthatstudentsdothemselves
• TeachersaremorecomfortableteachingstudentsaboutMHMthantheywerebeforethetraining• Teachersneedtobepreparedtounderstandthemenstrualcycle,answerquestionsfromstudents,
talkopenlyaboutwhathadpreviouslybeenconsideredasensitivetopic,helpstudentsbreakdowntaboos,andadjustcontenttobeage-appropriateforstudents
• Teachersrankedthemostimportantmodulesas:1)Puberty;2)menstruationandmenstrualcycle;3)menstrualhygiene;4)challengesfacedbygirlsandwomen;and5)myths,beliefs,&taboosaroundmenstruation
• Teacherssuggestedthatallothermodulesbesummarizedandcondensed• Studentsneedabooklettofollowalongwiththetrainings• Studentshadagoodunderstandingofpubertybutlittleunderstandingofthemenstrualcycleand
howtousedifferenttypesofmenstrualproducts
• Bothboysandgirlsshowedinterestinandexpressedcuriosityaboutthetopic,thoughgirlsweremorecomfortableaskingquestionsingender-segregatedgroups
• Boysaremoresupportiveofmenstruatinggirlsaftertheygothroughthetrainings
• TeachersareeagertoteachMHMinnationallymandatedafter-schoolhealthclubsoncethoseclubsareimplemented.
• MHMteachertrainingneedstobereplicatedatthenationallevelasuntrainedteachersdon’tunderstandtheimportanceofMHM
• SchooladministratorsshouldrecognizetheimportanceofMHMandencourageteacherstotraintheiruntrainedcolleagues
• Itiscriticaltoconveyaccurateknowledgearoundpuberty,menstruation,andMHMtoparents,andstresstheimportanceofbreakingthesilencearoundthesetopics.
d.BaselinedatareportonstudentsM&E
SHEconductedapre-knowledgeandpre-behaviorchangebaselineassessmentamongmaleandfemalestudentsinthe10schools.Thegoalofthisassessmentwastodeterminethestudents’knowledge,attitudesandskillsaswellastheirbehavioraroundMHMpriortothestartoftheMHMclubs.Theassessmentscombinedbothqualitativeandquantitativemethodsandwereconductedfromthe9thtothe20thMarch2015.Thetotalnumberofstudentsreachedwas657usingavarietyofdatacollectionmethodologiestoinclude:surveys,focusgroupsanddiaries.
Keyfindingsinclude:• Acrossallschools,students(primaryandsecondarystudentswithapproximateagesof10to15
years)werecorrectintheirMHMknowledge74%ofthetime,incorrect18%ofthetimeandnotsure8%ofthetime.
• Secondaryschoolstudentsweremorelikelytogivecorrectanswersthanwereprimaryschoolstudents(77%versus71%ofthetimeforprimary)
• GirlswerecorrectintheirMHMknowledge76%ofthetimeversusboys69%ofthetime.• While34%ofboysadmittedtheywereembarrassedtotalkaboutmenstruation,86%ofbothboys
andgirlsthinkthatboysshouldbeincludedinconversationsaboutmenstruation.• 15%ofgirlsand21%ofboysconsideredmenstruatinggirlsunclean.• 42%ofgirlsand24%ofboysbelievedthatgirlscouldparticipateinsportsduringtheirperiod.• 12.6%ofgirlsreportedthattheyhadmissedapartialorfulldayofschoolduringtheirmostrecent
menstrualperiod.• Ofthosegirlswhomissedallorpartofadayofschool,menstrualpainwasthereasonformissing
school79%ofthetime;lackofproductwasthecause8%ofthetime.• 72%ofgirlsreportedusingthepitlatrineforpaddisposal.
• 81.6%ofgirlswhocompletedthebehaviorsurveyuseddisposablepadsastheirprimarymenstrualproductduringtheirmostrecentperiod.
• Tenofthe191respondents(5.2%)reportedusingmorethanoneproductduringtheirmostrecentmenstrualcycle.8ofthosewereacombinationofdisposablepadandcloth.1wasacombinationofclothandcottonwooland1wasacombinationofnothingandclothing.
• Everytime47%andSupa44%werethemostpopulardisposablepadbrands.• Themajorityofgirls(48%)went2-4hoursbetweenchangingproducts.Girlsweremorelikelyto
stretchthatto4-6hoursandlongerifwearingapadthaniftheywereusingcloth.• Thevastmajorityofgirlsacquiredthepadsfromthestore(49%)orhome(44%).Only3%saidthey
gotthemfromschool.• 34%ofgirlshadrequestedpadsfromschoolinthepastandreportedthattheywereavailable97%
ofthetime.• Whenchangingtheirmenstrualproductatschool45%changetheirproductinthelatrine,37%
changedtheirproductinthegirlsroom• 14%ofgirlssaidtheyhadfeltashamedatsomepointduringtheirlastperiodand2%reportedthat
theyhadbeenteasedduringtheirlastperiod.
e.TeacherfeedbackonMHMimplementationinschools.
FeedbackfromourfirstcohortofteacherswillhelpusdeliverMHMteachertraininginthemosteffectivemannerpossible.Thisinformationwillhelpustomodifythemanual,andtobetteradvocateforotherteacherstobetrainedinthissubjectandconsequentlysupportandtrainstudentseffectively.
8. Pictures
Seeattached
9. Messagefordonors&community
Thankstoyoursupport,SHEtrainedover50teachersin10schoolsinKayonzaDistrict,whothenwentontotrain657studentsinMHM.WehopethatyoucontinuetosupportSHE28andourworktokeepgirlsinschool,period.
10. Listofexpensesincurred
Seeattached