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

ADDRESSiNgMENSTRUALHEALTHiNURBAN,WATER,ANDSANiTATiONiNTERVENTiONSiNTHEPACiFiCPRACTiTiONERGUiDE JUNE2023 ASIANDEVELOPMENTBANK ADDRESSiNgMENSTRUALHEALTHiNURBAN,WATER,ANDSANiTATiONiNTERVENTiONSiNTHEPACiFiCPRACTiTiONERGUiDE JUNE2023 ASIANDEVELOPMENTBANK CreativeCommonsAttribution3.0iGOlicense(CCBY3.0iGO) ©2023AsianDevelopmentBank 6ADBAvenue,MandaluyongCity,1550MetroManila,PhilippinesTel+63286324444;Fax+63286362444 www.adb.org Somerightsreserved.Publishedin2023. ISBN978-92-9270-174-1(print);978-92-9270-175-8(electronic);978-92-9270-176-5(ebook) PublicationStockNo.TIM230202-2 DOI:http://dx.doi.org/10.22617/TIM230202-2 TheviewsexpressedinthispublicationarethoseoftheauthorsanddonotnecessarilyreflecttheviewsandpoliciesoftheAsianDevelopmentBank(ADB)oritsBoardofGovernorsorthegovernmentstheyrepresent. ADBdoesnotguaranteetheaccuracyofthedataincludedinthispublicationandacceptsnoresponsibilityforanyconsequenceoftheiruse.ThementionofspecificcompaniesorproductsofmanufacturersdoesnotimplythattheyareendorsedorrecommendedbyADBinpreferencetoothersofasimilarnaturethatarenotmentioned. Bymakinganydesignationoforreferencetoaparticularterritoryorgeographicarea,orbyusingtheterm“country”inthispublication,ADBdoesnotintendtomakeanyjudgmentsastothelegalorotherstatusofanyterritoryorarea. ThispublicationisavailableundertheCreativeCommonsAttribution3.0IGOlicense(CCBY3.0IGO)https://creativecommons.org/licenses/by/3.0/igo/.Byusingthecontentofthispublication,youagreetobeboundbythetermsofthislicense.Forattribution,translations,adaptations,andpermissions,pleasereadtheprovisionsandtermsofuseathttps://www.adb.org/terms-use#openaccess. ThisCClicensedoesnotapplytonon-ADBcopyrightmaterialsinthispublication.Ifthematerialisattributedtoanothersource,pleasecontactthecopyrightownerorpublisherofthatsourceforpermissiontoreproduceit.ADBcannotbeheldliableforanyclaimsthatariseasaresultofyouruseofthematerial. Pleasecontactpubsmarketing@adb.orgifyouhavequestionsorcommentswithrespecttocontent,orifyouwishtoobtaincopyrightpermissionforyourintendedusethatdoesnotfallwithintheseterms,orforpermissiontousetheADBlogo. CorrigendatoADBpublicationsmaybefoundathttp://www.adb.org/publications/corrigenda.Note: Inthispublication,“$”referstoUnitedStatesdollars. ThispractitionerguidewaspreparedbyKateWalton,genderconsultant.ThankyoutoVivianCastro-Wooldridge,SueCavill,AlexandraConroy,IngridFitzgerald,AndrésHuesoGonzález,JingminHuang,SinéadLehane, ThérèseMahon,BronwynPowell,MalikaShagazatova,MariaTran,andEmmaVevefortheirinvaluableinputduringthedevelopmentofthispractitionerguide. Onthecover:WomenmakingheadgarlandsinChuuk,FederatedStatesofMicronesia.AllphotosbyADB. CONTENTS Figures,Boxes,andCaseStudiesiv Abbreviationsv glossaryvi ExecutiveSummaryviii 1introduction1 PublicationPurpose2 WhyMenstrualHealth?3 2WhatisMenstrualHealthandWhyDoesitMatter?5 3ExistingKnowledgeonMenstrualHealthinthePacific9 4HowDoesMenstrualHygieneManagementimpactDevelopmentOutcomes?13 GenderEqualityandSocialInclusion14 HealthandWell-Being14 Education15 Work,IncomeGeneration,andtheEconomy16 Water,WasteManagement,andtheEnvironment16 5EstablishingBaselineDataonMenstrualHealth17 6MainstreamingMenstrualHealthintointerventions23 MenstrualHealth-FriendlySanitationFacilities26 MenstrualMaterials31 Education,Awareness-Raising,andBehaviorChange32 CommunityInvolvementandConsultation33 EnablingEnvironment34 7WhatDoesSuccessLookLikeinMenstrualHealthinterventions?35 APPENDiXES37 1References,Tools,andGuidance38 2ExampleDesignandMonitoringFrameworkPerformanceIndicators41 3ExampleGenderEqualityandSocialInclusionSpecialistTermsofReference43 forConsultants FIGURES,BOxES,ANDCASESTUDIES FigURES 1EssentialComponentsofGoodMenstrualHealth4 2PercentageofWomenandGirlsAged15–49YearsExcluded15 fromSocial,School,orWorkActivitiesDuringMenstruation 3WheretoFindMenstrualHealthData19 4ExampleofaMenstrualHealth-FriendlyToilet30 BOXES 1AsianDevelopmentBankandMenstrualHealthinthePacific7 2DevelopingaMenstrualHealthSurvey20 3MenstrualHealthSurveyTools22 4EngagingMenandBoys32 5“MHMinTen”:PrioritiesforMenstrualHygieneManagementinSchools33 (2014–2024) CASESTUDiES 1MenstrualHealthKitsinEmergencies16 2CombatingBarrierstoEducationinVanuatu24 3LearningfromOtherIslandCountries:InclusiveWater,Sanitation,andHygieneFacilities26 atSchoolsinTimor-Leste 4SanitaryPadVouchersforSchoolgirlsinFiji31 ABBREVIATIONS ADBAsianDevelopmentBank GAPgenderactionplan GESIgenderequalityandsocialinclusion MHMmenstrualhygienemanagement OPoperationalpriority PNGPapuaNewGuinea SDGSustainableDevelopmentGoalWASHwater,sanitation,andhygieneWHOWorldHealthOrganization GLOSSARY GenderThesociallyconstructedcharacteristicsofwomen,men,andothers,suchasnorms,roles,andrelationshipsbetweenthem.Gendervariesfromsocietytosocietyandcanchange. Theconceptofgenderincludesfiveimportantelements:relational,hierarchical,historical,contextual,andinstitutional.Whilemostpeopleareborneithermaleorfemale,theyaretaughtappropriatenormsandbehaviors,includinghowtheyshouldinteractwithothersofthesameoropposit