Measuring the Influences of School WASH-based MHM interventions on adolescent girls’ Educational Engagement in Accra, Ghana

The GAMA* & Water Project *Greater Accra Metropolitan Area

Menstrual Management (MHM) refers to the process of handling . Without good MHM adolescent girls may struggle to attend school during menstruation. Good MHM consists of the following elements:

MHM Knowledge: Sanitary Products: WASH Facilities:

Private & clean toilet facilities to Knowledge of puberty, menstruation, and Clean materials to absorb or collect change sanitary products. Latrines with how to practice good menstrual hygiene. menstrual blood. locked doors, light and space. Menstruation is normal, not an illness. Clean, re-usable cloth Disposable, ready-made sanitary pads Water and soap. For personal hygiene and rinsing Physical Development during puberty. or menstrual cups. cloths and menstrual cups. Feeling self-confident, freedom from shame. How to deal with menstruation, both fluids and pain. Appropriate waste disposal facility For soiled materials and used sanitary products.

Despite the government's efforts, public schools have not been able to retain Ghana faces significant challenges with Menstrual Hygiene Management. girls at the junior high level because of prevailing learning challenges, social environments and physical conditions. Impact in education Primary schools 11.5 Gender Parity Index, Basic Schools Ghana million of women lack Kindergarten access to waste disposal facilities that adequately Primary separate MHM waste Junior High from human contact & School 2009/10 10/11 11/12 12/13 13/14 14/15 only 59% only 62% 2.5 have adequate water have adequate sanitation A Sketch of Girls’ million of women supply systems systems Enrollment lack access to private facilities in public spaces to manage Coordinated investment in infrastructure menstruation and education are essential to address the lack of water and sanitation infrastructure 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Typical School Enrollment in public spaces, specifically in schools Age of Girl

WASH facilities and MHM self-efficacy (or Self-efficacy and WASH facilities) The role of school management is critical to ensuring access to resources for sanitation, providing teacher training on this sensitive topic, and oversight and monitoring of MHM education. Facilitation of adequate menstrual hygiene management Materials to Menstruation is a absorb or collect normal physiological menstrual blood process Individual Material knowledge resources Private and clean facilities Physical development to change and dispose of in adolescent girls Social soiled materials (at home, school, and work) environment

How to deal with Facilities for menstruation personal hygiene

When a doctor Pain management may be helpful

Enabling and encouraging: No restrictions menstruation is normal

Debunking taboos and myths

Lack of MHM resources may hinder Education is an important factor in educational engagement in girls poverty alleviation, especially for Girls tend to feel ashamed and MHM is knowledge of and access to materials women and girls uncomfortable, which leads to More attention should be placed on identifying negative, long-term side effects on and facilities for proper management of and addressing the challenges girls face in their educational and health outcomes menstrual hygiene schools, such as socio-emotional factors impacting self-esteem and self-efficacy

School environments inhibits female students and teachers to manage their menstruation with safety, dignity, and privacy This can negatively influence socio-emotional indicators such as self-esteem, self-efficacy and eventually ability to succeed and thrive within and outside the school environment.

Findings and Recommendations Lack of adequate WASH facilities MHM-centered WASH facilities and Access to private and clean WASH in schools to promote good improved behavior and educational facilities can impact a post- menstrual hygiene practices can interventions are necessary to break girl's level of engagement in school act as a barrier to education, the cycle of gender inequality in engagement in sports and associated schools Good MHM and WASH interventions development affecting gender must be integrated into school curricula to increase access to education for girls equality