Addressing Menstrual Health in Urban, Water, and Sanitation Interventions in the Pacific: Practitioner Guide

ASIAN DEVELOPMENT BANKJUNE 2023Addressing MenstruAl HeAltH in urbAn, WAter, And sAnitAtion interventions in tHe PAcificPractitioNEr gUidE ASIAN DEVELOPMENT BANKJUNE 2023Addressing MenstruAl HeAltH in urbAn, WAter, And sAnitAtion interventions in tHe PAcificPractitioNEr gUidE creative commons attribution 3.0 igo license (cc BY 3.0 igo)© 2023 Asian Development Bank6 ADB Avenue, Mandaluyong City, 1550 Metro Manila, PhilippinesTel +63 2 8632 4444; Fax +63 2 8636 2444www.adb.orgSome rights reserved. Published in 2023. ISBN 978-92-9270-174-1 (print); 978-92-9270-175-8 (electronic); 978-92-9270-176-5 (ebook) Publication Stock No. TIM230202-2 DOI: http://dx.doi.org/10.22617/TIM230202-2The views expressed in this publication are those of the authors and do not necessarily reflect the views and policies of the Asian Development Bank (ADB) or its Board of Governors or the governments they represent. ADB does not guarantee the accuracy of the data included in this publication and accepts no responsibility for any consequence of their use. The mention of specific companies or products of manufacturers does not imply that they are endorsed or recommended by ADB in preference to others of a similar nature that are not mentioned.By making any designation of or reference to a particular territory or geographic area, or by using the term “country” in this publication, ADB does not intend to make any judgments as to the legal or other status of any territory or area.This publication is available under the Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO) https://creativecommons.org/licenses/by/3.0/igo/. By using the content of this publication, you agree to be bound by the terms of this license. For attribution, translations, adaptations, and permissions, please read the provisions and terms of use at https://www.adb.org/terms-use#openaccess.This CC license does not apply to non-ADB copyright materials in this publication. If the material is attributed to another source, please contact the copyright owner or publisher of that source for permission to reproduce it. ADB cannot be held liable for any claims that arise as a result of your use of the material.Please contact pubsmarketing@adb.org if you have questions or comments with respect to content, or if you wish to obtain copyright permission for your intended use that does not fall within these terms, or for permission to use the ADB logo.Corrigenda to ADB publications may be found at http://www.adb.org/publications/corrigenda.Note: In this publication, “$” refers to United States dollars.This practitioner guide was prepared by Kate Walton, gender consultant. Thank you to Vivian Castro-Wooldridge, Sue Cavill, Alexandra Conroy, Ingrid Fitzgerald, Andrés Hueso González, Jingmin Huang, Sinéad Lehane, Thérèse Mahon, Bronwyn Powell, Malika Shagazatova, Maria Tran, and Emma Veve for their invaluable input during the development of this practitioner guide.On the cover: Women making head garlands in Chuuk, Federated States of Micronesia. All photos by ADB. iiiCONTENTSfigures, boxes, and case studies ivAbbreviations vglossary viexecutive summary viii1 introduction 1Publication Purpose 2Why Menstrual Health? 32 What is Menstrual Health and Why does it Matter? 53 existing Knowledge on Menstrual Health in the Pacific 94 How does Menstrual Hygiene Management impact development outcomes? 13Gender Equality and Social Inclusion 14Health and Well-Being 14Education 15Work, Income Generation, and the Economy 16Water, Waste Management, and the Environment 165 establishing baseline data on Menstrual Health 176 Mainstreaming Menstrual Health into interventions 23Menstrual Health-Friendly Sanitation Facilities 26Menstrual Materials 31Education, Awareness-Raising, and Behavior Change 32Community Involvement and Consultation 33Enabling Environment 347 What does success look like in Menstrual Health interventions? 35APPendiXes 371 References, Tools, and Guidance 382 Example Design and Monitoring Framework Performance Indicators 413 Example Gender Equality and Social Inclusion Specialist Terms of Reference 43 for Consultants ivFIGURES, BOxES, AND CASE STUDIESfigures1 Essential Components of Good Menstrual Health 42 Percentage of Women and Girls Aged 15–49 Years Excluded 15 from Social, School, or Work Activities During Menstruation3 Where to Find Menstrual Health Data 194 Example of a Menstrual Health-Friendly Toilet 30boXes1 Asian Development Bank and Menstrual Health in the Pacific 72 Developing a Menstrual Health Survey 203 Menstrual Health Survey Tools 224 Engaging Men and Boys 325 “MHM in Ten”: Priorities for Menstrual Hygiene Management in Schools 33 (2014–2024)cAse studies1 Menstrual Health Kits in Emergencies 162 Combating Barriers to Education in Vanuatu 243 Learning from Other Island Countries: Inclusive Water, Sanitation, and Hygiene Facilities 26 at Schools in Timor-Leste4 Sanitary Pad Vouchers for Schoolgirls in Fiji 31 vABBREVIATIONSADB Asian Developmen