MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

PRESENTED BY THE Water Supply and Sanitation Collaborative Council (WSSCC) IN COOPERATION WITH THE Indian Institute of Public Administration NEW , 24-27 SEPTEMBER, 2013 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Abbreviations 2

Introduction 3 Background 4 Nirmal Bharat Abhiyan: Menstrual Hygiene Management in Policy Interventions 5 Conceptual Framework 6 Three Dimensions of Menstrual Hygiene Management 6 Right to Sanitation 6 Breaking the Silence 7 Understanding Menstrual Hygiene Management 7 Training Resources and Skills 8 Action Plans and Next Steps 9 Conclusion 9

Annexes 11 Annex 1: Participant List 11 Annex 2: Training Programme 15 Annex 3: State Action Plans 17 1. Delhi Plan 17 Contents 2. Uttar Pradesh (NGO) Plan 18 3. Uttar Pradesh NRHM Plan 22 4. Uttar Pradesh Government Plan 23 5. Madhya Pradesh Plan 24 6. Jharkand State Plan 26 7. Bihar Plan 27 8. Chhattisgarh Plan 28

Abbreviations MHM Menstrual Hygiene Management WSSCC Water Supply and Sanitation Collaborative Council NRHM National Rural Health Mission NBA Nirmal Bharat Abhiyan NBY Nirmal Bharat Yatra MDWS Ministry of Drinking Water and Sanitation IEC Information, education and communication GOI Government of India TOT Training of Trainers IIPA Indian Institute of Public Administration

2 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Introduction

This report presents the main highlights and insights from the Training of Trainers (ToT) on Menstrual Hygiene Management (MHM) Programme, which was run by the Water Supply and Sanitation Collaborative Council (WSSCC) from September 24- 27, 2013 in with the support of the Indian Institute of Public Administration.

The first of its kind, this national training initiative was organised with the objective of creating master trainers from Hindi-speaking states capable of returning to their communities as champions for a deeply stigmatised and taboo issue – an issue which is central to the dignity, health and well-being of women and girls. Sixty-two participants from Uttar Pradesh, Jharkhand, Bihar, Madhya Pradesh, Chhattisgarh, Uttarakhand and Delhi who attended the four-day training. The National Rural Health Mission (NRHM) and Water, Sanitation and Hygiene (WASH) sectors were well-represented by government representatives and NGO practitioners. The training was boosted by the presence of Mr Pankaj Jain, Secretary of the Ministry of Drinking Water and Sanitation, and Ms Pratima Joshi, Director of the Nirmal Bharat Abhiyan, both of whom emphasized the importance of using MHM to achieve a cleaner India and expressed their support for including MHM in the NBA guidelines. They also gave examples of the need for building capacity to address the three prongs of MHM, including breaking the silence on this taboo subject, incorporating MHM into IEC strategies and encouraging the use of NBA funds for safe disposal of used menstrual materials.

3 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Background

Only According to a study by AC Nielsen and Plan International there are 355 million menstruating females in India; but only 12% use sanitary napkins, and the large majority live with the indignity 12% of stigma, shame and taboos surrounding menstruation. Stress of Indian and loss of productivity are only two of the many unwarranted menstruating consequences attached to this biological phenomenon, which women use should be a source of pride as it is a key element of the female sanitary napkins reproductive cycle, and one that helps perpetuate the human race.

WSSCC’s Menstrual Hygiene Lab, which ran during the 51-day Nirmal Bharat Yatra (NBY) across five Indian states between October 2 and November 19, 2012, found that 80% of girls interviewed did not have any knowledge of menstruation until the onset of menarche. For these girls, their first period was accompanied by fear of dying, shame and distress. Women and girls alike responded enthusiastically to the opportunity the MHM Lab gave them to talk about the issue, learn how to address it at a personal and societal level, and commit to taking transformative action. Based on this overwhelming response and the demand for information and knowledge on MHM, WSSCC embarked on a twin strategy of working with the GOI to articulate these needs clearly in national policy, while building capacity to implement this policy across a range of stakeholders at state and district levels. The Training of Trainers (TOT) Programme organised in Delhi was the first of its kind to have the objective of equipping trainees with tools and knowledge for advocacy and training that focused on arriving at an individual action plan, which each trainee could take forward to their respective states and organisations.

4 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Nirmal Bharat Abhiyan: Menstrual Hygiene Management in Policy Interventions

The inaugural session with Mr Pankaj Jain, Secretary of the Ministry of Drinking Water and Sanitation (MDWS), Dr T. Chatterjee, Director of Indian Institute of Public Administration (IIPA) and Prof. Sushma Yadav of IIPA highlighted the importance of the issue and the work to be done on MHM in India. Mr Jain pointed out that while NBA guidelines and the majority of WASH initiatives do not explicitly mention menstrual hygiene there is a provision for piped water to households, which would help improve hygiene across the board. He also pointed to examples of successful initiatives on MHM in schools in Tamil Nadu and Madhya Pradesh that could serve as an example and inspiration to the rest of the country. Mr Jain said that his recent exposure to this issue had convinced him of the need to include it in sanitation and hygiene policy, and mainstream the issue in schools and colleges so that girls and women would not feel vulnerable and frightened. Both Mr Jain and Dr Chatterjee touched upon the crucial issue of safe disposal through incinerators and composting, highlighting the complexity of the challenge and the need for further effort and action research. Taking these themes forward, Prof. Yadav appealed to trainees to make full use of Examples of successful this opportunity to equip themselves with the knowledge and ability to break the initiatives on MHM taboos and silence around menstrual hygiene. She was excited by the innovation and in schools serve as courage behind the training and pleased to be associated with such a central issue as an example and MHM, which affects hundreds of millions of women and girls. She said that the ToT programme illustrated vividly and creatively the correlation between MHM and IIPA’s inspiration to the rest focus on better administration and governance in India. of the country

▲ Volunteers from WSSCC partner Goonj, an Indian NGO, show girls how they can make sanitary napkins at home from cleaned, recycled cloth © WSSCC. 5 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Conceptual framework

Three dimensions of Menstrual Hygiene Management The training was based on WSSCC’s framework for Menstrual Hygiene Management (MHM), which includes the three interlinked dimensions of managing menstruation hygienically. Ms Archana Patkar shared these aspects with the group. The three prongs of MHM are:

1. Breaking the silence – fostering understanding that menstruation is a fact of life and a distinct biological female attribute of which women should be proud, not ashamed. Girls should be encouraged to talk about this biological phenomenon in an informed and positive manner, to prepare them emotionally and physically for the onset of menstruation and subsequent monthly menstrual periods. 2. Managing menstruation hygienically and safely – ensuring adequate water, cleansing and washing materials and private spaces for managing menstrual flows hygienically and privately, and with dignity, in the home and in public spaces. 3. Safe reuse and disposal solutions – ensuring mechanisms for safe reuse, collection and disposal of menstrual waste, with dignity and environmental safety.

Right to Sanitation Following the three-pronged approach was a discussion about the rights framework, the Right to Sanitation, and barriers to access and use, which set the tone for the next four days. The group was quick to understand and point out that often policies, as well as the implementation of sanitation initiatives, do not take into account gender, age and disability. There were several critical questions raised, including: “If the Right to Sanitation is established and ratified why is there no demand for this right?” and “Can RTS be achieved for women and girls without considering MHM?” Perhaps the most important point raised was that although infrastructure and facilities play a crucial role, women are unable to demand their rights because of lack of confidence and “If the Right to security. For example, while girls may have the necessary facilities in school, they still Sanitation is stay at home during menstruation because of fear and parental restraints on their established and mobility during this time. ratified why is there Archana Patkar shared her experience from the Nirmal Bharat Yatra, where the highest demand among girls was not for sanitary napkins but for a counsellor or no demand for teacher they could talk to. A recurring question was for more information on this right?” this issue.

6 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Breaking the Silence The training began with an experience-sharing exercise in which participants talked about their first encounter with menstruation. It was evident from the participants’ Breaking the enthusiasm over the course of the exercise that for many (especially male silence participants) this forum was the first opportunity they had had to openly discuss this topic. Furthermore, it was clear that silence and shame attached to menstruation had touched everyone in one way or another. Stories from men often highlighted confusion, secrecy and separation between boys Managing Safe reuse and girls, while women’s anecdotes illustrated the shame, isolation, fear, sadness menstruation and disposal hygienically and taboos associated with menstruation. Some interesting anecdotes included: solutions and safely “As a young boy, I used to see advertisements for sanitary napkins and imagine that wearing these pads would help me run faster. It wasn’t until biology class in school that I realised what was going on. And the family would always make an effort to cover or avoid us watching these ads. I asked but was never told what it was.” “In my village I used to notice that a lot of cloth was thrown out in piles outside. On one occasion I noticed that some of the cloths looked familiar and were from my house and I became suspicious and began questioning adults about why they were thrown out. I was given a very vague explanation around menstruation, that is was something that women encountered, and was shut out from having any further conversation around it.” An unusual anecdote highlighted the involvement of a progressive male family “As a young boy, I used member. It inspired the group to use the portrayal of a positive figure to create the to see advertisements concept of ideal role models and champions for this cause. for sanitary napkins “My first period was extremely painful and I was scared and in a great amount of and imagine that pain. It was my father who actually taught me how to use the pads and to take care of my health and nutrition. I was actually informed that it was a good thing – and wearing these pads given full information about the regularity of my period, etc.” would help me run At the end of the exercise it became obvious that menstruation was shrouded in faster. It wasn’t until shame, taboo, fear, secrecy and isolation. Perhaps the most significant feature biology class in school of this session was that for the first time both male and female participants had that I realised what experienced an equal and open platform to share and discuss menstruation and how it had touched their lives. was going on. And the family would always make an effort Understanding Menstrual Hygiene Management to cover or avoid us The next two training sessions were spent understanding the three main aspects watching these ads. of menstrual hygiene management (as mentioned previously). The trainees were I asked but was never divided into groups and studied tools developed by WSSCC and its partners, which explain the menstrual cycle and changes in the human body from childhood and told what it was.” adolescence to adulthood. The tools and training guides developed by WSSCC are living material, designed to change, evolve and be adapted to different contexts. While this session aimed to improve understanding of the biological processes linked to the menstrual cycle it also enabled participants to systematically provide feedback on the training tools they used. Valuable feedback was acquired from the group on the menstrual wheel and the Kavaad tool, which will be incorporated into the toolkits to refine them before being shared with the trainers for future use. The groups then brainstormed on the three aspects of MHM and shared solutions on how to address the challenges we face breaking the silence, on MHM practices and safe reuse and disposal.

7 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

These included: n Gender Sensitisation – MHM at its core is about equity and a life of dignity for women and girls, n Sex education – while this has been a controversial issue it is crucial that sex education be added to school curricula, with a focus on a practical understanding of the body, n MHM should be clear in policy guidelines – health workers are incentivised to work on an issue only if is included in the policy and guidelines, and indicators are monitored, n Using mass media – the involvement of Vidya Balan has changed things because now people are thinking about toilets as an issue, and the same should be applied to MHM, n Education on safe hygienic practises, n More research on disposal practices, n Research on links between menstrual hygiene and reproductive tract infections.

Training Resources and Skills Having spent almost two days learning and discussing the various aspects of MHM, each group prepared a session from the training modules and conducted a training exercise in plenary. As each group contained different kinds of workers, managers, trainers and facilitators, they displayed a good understanding and internalisation of the complexity of issues attached to MHM, including the role of disability, role played by boys and men in MHM and the links between reproductive health and MHM. All of the trainees employed creative tools, such as role-playing exercises linked with question and answer sessions, to impart the training, while bearing in mind the distinctive needs of rural and semi-urban target groups. These training sessions helped the WSSCC team understand the efficacy of the training manuals and the trainees’ level of understanding. Consequently, sensitive issues such as disability, and technical topics that needed a medical understanding, may require more supporting materials and tools. The last two sessions of the training moved away from the foundations of MHM to training-based soft skills. Expert trainers conducted sessions on communication and training skills. These sessions were particularly well-received by the participants as they put the issues discussed over three days in the context of effective communication and training.

Action Plans and Next Steps On days three and four the groups divided into sub-groups based on trainees’ home states and sectors. They then developed action plans for 2014, given existing manpower and resources. This was a powerful exercise as the participants were able to apply the learning from the previous two days, and put it into actionable steps using existing know-how and the resources available to them. Action plans (summaries of which are included in the Annexes) focused on immediate next steps and using existing resources with potential technical assistance from WSSCC.

8 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

There were several motivated plans from around the country. For example, the NGOs drew up plans to conduct surveys and trainings with adolescent youth and women in their communities, while some government workers created a work plan for community mobilisation and advocacy with policy makers in their region. Depending on capacities and roles, the plans varied from being extremely comprehensive to ambitious. An organisation in Delhi, for instance, aims to train 1000 adolescent girls and boys and 1000 women in MHM. The NGO group from Uttar Pradesh conducted an impressive self-analysis and created a multi-stakeholder plan that includes training in villages, schools and community-based organisations with women. The Uttar Pradesh NRHM group plans to direct its energy onto advocacy across different levels. Chhattisgarh is planning on focusing its efforts on advocacy, capacity building and development of resources and communication materials, while the Madhya Pradesh group has developed comprehensive advocacy and training plans. The action plan summaries submitted by the participants can be found in Annex 2.

Conclusion The training of trainers conducted by WSSCC in Delhi for Hindi-speaking states was an unusual TOT, in more ways than one. Creating a cadre of master trainers for MHM, an area often mistakenly considered esoteric or minor, meant that participants had to make significant leaps in becoming comfortable with discussing menstruation, understand the topic and its challenges, and then build the skills needed to transfer this knowledge. This was an ambitious task for such a short training. Over the course of four days, not only did several participants (who have never discussed menstruation openly) conduct training sessions for over 50 people, they were also able to create plans for advocacy, communications and training within their respective organisations. Additionally, this group also served as first testers of the materials and resources developed by WSSCC. All of this feedback has been recorded and will be incorporated into the material as well as the next set of training sessions. ▼ Participants at the training programme

9 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

As a bonus, thanks to the MDWS’s involvement, MHM has now been included in the NBA guidelines – a clear and important milestone toward mainstreaming MHM in India. Moved by the ToT programme, Ms Bhagwati Sharma, a trainee who works with the NBA in Chhattisgarh, wrote and composed a song on the shame and silence that she had experienced as a young girl on issues concerning menstruation. The song and an English translation are shown below in Box 1.

10 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Annexes

Annex 1: Participant List

S.no Participants S.no Participants 1. Ms Rasmi Mishra 2. Ms Shalini Singh Trainer Sakthak s-20/51-7A Nepali Khoti, Mob: 08187999118 Varuna Bridge Varanasi Cantt 221002 3. Mr Pankaj Jain 4. Ms Nilima Achwal Secretary Villgro Ministry of Drinking Water and Sanitation, Apt 101, Silver Springs Government of India C/447 Perry Road, Bandra (W) Mumbai 400050 Mob: 9833238169 Email: [email protected] 5. Ms Varsha Sharma 6. Prof. Sushma Yadav Editor/Writer for WSSCC Programme Coordinator New Delhi Indian Institute of Public Administration, New Delhi Mob: 9810275804 Email: [email protected] 7. Mr S.K. Singh 8. Dr T. Chatterjee Vice-Chairman Director Meerut Development Authority, Meerut Indian Institute of Public Administration, New Delhi 9. Ms Sunita Kumari Samanta 10. Ms Bhagwati Sharma Assistant Engineer NBA, PHED, GARIYABAND Drinking Water and Sanitation Dept. Jharkhand Mob: 8085542821 Mob: 8987473741 Email: [email protected] Email: [email protected] 11. Ms Shaista Khanam 12. Ms Satya Suya Dasika State Trainer Director, Programmes U.P. NRHM Knowledge Links Pvt Ltd. Mob: 09415474359 KA-54, 1st Floor, Kaushambi, Ghaziabad Email: [email protected] Mob: 9810516216 Email: [email protected] 13. Mr Jama Mohammad 14. Ms Renuka Patel Project Manager Training & Hygiene Specialist Arthik Anusanthan Kendra Dewari Naditeer, Haliya, Bilaspur Mirzapur U.P. Mob: 8109298988 Mob: 9793817860 Email: [email protected] Email: [email protected]

11 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

S.no Participants S.no Participants 15. Ms Dipali Roy 16. Ms Durga Mandavi Training & Hygiene Specialist Member of Lok Shakti Bilaspur Samaj Scri Sansthan, Mob: 9770160602 Rajnandgaron District, Chhattisgarh Mob: 9407782964 17. Ms Pramila Sharma 18. Ms Sarita Tyagi Member of Lok Shakti Ganeshpur Village, Samaj Scri Sansthan, Mawana, Rajnandgaron District, Meerut U.P. Chhattisgarh Mob: 9690439637 Mob: 7587303890 19. Mr Ajay Kumar 20. Ms Prachi Arya Secretary, Satyakam Manav sewa samiti, H-99 Satyakam Manav Seva Samiti, H-99 Ganganagar Ganganagar Meerut U.P. Meerut U.P. Mob: 9410814135 Mob: 9897265724 Email: [email protected] Email: [email protected] 21. Ms Ruchi 22. Munmun Dey Satyakam Manav Seva Samiti Programme Officer H-99, Ganga Nagar, Mawana Road NEEDS, Jharkhand – 814112 Meerut 250001, U.P. Mob: 07781002447 Mob: 9769941556 Email: [email protected] 23. Mr Sarbani Bhattacharya Documentation 24. Mr Raghubir Singh Coordinator Force District Programme Manager C-8/8035, Vasantkunj, New Delhi 43 Madhubani Colony, Moradabad Mob: 8745017932 Mob: 8005193077 Email: [email protected] Email: [email protected] 25. Ms Seema Pandey 26. Ms Reena Toppo Asst. Project Coordinator Chief Community Mobilizer 175, Bangali Colony Kanapur Global Sanitation Fund, Mob : 8400998031 Lok Jagriti Kendra Email : [email protected] 52 Bigha Madhupur, Deoghar 815353, Jharkhand Mob: 09431734467 Email: [email protected] 27. Ms Pyari Kisku 28. Ms Shamim Community Mobilizer, Facilitator GSF Project IDENT, 5/27A Jangpura, B Mathura Road, Dumka, SIY Pahar, S.P. College, Dumka New Delhi Mob: 09572895220 Mob: 9718193626 Email: [email protected] 29. Ms Bharti 30. Mr Janardan Singh Facilitator Programme Coordinator 5/27A Jangpura, B Mathura Road, New Delhi MDSS VDA, Flat (Near Kachahari) Mob: 9718724748 Mirzapur District, U.P. Email: [email protected] Mob: 09450244259 Email: [email protected] 31. Ms Rajesh Kumari 32. Ms Vandana Tayagi MPF MPF Meejapur Meejapur Mob: 9897210504 Mob: 9557310778

12 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

S.no Participants S.no Participants 33. Mr Shivendra Pratap Srivastav 34. Mr Depinder S. Kapur Programme Manager India Wash Forum, New Delhi Samaj Kalyan Evam Bal Vikas Parishad Biraichi, Biraicha, Ghughli, Maharajganj U.P. Mob: 9935202321 Email:[email protected] 35. Ms Rita Urwashi 36. Mr Rupesh Kumar Rathure Facilitator (MRYDO) State Consultant, CCDU, 81 A Block B Phase III Prem Nagar Naiapgarh Engineer in Chief, Public Health Engineering Mob:9213301409 Department near Bhavan, civil lines Raipur Email: [email protected] Mob:09229260444 Email: [email protected] 37. Ms Bharti Kushwah 38. Ms Sanju Sharma CLTS, MP Mob:7415152325 Mob:7354890353 39. Mr Madhurima Masih Nanda 40. Mr Saurabh Kushwaha Regional Consultant CCDU, Project Coordinator Office of Superintending Engineer , Durg Circle (C.G.) , 392 Vikas Nagar, Kanpur Mob:9407694312 Mob:7897992895 Email:[email protected] Email:[email protected] 41. Ms Seema Savita 42. Ms Gita Community Facilitator Community Facilitator Mob:9198897533 Mob:9198897533 43. Ms Mridula 44. Mr Durgesh Mall Youth Organizer District Community Process Manager New Delhi Distt. Programme Management Unite N.R.H.M., Basti Mob:9810758144 U.P. Mob:9450479232 Email:[email protected] 45. Mr Balram Tiwari 46. Ms Asita Maldahiyar Regional ASHA Coordinator Programme Manager 19, A Vidhan Saha Marg, Lucknow ADITHL, H/0 Er K.P. Singh, IAS Colony west of canal, off Mob:09335071100 bialy Road, Patna Email:[email protected] Mob:9334750500 [email protected] 47. Mr Sabir Iqbal 48. Ms Suman Singh Community Design Specialist, Secretary State Water and Sanitation Mission, NBA, Office of SAKHI, Mtsya nagar, Bhagwtipur, PO- Rudrapur, Development commissioner, Vindhyachal Bhavan, Andhrathai 2nd floor, room-126 Bhopal Mob:09431021204 Mob:9669494594 Email: [email protected] Email:[email protected] 49. Mr Kumar Pankaj Anand 50. Ms Radha Shukal District Programme Manager, Coordinator DPMU, NRHM, U.P. 392, Vikash nagar Lokhanpur, Mob:9415390387 Kanpur Email:[email protected] Mob:9935535682 Email:[email protected]

13 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

S.no Participants S.no Participants 51. Ms Sultana Usmani 52. Mr Bikramaditya Sen Advocating Reproductive choices Secretary State Consultant, C-142/C2, Sector A Mohanagar, ANGEL C/0 Main road Borio Post Borio, Distt Sahebganj Lucknow, UP Mob:8102559081 Mob:9839837395 Email:[email protected] Email:[email protected] 53. Mr Sanjeev Kumar Bhagat 54. Mr Jasvinder kaur Force Director Field Area In charge Lok Kalyan Seva Kendra, Mob:8447120303 At+Po Devinagar, Mahaeshpur Email:[email protected] Mob:943136848 Email:[email protected] 55. Ms Rashmi Singh 56. Mr Purusottam Panda Social Mobiliser Regional Consultant Sakhi,Matysanagar, Bhaghwtipur, Andharathodi At-CCDU- PHED Mob:8252445447 Chhattisgarh Email:[email protected] Mob:7898804289 Email:[email protected] 57. Mr Santosh Pant 58. Mr Suresh Arya Uttarakhad Academy of Administration, Nainital Uttarakhad Academy of Administration, Nainital Mob: 9720988129 Mob: 9410374441 59. Jaspreet Kaur 60. Giriraj Sharma Sub-divisional Engineer CLTS Champion Water and sanitation Division. Guna, Bhatinda, Madhya Pradesh Punjab 61. Veenakshi Sharma 62. Birendra Kochar Director CCDU

List of resource persons

Mr Anchal Prakash Ms Archana Patkar Executive Director Programme Manager, Networking and Knowledge Saci Water South Asia Management Mob:961884459 Water Supply and Sanitation Collaborative Council, Geneva Email: [email protected] Email: [email protected]

Mr Krishana Ramavat Mr Vinod Mishra Team Goonj National Coordinator Neelkanin Hotal 119, Gangori, Uttarkashi, Water Supply and Sanitation Collaborative Council, Geneva Uttarakhand Mob: 9411107760 Email: [email protected] Email: [email protected]

Mr Shivangini Tandon Consultant, SKARMA, MIT, Green Park Main, New Delhi Mob: 9967788899 Email: [email protected]

14 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Annex 2: Training Programme

Time Session Facilitators Day One: 24 September, 2013 9.00-9.45 Registration 9.45-11.00 Inauguration 9.45 National anthem Welcome and Introduction Vinod Mishra 10.00 Training of Trainers’ Overview Archana Patkar 10.25 Welcome by Director IIPA T. Chatterjee, Director, IIPA 10.35 Government of India’s vision and strategy: Menstrual Pankaj Jain, Secretary, Ministry of Drinking Water and Hygiene Management in NBA Sanitation, Govt. of India 11.00 Vote of Thanks Prof. Sushma Yadav 11.10 Tea break 11.30 MHM: What is it? What do you know about it and Archana /Krishna/Nilima why is it important? Participant analysis (film ) 12.30 Feedback and discussion 13.30 Lunch 14.30 Conceptual framework Archana/Nilima 16.00 Tea break 16.15–18.00 Group work Six groups work on: 1) Breaking the Silence (Vinod and Varsha); 2) Managing Menstruation Hygienically (Nilima and Archana); 3) Safe Reuse and Disposal (Krishna Ramawat) Day Two: 25 September, 2013 09.30-11.00 Feedback from Group Work and Reflections from Day 1 11.00-11.30 Tea break 11.30-13.30 Training of Trainers Manual Learning Units 1, 2,3,4,6 and 7 – 12 groups of five each read and discuss with facilitator for 45-minutes and then train partner group Lead trainer and co-trainer manage first 10 minutes, then switch roles to rapporteur and observer. Recording difficulties and questions is main learning point. Exchange roles – trainer becomes trainee. Share experiences. 13.30 Lunch 14.30-15.15 Plenary – Learning Unit 5 – stakeholder analysis and institutions for NRHM. 15.15-16.00 Communicating sensitive topics such as MHM – Learning Unit 8 16.00 Tea 16.30-18.00 Learning Units 9 and 10 (Krishna and Nilima)

15 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Day Three: 26 September, 2013 09.30-10.30 MHM LAB –MC Ki Patshala – concept and vision 10.30-13.30 Group work and tea – three large groups followed by six smaller groups – MHM loop using all training materials – wheel, flip book, etc. – rotate with health practitioners’ training 13.30-14.30 Lunch 14.30-15.00 Participant feedback and reflections 15.00-16.30 Monitoring participation, quality and evaluation of impact 16.30 Tea break 17.00-18.30 Participant ideas on theme, interaction with director, NBA and way forward

Day Four: 27 September 2013 08.00-12.00 Working sessions on: 1) Final reporting; 2) Participant suggestions and recommendations (material and training roll out in their states), state roll out in 2014 – work plans, M&E plans 13.00 Thank you – WSSCC National Coordinator 13.30-14.30 Lunch

16 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

Annex 3: State Action Plans

1 Delhi Plan

On behalf of Action India Work Area: Nine areas in Delhi, namely Dakshginpuri, Madangiri, Dwarka Sector-16, New Seemapuri, Kalandar Colony, Sundernagri, Jahangirpuri, Bhalswa, Janta Majdoor Colony (Welcome). Target Groups: n 9 to 12 years girls’ Nanisabla group n 13 to 20 years girls’ G.L.I group n 9 to 12 years boys’ Tarun group n 13 to 25 years boys’ youth groups n 25 to 40 years women groups and community workers Trainers: Youth organizers, facilitators, youth leaders. Activities and Mediums: Meetings, group discussions, focus group discussions, street plays, role play, IEC material, flash cards, surveys, etc. (monthly menstrual cycle module and film). Target Numbers: n 1000 girls and boys n 1000 women aged 25-40 Time duration: 18 months (starting from November, 2013) Stakeholders: ASHA, ANM, Anganwadi workers, GRC, government dispensary, MCD schools, Nigam Parshad, counsellors and NGO network. Resources: Menstrual health and hygiene experts, Action India facilitators, NBY guidelines. Methodology: Focus Group Discussions. For the first six months information will be provided on menstrual health and hygiene to the target groups. Over the next six months each work area will be visited and changes in the target groups’ habits will be recorded, based on the information they received. Once this process has ended, researchers will return to the field to review how effectively each group they passed on the acquired knowledge to their communities. Evaluation: At the start of the process a survey will be conducted to ascertain the level of information the groups have on the issue. At the end of the process, a follow-up survey will be carried out to measure the increase in their knowledge and practice. The groups will also be assessed on the practices they are following, their sexual health and how much they have reached the larger community. Peer educators will be trained in each community to facilitate the surveys, GDs and FGDs in their respective communities.

17 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

2 Uttar Pradesh (NGO) Plan

Group profile Name Designation Responsibilities Operational Field Stakeholders Available Resources & Org. Shivendra Pratap P.M. Coordination Health Schools HR Srivastav SKBVP Documentation Water NGOs Vehicles Publication Education PRIs Training Centre Sanitation SHGs Environment Protection Rashmi Mishra Field Animator Child Right Education ANMs Staff NGO Women Health Nutrition ASHAs Health PRIs Schools AWWs Vandana Tyagi & Trainer SHGs formation Health ASHAs Staff Rajesh Kumari NGO MHM ANMs Training Centre Immunization AWW Schools Government Community Jama Mohammad PC Training Health, Sanitation, ASHAs Staff NGO Hygiene, MHM ANMs Training Centre PRIs Schools Government Community Surabh PC Coordination Water ASHAs Staff NGO Sanitation ANMs Hygiene AWW Schools Government Community Seema SHG Member Facilitation Solar Energy ASHAs _ ANMs Community Seema Pandey Asst. PC Coordination Water ASHAs Funds for drinking NGO Facilitation Sanitation ANMs water Hygiene AWW Master Trainers Schools Slum Community Radha Project Coordination WASH Community Radio station Coordinator Facilitation Health PRIs NGO Livelihood Education

18 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

2 Uttar Pradesh (NGO) Plan

Strengths The presence of the elements identified in the diagram below are seen as being strengths to the Utar Pradesh Group.

WASH Health Education Livelihood

ASHAs ANMs Well-experienced Schools Group staff Slum community

Villages – 450 Slums – 150

19 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

2 Uttar Pradesh (NGO) Plan

Situation analysis Issue Rural Responsibilities Awareness 1-2 marks out of 10 4 marks out of 10 Infrastructure 1 mark out of 10 5 marks out of 10 Facilities 1 mark out of 10 1 mark out of 10 Myths/Taboos 9 marks out of 10 6-7 marks out of 10

Three commitments from each member Member Commitments Shivendra Pratap Srivastav n Holistic approaches with School Management Committee (SMC) n SHGs training and empowering their livelihoods through sanitary pad making n Sharing with Friend Circle Rashmi Mishra n Establishment of Bal Sanrakashan Samiti n CBOs training n Sharing with Friend Circle Vandana Tyagi & Rajesh Kumari n MHM training in five villages, through individual efforts n At least one session on MHM in every training n Building relationships with adolescents Jama Mohammad n Engaging staff and volunteers in MHM project n Formation of village level committee n SMC level approach Surabh n Raising awareness through social media n Literature n School, communities and ASHAs level approaches Seema n Meena Munch n ASHAs level approach n Engagement of PRIs Seema Pandey n Training on MHM in 24 Schools n Training on MHM in 60 slums n Counselling adolescents Radha n Literature n Use of documentary films n 30 Volunteers will be engaged in this programme

20 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

2 Uttar Pradesh (NGO) Plan

Plan Activities Responsibilities Timeliness Resources WSSCC Stakeholders FGDs Self Three months Trainer/Facilitator Learning Materials Staff Schools Teachers ASHAs ANMs CBOs Training Self and state One-year 1. Trainer 1. Trainer Honoraria As above level training 2. Training Centre 2. T.A. 3. Communication Mass Mobilization Self Six-months Radio IEC and other learning As above materials

Evaluation The approach to the evaluation process will be driven by an assessment of the focus group discussions and the elements concerning training.

No. of FGDS No. of Training

No. of Feedback FGDS Training Participants

No. of No. of participants villages/slums Pre- and post- assessment

Mass Mobilization: No. of released programme

21 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

3 Uttar Pradesh NRHM Plan

NRHM team U.P. Name of members: Sultana Usmani Durgesh Janaradan Raghuvir Singh Shaista Shalini Pankaj Balram

Work plan Activities Responsibilities Timeliness Resources WSSCC Stakeholders State Advocacy State Nodal One-day UNICEF/NRHM WSSCC DPMU Officer (October) Health (Adolescent ICDS health-NRHM) Educational Institution WASH District Advocacy District Three-days NRHM/UNICEF Technical Support Development Training Management (December) Department Unit NRHM Counselling in 35 As above As above UNICEF WSSCC DHEIO District DPM DCM NGO Advocacy at Block/ DPMU/NGOs One-three days Funds/Resources As above Govt. Village/ (February 2014) Girls’ Schools HEO NGOs ANM AWW ASHAs

22 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

4 Uttar Pradesh Government Plan

U.P. work plan (govt)

GROUP MEMBERS 1 - Sultana Usmani NRHM 2 - Raghubir Singh [email protected] 8005193077 9412470894 NRHM 3 - Pankaj NRHM 4 - Durgesh NRHM

ACTIVITIES Intersectoral convergence meeting at state level WITH ICDS, Education, PRI, Health Water Corpn, Municipal Corpn, Water Corpn, NGO / dev partner, TRAINING NYK State, distt, block level tot up to front line worker

STATISTICAL DATA District -75 AWW 165000 Batch size = 30 participants ASHA 135000 ANM 2250

COOPERATION 1 - WSSCC 2 - UNICEF 3 - Govt Dept 4 - NGO 5 - Stakeholder

RESOURCES Training tools including modules

M&E State level observation with the help of district level NRHM staff Visit by the state level master trainer

23 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

5 Madhya Pradesh Plan

Team Name of members: Sabir Iqbal – State Consultant: [email protected] Smt Bharti Kuswaha Sanju Sharma Sabir Iqbal CLTS Motivator CLTS Motivator Communication, Material Design and Facilitator and Trainer Facilitator and Trainer Training Specialist, District: Guna District: Guna State Consultant, M.P.

MHM alignment with WASH & health training

Jal aevam Swatchta CLTS Motivator Vibhag (TSC/PRD)

ASHA, ANM, AWW, teacher Swatchta Doot etc at State and District level training (S.D.)

Village & Block level training Village & Block level training

24 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

5 Madhya Pradesh Plan

Sanitation hygiene advocacy and communication strategy, including MHM

State Level State programme Office (SPO)-NBA

Report and information flow

District Level CEO Zila Panchayat NBA District Coordinator

Instruction flow

Block Level Supportive supervision & CEO Zila Janpad data validation after 6 months NBA Block Coordinator

Quarterly meeting GP Nodal Officer supervision

Gram Panchayat Level Swatchadoot

25 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

6 Jharkand State Plan

Activity: Meeting with target group in target area n MHM awareness programme n Liaising with sahiya/aganwari worker/change-maker in different area n Liaising with project management units/department so that they can issue a circular on MHM progress in the State n Make monthly progress reports based on M&E with local indicators n Linkage with traditional birth attendants/village head, especially in tribal area

Key stakeholders: n Trained worker n Donor agency/project head n Working group n Change workers

Duration: One year (October 13, 2013 – September 14, 2014) Resource: Tool kits, stationary, display materials, TA/refreshment costs Corporation requirement: WSSCC Team/CCDU Jharkhand/NGOs head/PMU Jharkhand/WASH Forum Related stakeholder: Workers/Sahiya/AWW/community/health department/officials/PRI

26 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

7 Bihar Plan

Name of members: Aditi [email protected] 9334750500 Sakhi [email protected]; [email protected] 9431021204

Intervention area – Patna, Maner, Madhubani, BL – Jhanjharpur/Andhrathari

Activity: 1. Community awareness and mobilisation 2. Advocacy for MHM at state/district/block/panchayat 3. Training at all levels a. As on demand as a trainer b. Our project level 4. Listening and coordination with government/community/school/etc. 5. Action research

Responsibility: Aditi, Sakhi, government Timeline: One-year Resources: Government and other funders, materials (training), audio/video/resource person Support needed: Government, policy makers, community and other champions (WSSCC) Stakeholders: All line departments/PRI/District/Block/Panchayat/VHSC/SHG/community/NGOs/women cooperative/VISWASH state network Impact: n Increase understanding about MHM n Increase participation at all levels

Most important Behaviour change in intervention area: n 50% girls and women use sanitary napkins n 50% girls and women take care of themselves n Increase in hand washing practices n Increase in safe disposal n Case studies of best practices n Decrease in UTI cases

27 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

8 Chhattisgarh Plan

SL. ACTIVITY RESPONSIBLE TIME RESOURCES SUPPORT RELATED NO. REQUIRED STAKEHOLDERS 1. Advocacy of Communication and By Jan Funds/ Protocol type of Water State Water Decision Makers Capacity Development 2014 Materials Supply and Sanitation and Sanitation Unit (CCDU) Collaborative Council Mission(SWSM)/ (WSSCC) District Water and Sanitation Mission (DWSM) 2. Capacity Building Communication and By March Funds/ Protocol type of Water Assistant Engineer, of Master Capacity Development 2014 Materials Supply and Sanitation Executive Engineers Trainers Unit (CCDU) Collaborative Council & Coordinators of (WSSCC) Public Health Engineer Departments ( PHE) 3. Development of Communication and By Feb Funds/ Resource person Block Resource Training Modules Capacity Development 2014 Materials should be from Water Coordinators/ on MHM Unit (CCDU) Supply and Sanitation Swachhata Doot from Collaborative Council Public Health Engineer (WSSCC) Departments ( PHE) 4. Incorporation of Communication and By Dec Funds flow Resource person Village Water and incinerators in Capacity Development 2013 from Solid should be from Water Sanitation Committee SLWM Plan of Unit (CCDU) Liquid Waste Supply and Sanitation (VWSC)/Block Water Gram Panchayat Management Collaborative Council and Sanitation under Nirmal (WSSCC) Committee (BWSC)/ Bharat District Water and Abhijan Sanitation Committee (NBA) 5. Incorporation District Water and By March Funds Under Resource person District Water and of IEC activities Sanitation Committee 2014 IEC under should be from Water Sanitation Committee on Menstrual (DWSC) Nirmal Supply and Sanitation (DWSC) Hygiene Bharat Collaborative Council Management Abhijan (WSSCC) under Annual (NBA) Implementation Plan 2014-15 6. Development Communication and By April Funds Resource person Front Line Worker/ of IEC materials Capacity Development 2014 should be from Water Block Resource Centre/ on Menstrual Unit (CCDU) Supply and Sanitation Swachhata Doot Hygiene Collaborative Council Management (WSSCC) (MHM) 7. Use of Radio Communication and By April Funds Radio Spot Adolescent Girls and Programme Capacity Development 2014 Women Unit (CCDU) 8. Convergence Communication and By April Funds UNICEF/Water Aid Health (NRHM)/ Workshop at Capacity Development 2014 Education/W&CD/ State Level Unit (CCDU) Rural Development/ NGO

28 MENSTRUAL HYGIENE MANAGEMENT: TRAINING OF MASTER TRAINERS

8 Chhattisgarh Plan

Work plan for implementation on MHM Programme 09893114529 (Deep Narayan Bennergi – [email protected]) State: Chattisgarh Organization: Carmdaksh (NGO) and Lok Shakti Smajsewa Sanstha

Carmdaksh works on an MHM project in partnership with WaterAid. Their intervention areas are Bilaspur Distrtict, Raigargh and Korba in CG, where they focus on 28 villages, 21 schools and 6,500 households at Pali block, but need additional support to make improvements in other areas.

SL. ACTIVITY RESPONSIBLE TIME RESOURCES SUPPORT RELATED NO. REQUIRED STAKEHOLDERS 1. Advocacy of Carmdaksh By Nov WaterAid Protocol type of Front line worker, SHG decision makers 2013 Materials WSSCC and their MHM work

2. Capacity building Carmdaksh Cont. Funds/ Protocol type of Carmdaksh team, of Master Materials WSSCC frontline worker village Trainers leader, CRP 3. Development of Carmdaksh By Oct Funds/ Resource person Carmdaksh MHM training modules 2013 Materials should be from CCDU Team, frontline worker on MHM from and WSSCC village leader, CRP WaterAid 4. Development Carmdaksh Cont. Funds from Resource material Adolescent girls and of materials WaterAid should be from SHG women, with a for MHM and NEEDS WaterAid and WSSCC special focus on men programme

5. Use of Carmdaksh By Feb Funds Radio spot Adolescent girls, documentary 2014 required women and men programme

29 The Water Supply and Sanitation Collaborative Council (WSSCC) The Water Supply and Sanitation Collaborative Council (WSSCC) is a global multi- stakeholder partnership and membership organization that works to save lives and improve livelihoods. It does so by enhancing collaboration among sector agencies and professionals who are working to improve access for the 2.5 billion people without safe sanitation and the 780 million people without clean drinking water. Through its work, WSSCC contributes to the broader goals of poverty eradication, health and environmental improvement, gender equality and long- term social and economic development. WSSCC supports coalitions in around 20 countries, members in more than 160 countries, and a Geneva-based Secretariat hosted by the United Nations Office for Project Services (UNOPS).

The Indian Institute of Public Administration The Indian Institute of Public Administration (IIPA) is a premier public policy school for public administration studies and one of the major social science resources in India. Since its inception in 1954, the IIPA has been at the forefront of academic work that has contributed to enhancing the managerial and leadership qualities of executives, policymakers and public officials in India. Enhancing leadership and managerial qualities on the one hand and developing a service-orientation on the other are the thrust areas of the Institute’s education and training activities. A key product of the IIPA is the internationally known ‘Indian Journal of Public Administration’ which has been published since 1955. IIPA has published over 400 books, monographs and reports. The current President of the IIPA is the Vice President of the Republic of India, Mohammad Hamid Ansari. For more information on the IIPA, go to http://www.iipa.org.in/index.html.

WATER SUPPLY AND SANITATION COLLABORATIVE COUNCIL

15 Chemin Louis-Dunant 1202 Geneva Switzerland

Telephone: +41 22 560 8181 Fax: +41 22 560 8184 www.wsscc.org [email protected]