#MHM practices in Nepal, a Technical review

#MHM practices in Nepal, a Technical review

by Radha Paudel
Comments on Review of all Technical Papers[1]
1.    It is my great pleasure and privilege to work as Coordinator for Technical review committee. I would like to extend my sincere thanks and gratitude to Ministry of Water and Sanitation as well as WSSCC, National Chapter for trusting and of course my team members; Priya, Kalawati, Manima, Aratti for their generous support.

2.    Due to time constraints, we have gone through so quickly and try to come up with inputs or perspectives not comments indeed. It is all because of way of our work and mindset.
3.    In some extent, specially me is bit critical does it mean that we are creative towards tissue and the Peace, Human right, empowerment and SDGs broadly. You might upset by seeing way of saying. Sincere apology for that.
4.    We do not go with details. we simply see the way where we are moving and what are the major gaps or potential to create gaps, in presentation, contents and understanding the issues. We are trying to see the papers on to what extent we are able to address or understand the underlying cause of menstrual practice in Nepali community and how can we redress collectively.
5.    This is beginning, we all are on the way of learning though we have ignored or forget this issue which has with us when the nature mother created as male and female.
6.    The comments presented in two categories as follows
A.     Applied to all
1.         Structure of the Presentation
       Brief Introduction
       Practices in Nepal
       key intervention or process or Methodology with specification but brief or                       bullets
       Achievements and impacts 
       lesson learns supported by some instances 
       way forward 
       If any success stories/voice of people or photos or facts
B.     Applied for specific presentation (Please follow as individual    presentation)
1. Participatory photography project – Sirthauli, Sindhuli, Wateraid
1.    In Nepal, the use of technology by adolescents is becoming debateable. Even experts arguing that the child marriage and school dropped out rate is increasing because of mobile and Facebook. Here, technology created opportunity for learning and empowerment as well as understand the gravity of the issue among girls. Thus, highly appreciated.
2.    Due to practice or learning by doing approach, it is more not only visible but also sustainable
3.    However, how can the girls from rural, poor communities can manage such approaches, or how can we extend this approach at larger level
4.    Is this photography skills linked with other opportunities e.g. entrepreneurship related with and without MHM?
2. Study on menstrual hygiene management in Udaypur and Sindhuli districts of Nepal, WaterAid Nepal
1.    Even though the study conducted in two district, findings are similar or applied across countries
2.    The absence in school during period is leading to poor education and employment which is serious concern to all stakeholders
3.    Urgency to peel up the rumours, myths and misconceptions around menstruation in order to empower girls at family, school and community at large
4.    The engagement of private sectors, boys, men and also crucial to accept the natural beauty of menstruation as well as hold accountability at an individual level
5.     Innovative approaches for initiate enterprise on MHM also a one key area to explore and intervene where win-win situation could be achieved

3. An Overview of Chhaupadi Practices in Mid and Far Western Region of Nepal, By Ritu
  1. The study is very comprehensive in way to understand the patterns of chhaupadi, restrictions and its impact associated with
  2. The analysis regarding chhaupadi is still considered as narrow sense or limited it only in far and mid-west context which is not true. The Chhaupadi practice is across globe where Nepalese communities are living. Because chhaupadi associate with many forms of restrictions which is being practice in Kathmandu, eastern Nepal, UK, and USA. The only a difference is range of restriction
  3. Humla also have same level of chhaupadi
  4. The elites are more resist for change, they keep blaming to other family members specially women and sometimes seniors. They are very good in communication, they communicate one thing in public and doing other thing in private. Sometimes, it also depends on project staff. The chhaupadi is complex behaviour associated with culture, religion, communal honour, poverty, ignorance, gender etc. It is very hard to identify if someone will not provoke the practices tactfully. Not living in shed doesn’t mean of abolish of chhaupadi. We have to see critically whether they aware on science and nature behind the menstruation or not
  5. The engagement of faith healers, boys and men are important rather liner way of educating or empowering e.g. women
  6. The radio program is useful for the awareness raising but is it accessible to them who are practicing chhaupadi
  7. Chhaupadi is continued by health educators, teachers because people or NGO people not know the facts about menstruation. The staff who is practicing chhaupadi at home and asking to abolish in public which is very contrary way of project implementation and also key barrier of chhaupadi or poor MHM in Nepal.
  8. First, good MHM and MR practice include in to the code of conduct of office or job. Those who can clean their house properly, only they can shout to their neighbour for clean
  9. The capacity building should be participatory followed by coaching and follow up review and reflection at least between 3-4 months for a year to see the changes
4. Draft Case on Menstruation Hygiene Management from KIRDARC  Jumla
Use only a case study, the other file, I failed to open)
1.  The story was so moved,
2.  It is real case scenario of many districts specially in western Nepal
3.  The impact was mentioned very well, how the girls suffered at immediate and long term
4.  There is huge gap or misunderstanding around the menstrual restriction or taboo. Because the support in construction of toilet, provision of sanitary pads are easy ways to intervene and community also like the hard ware part but not a solution of addressing underlying causes of restrictions during period.
5.  The rumours, misconceptions are not addressed so the pattern of violence is changing associated with menstruation e.g. abuse in shed,
6.  This case urged to everyone to act urgently in following ways:
ü  Engagement of the all segment of population in community in rationalization of rumours, practices first. Once they realized, they will construct the toilet or seek sanitary pads then the project can support as partner. This is most empowering and sustained approach which demands more time, mentoring, coaching.
o   or
ü  the software and hard ware could go side by side. It is easy but community may not own the responsibility
ü  Engagement with boys and men for accountability practice is very crucial to protect the human rights of girls and women. Because it is beyond the involve of boys and men in program (They should hold accountability at personal level, transformation)

5. Student’s knowledge regarding Menstrual Hygiene Management and practices in Kathmandu District
1.    As other papers, here the way of understanding the MHM is biased e.g. the first sentence says; Inadequate knowledge of menstrual hygiene at schools may lead to poor hygiene practice which in long term, can aggravate the both the health of school students and school environment as well, indeed, there is inadequate knowledge in menstruation that is why they are not understand the good MHM
2.     No matter what sorts of concept around menstruation, they all are ranges of restriction and similar with Chhaupadi so it helps to understand the chhaupadi is practicing in Kathmandu. 7% of respondents responded menstruation as the Untouchability, more  than 82% responded that they are not allowed to enter in the kitchen and worship area. Also 3% responded that they couldn’t sleep at home. Similarly, 10% responded of other concepts such as, girls can’t touch plants/flowers, they are not allowed to touch water or even look at the sun etc.  And nearly 1% didn’t respond at all.
3.    Only 11.7 % respondents do not know the sanitary pads.which is not bad. Why did we need to worry on not using sanitary pad? The type of sanitary pad is choice of an individual just need at least clean and cotton 
4.    From the data of school leaving, drying the cloth pad, menstrual needs and rights being confined only for women. Principally, there is no difference between western Nepal and Kathmandu
 6. Community Understanding on Menstrual Hygiene Management, CODEF
1.  Very alignment with MHM practice
2.  Exist varieties of restriction, stigma, misconception that socialized from family and school which impacted in education and other daily life of girls and women
3.   using pads is quite impressive
7. Legitimizing ODF and Changing Chhaupadi, SEBAK/USAID
1.    The process, contents are aligned with MHM.
2.    Engaging men in campaign is very important and appreciated
3.    Since Menstruation is complex and multifaceted issue related with emotional and behaviors change so the orientation or training should be in such as way where any stakeholder can understand the physiology of menstruation, cross cut all rumors, myths around menstruation, see the link with national and international human rights frame
This is 46 page report so hard to go in such limited time. More importantly, chhaupadi is covered almost all papers so I escape.
9. Helping Girls Transition from Childhood to Womanhood in Nepal
1.    More comprehensive in concepts and implementation plan
10. Quality Control Aspects of Sanitary Napkins, Shobha
2.    Good imitative, appreciated  
3.    It is important to produce locally with quality, affordability
4.    Expect the home based experienced or usability by girls and women in Nepal
5.    what about the cost? duration of absorbent?
6.    Any reversed affect from using this?
7.    3 Ps (profit, planet, people) ???
8.    Cost for installation of a plant at rural village and its market ???
11. ljBfno :jf:Yo kf]if0f tyf ;DklQ Joj:yfkg zfvf,;fgf]l7dL, eQmk’/,Division of Education
Mostly focused on policy and practice, showed that the government already cascading the SDGs and Constitutional rights 2015 and ready to transfer in to action.  The entire presentation is self-explanatory and we are just in beginning of SDGs so have to wait and see. More importantly, we all have to work together for creating synergy among all of us.

[1] Coordinator : Radha Paudel, Members: Kalawati Pokhrel, Arati Shrestha, Priya Shrestha, Manima Budathoki

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