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Situation Analysis Study on Menstrual Hygiene Management (Mhm) in 14 Districts of Uganda: Ministry of Education and Sports (Moes)

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Situation Analysis Study on Menstrual Hygiene Management (Mhm) in 14 Districts of Uganda: Ministry of Education and Sports (Moes) FINAL REPORT: SITUATION ANALYSIS STUDY ON MENSTRUAL HYGIENE MANAGEMENT (MHM) IN 14 DISTRICTS OF UGANDA: MINISTRY OF EDUCATION AND SPORTS (MOES) BY SARAH KALEMBE & PAUL EMOJONG NOVEMBER 2020 1 | P a g e TABLE OF CONTENTS 1.0 EXECUTIVE SUMMARY .......................................................................................................................... 6 1.0 INTRODUCTION AND BACKGROUND ........................................................................................... 12 1.1 The Concept of Menstrual Hygiene Management (MHM) ............................................................ 14 1.2 Menstrual Hygiene Management in Uganda (Context Analysis) .................................................... 14 2.0 LEGAL AND POLICY FRAMEWORK ................................................................................................. 17 3.0 THE SITUATIONAL ANALYSIS DESIGN ......................................................................................... 19 3.1 Figure 1: The menstrual hygiene management conceptual framework ................................................ 19 3.2 Methodology ............................................................................................................................................ 20 3.2.1 Sampling ............................................................................................................................................... 20 3.2.2 Tools for Data Collection .................................................................................................................... 21 4.0 FINDINGS FROM THE SITUATIONAL ANALYSIS ........................................................................ 23 4.1 MENSTRUAL KNOWLEDGE, ATTITUDES AND PERCEPTIONS (KAP) .................................. 23 4.1.1 Knowledge about menstruation ............................................................................................................... 23 4.1.3 Voices depicting ignorance, shock & challenges of Menstruation ...................................................... 25 4.1.4 Knowledge gaps/ most frequently asked questions by women and girls ............................................ 26 4.1.5 Importance of knowledge in MHM (Respondents perspective) ........................................................ 27 4.2 Culture and Menstruation; (Attitudes and Perceptions) ........................................................................ 28 4.2.1 Local menstruation terms ..................................................................................................................... 30 4.2.2 Varied MHM cultural perceptions across sub regions ....................................................................... 31 4.2.3 Impact of culture on menstrual hygiene management ........................................................................ 35 4.2.4 Women and Girls’ First Menstrual Experiences ................................................................................ 35 4.2.5 Menstruation and Absenteeism in schools .......................................................................................... 36 5.0 ACCESS TO MHM INFORMATION .................................................................................................... 39 6.0 ACCESS TO MHM SANITARY MATERIALS ..................................................................................... 43 6.1 Use of re-usable pads ........................................................................................................................ 45 6.2 Use of pieces of cloth ........................................................................................................................ 45 6.3 Access to Emergency pads: ............................................................................................................... 46 6.4 Senior Women/ Men Teachers & MHM ........................................................................................ 48 6.5 Impact of Inadequate Provision of Menstrual Pads to School Attendance .................................... 48 6.6 Drying of Sanitary materials .............................................................................................................. 48 6.7 Challenges of access & utilization of safe sanitary pads among girls and women ........................... 49 7.0 WATER, HYGIENE AND SANITATION ............................................................................................ 50 2 | P a g e 7.1. Access to Safe Water .............................................................................................................................. 50 7.2 Access to water in schools ....................................................................................................................... 53 7.3 Estimated water coverage in schools ....................................................................................................... 54 7.4 Contextual water challenges; respondents perspective ........................................................................... 54 7.5 Access to Hygiene and Sanitation Facilities ............................................................................................ 55 7.5.1 Hygiene and Sanitation in Schools ...................................................................................................... 56 7.5.2 Separate toilets status ............................................................................................................................ 56 7.5.3 Pupil-Stance ratio .................................................................................................................................. 57 7.5.4 Latrines for children with special needs .............................................................................................. 58 7.5.5 Toilets at household/ community level ................................................................................................ 59 7.5.6 Bath shelters/washrooms ...................................................................................................................... 59 7.5.7 Access to Changing rooms ................................................................................................................... 61 7.5.8 Factors that affect usage of the changing rooms .................................................................................. 63 7.5.9 The practice of changing sanitary towels/ pads ........................................................................................ 63 7.5.10 Access to rest rooms ........................................................................................................................... 65 7.5.11 Access to & Utilization of Hand Washing Facilities ......................................................................... 65 7.2.12 Functionality of WASH Structures in Schools.................................................................................. 66 8.0 MENSTRUAL HYGIENE WASTE DISPOSAL FACILITIES ........................................................... 68 9.0 ACCESS TO OTHER MHM SUPPORT................................................................................................ 70 9.1 Access to emergency/ menstrual clothing ............................................................................................... 70 9.2 Access to means of managing painful periods; (e.g. pain killers) ........................................................... 71 9.3 Access to soap and basins ........................................................................................................................ 72 9.4 Access to psycho socio support ............................................................................................................... 72 9.5 Social Support Networks ......................................................................................................................... 73 10.0 ROLE OF THE SECTOR MINISTRIES .............................................................................................. 75 10.1 Ministry of Water and Environment .................................................................................................... 75 10.2 Ministry of Education and Sports ......................................................................................................... 76 10.3 Ministry of Health ................................................................................................................................. 78 10.4 Ministry of Gender ................................................................................................................................ 79 10.5 Opportunities for MHM Programming in Uganda ............................................................................. 79 11.0 MHM CHALLENGES AND RECOMMENDATIONS ..................................................................... 80 3 | P a g e LIST OF TABLES: Table 1: Summary of Respondents and Key Informants ................................................................... 21 Table 2: Locally disguised menstrual terms ........................................................................................ 31 Table 3: Cultural attitudes and perceptions in Western Uganda ....................................................... 32 Table 4: Cultural attitudes and perceptions in Central Uganda ......................................................... 33 Table 5: Cultural attitudes and perceptions in eastern Uganda .........................................................
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