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Monday, 1 September 2014

SANITAION AND GIRLS EDUCATION





INVESTIGATING THE IMPACT LACK OF APPROPRIATE SANITARY FACILITIES ON SCHOOL ATTENDANCE & DROP-OUT RATE AMONG PUBESCENT GIRLS

1.      Introduction
Literacy is one of the major indicators of a nation’s development. Girl Education is receiving more attention. The millennium development goals has the elimination of gender disparity in primary and secondary education as its target by 2015. (MDG3). Moreover education for girls has numerous positive externalities. Education, among women is associated with low fertility rates and increased access to resources. It is against this background that the government of Malawi introduced the free primary school in order to increase student’s enrollment and increase literacy levels. However, they are a number of factors impeding progress. Poverty remains one of the major challenge. In most communities’ girls’ education are mostly affected as parents prefer to educate male children than their female children. Of late another challenge relates to menstruation. Management of menstruation among pubescent girls is difficult in environment where there are no proper sanitation facilities such as water, adequate pit latrines and sanitary pads. Girls of puberty age miss many classes as the schools they have do not have the proper sanitation facilities. It is imperative that governments need to make measures ensuring that there are adequate sanitation facilities in schools that will ensure easy menstrual management. It has been noted that the denial of Menstrual Hygiene management is a denial of human right as it affects the dignity of these young girls and the birth right to education. Poor hygiene management has also adverse impacts of the health of young girls. The total factor of poor hygiene management is that it result in a national development loss.
  
2.   Problem statement
Though increasing literacy rate among females has been one of the key policy priority areas in many developing countries girls are still lagging behind boys in schooling attainment. Many factors such as poverty. According Lee & Kerner the  reasons  for  low  enrollment  and  incompletion  of education  are  numerous,  but  the  health  and  nutrition  status  of  the  children  are  critical  factors[1].  Hygiene in schools has contributed poor health of children and interventions have been made to address this problem. In Malawi efforts to improve sanitation facilities have been undertaken to generally prevent health problems. The government of Malawi in conjunction with UNICIEF are currently implementing a pilot project in 100 schools in the districts of Nkhatabay and Kasungu (DeGabriele et-al 2014). The objectives of the project have been the promotion of general hygiene among the students at the schools, promoting a gender sensitive school sanitation and using the students as carriers of hygiene messages to the communities from which they are coming. Recognition has also been made that the availability of adequate and proper hygiene facilities has an effect on school attendance of both boys and girls. However, the extent to which absence of sanitation facilities affects menstrual management and its effect on absenteeism has not been substantially established. 
That is despite the recognition that absence of proper sanitation facilities has an effect of school attendance for both boys and girls more especially at younger age, there is no systematic research that has been conducted on the relationship between the lack of appropriate sanitary facilities and vis-à-vis menstruation management and the drop-out rate of adolescent girls[2]. Existing studies have focused on examining the relationship between menstruation and school attendance. These studies have not incorporated the component of access to sanitation facilities as a possible determinant of menstrual management which in turn affect school attendance among female students. In his study Ahmed recommends that further research need to be done to examine factors related to managing menstruation such as sanitation and their effects on school performance. This study therefore aims to fill that gap.
   
3.   Purpose of the study
This study seeks to investigate the impact of lack of adequate and proper sanitation facilities on girl’s menstruation management and school attendance. Owing to differences in gender roles between males and females the absence of proper sanitation facilities should have different impacts between girls and boys of puberty age. Results from this study will increase gender awareness among education policy maker and other development stakeholders. It will foster the designing and implementation of development interventions that are gender sensitive and allow the mainstreaming of gender in various development school activities.
4.   Literature review
The onset of puberty comes with changes in the body of girls. Among girls menstruation marks a major transition from childhood to adult. Menstruation  or  bleeding  is  a  natural  process,  which  begin  to occur for girls between the ages  of 9 and 16  years with a mean of  13  years  (Dasgupta  and  Sarkar,  2008;  Jones  et  al.,  2013)  This Process takes place about once a month during a woman’s reproductive years and last for about two seven days[3]. Girl’s menstruation at the age of puberty brings a number of challenges that they have to cope with.  In many societies menstruation is perceived with negativity and a public discussion of it is considered as a taboo. In South Asia women are uncomfortable discussing the topic of menstruation in public (Mahon & Fernandes, Water Aid report: 4). In Kenya menstruation most girls brings challenges that push girls out of school (Chebi S, 27). Further it is argued that for Kenya menstruation is not a healthy concern today but also an educational policy concern. In Malawi, interventions to deal with menstrual management seems to cropping from studies done in other countries and there is no systematic studies that have been to establish the linkage between menstruation and school attendance.

Several studies have been conducted to investigate the impacts of menstruation management on school attendance (UNICIEF, SNV& IRC[4], Bharadwaij and Patkar, 2004 and Bodat et-al 2013). Guya notes that in some time studies aimed at finding the factors influencing school dropout they did not consider it as one of the factor.  (Guya E, et-al 2004). This may be a result of regarding the issue of mensuration to be of little priority. Existing evidence on the impacts of menstruation has been conflicting. UNICIEF estimates have demonstrated that menstruation has a negative impact of girl’s school attendance. It has estimated that 1-10 school age fail to attend school during their menstruation.  In India a study conducted on two reached the conclusion that menstruation characteristics and associated physical and psychological discomforts have an in effect on school performance[5]. The study demonstrated that in a sample of about 180 students menstruation effects on students homework were 69.2%, on school attendance, 23.2% and on exams it was 62.7%  and on participation in class activity it was 57.1%.[6]  Another study conducted on 740 adolescent girls in school discovered that 249 girls (43.2%) were absent from school during the time they had menstruation.  The study recommended that in order to prevent school absenteeism among these girls there is need for interventions that will focus on provision on menstrual management facilities.   
On the other there is also a body of evidence suggesting that menstruation has little impact on school attendance of pubescent girls. A study in Nepal aimed at finding the impact of provision of better sanitary technologies such as sanitary pads and menstrual cups made the conclusion that the attendance gap induced by menstruation was less than a day in 365 days (Oster E, 2011: 92). It rejected the view that better sanitary technology closes this small gap and that policies to aim to address this issue are unlikely to result in schooling gains (Ibid). However another was study was done in Nepal by Water Aid showed a correlation between menstruation and school attendance.  Mahon & Fernandes notes that over half of the respondents in the Nepal study reported being absent from school at some time, due to menstruation (Water Aid Report, 2010: 6). Lack of privacy for cleaning and washing was the main reason. This difference in research results indicates that factors relating to menstruation affecting school attendance have different weights. One also needs to be aware that the study by Oster was focusing on impact of the provision of better sanitary technologies while the later focused on the broader impact hygiene facilities on menstrual management. This difference in focus is bound to produce different results.  
Locality may also be a factor resulting in different outcomes from these studies. Menstruation management can be affected by variables and therefore it is appropriate to control relevant variables in order to derive results that are reliable and consistent
It is worth pointing out that the study by Oster E, 2011 (cited above) was done using quantitative methods. Quantitative studies have shown to be producing different results from qualitative studies done on this subject. This has also been noted by a study that was conducted by Adukia (2013) which was investigating the relationship between sanitation and education.     

Cultural perceptions about menstruation are different across societies of the world. In his study Abraham[7] (2001) argues that poor sanitation facilities do not necessarily keep girls away from school, and that cultural beliefs are more of a barrier than the absence of sanitation facilities. In most societies of Africa menstruation is perceived with more negativity. It is this perception that even makes menstruation a private issue. Lukalo (2010) as cited in Chebi noted that menstruation is not just a private affair but also an embarrassing and often a source of stigma for the girls when it is publicly exposed (Chebi page 29). Therefore, in a culture where menstruation is highly regarded as a taboo it is necessary to ensure privacy of the young girls in school by providing them with good sanitation facilities that will enable the preservation of their dignity and integrity. On the same it is important to devise measures that will promote the free discussion of the topic of menstruation. Both UNICIEF and water aid have also considered the provision of puberty education as one way of eradicating which stigma which is promoted by societal beliefs. 
Sanitation facilities specifically infrastructure such as water and gender specific toilets are an important variables in the management of menstruation among girls of adolescent age. When a girl reaches puberty access to a safe, private toilet can make a crucial difference. Due to poor sanitation facilities get have pretended to be sick when they have monthly periods[8]. Girls need clean water to wash themselves or their menstrual cloths and a place to dispose of their menstrual pads if they are using them (World Toilet Day Advocacy report 11). However, most of these are under provided or not even available in most education institutions in Malawi. Most primary schools and secondary do not have enough and clean sanitation facilities and this makes the management of menstruation to be problematic. UNICIEF estimates in 2011, indicates that only 45% of schools in least developed and low-income countries had adequate sanitation facilities[9]. Sanitation facilities are almost considered as a luxury in the design and construction of many schools. This study seeks to investigate if lack of sanitation facilities is a major factor that could affect class attendance among pubescent in Malawi. Poor sanitation facilities does not only affect female students. Female teachers are also affected by the problem to the extent they too miss classes when their work places do not have facilities that will ensure their privacy[10]. Therefore, gains accrued from improving sanitation at schools will not only improve student’s attendance but also teacher’s attendance.





References
Ahmed H and Piro S, Impact of menstruation on school performance in Sarwaran and Shahid Khajabawa high school in Erbil city, Hawler Medical University,
Bharadwaj, et-al (November, 2004), Menstrual Hygiene and Management in Developing Countries: Taking Stock,
Chebii SJ, Menstruation and Education: How a lack of sanitary towels reduces school attendance in Kenyan slums BUWA! A Journal on African Women's Experiences
Dasgupta A and Sarkar M (2008).  Menstrual hygiene:  how hygienic is the adolescent girl in India, Journal of Community Medicine, 33(2): 77-80
DeGabriele, et-al (2014) Evaluation of the Strategic Sanitation and Hygiene Promotion for Schools Pilot Projects Nkhatabay Bay and Kasungu District,
Jones LL, et-al (2009). Age at menarche and the evidence for a positive secular trend in urban South Africa. Am Journal Human Biology, 21: 130-132
Patchett, E (2010) 'The Curse': the impact of sanitation on schoolgirls in the developing worldhttp://www.theguardian.com/journalismcompetition/sanitation-schoolgirls.
Suman B, et-al, (2013) School absenteeism during menstruation among rural adolescent girls in Pune, National Journal of Community Medicine Volume 4Issue 2
Thérèse Mahon and Maria Fernandes (2011) Menstrual hygiene in South Asia a neglected issue for WASH (water, sanitation and hygiene) programmes, Water aid report
Uniliver & Water Aid, We can’t wait a report on sanitation and hygiene for women And girls, World toilet day advocacy report
WHO Progress on sanitation and drinking-water - 2013 Update.


[1] Save the children
[2] http://www.wsp.org/Hygiene-Sanitation-Water-
[3] The INFO Project Johns Hopkins Bloomberg School of Public Health www.infoforhealth.org
[4] Study on menstrual management in Uganda
[5] Hamdia Mirkhan Ahmed, Impact of menstruation on school performance in Sarwaran
  and Shahid Khajabawa high school in Erbil city
[6] Ibid

[7] Abraham (2001) cited from http://www.wsp.org/Hygiene-Sanitation-Water-Toolkit/BasicPrinciples/GenderRoles.html
[8] Patchett, E (2010) 'The Curse': the impact of sanitation on schoolgirls in the developing world
[9] Raising even more clean hands: Advancing health, learning and equity through WASH in schools.’ UNICEF 2012
[10] http://www.wsp.org/Hygiene-Sanitation-Water-Toolkit/BasicPrinciples/GenderRoles.html

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