MENSTRUAL HYGIENE MANAGEMENT - Fit For School

MENSTRUALHYGIENE MANAGEMENTWinS MONITORING RESULTS PHILIPPINES // SCHOOL YEAR 2017/2018 TO 2018/2019

BACKGROUNDThe Joint Monitoring Programme (JMP) of the WHO and UNICEF provide a definitionfor Menstrual Hygiene Management (MHM):“Women and adolescent girls use hygienic materials to absorb or collectmenstrual blood, which can be changed in privacy as often as necessary forthe duration of a menstrual period, use soap and water for washing the bodyas required, and have access to safe and convenient materials to dispose ofused materials. They understand the basic facts linked to the menstrual cycleand how to manage it with dignity and without discomfort or fear.”Inherent in this definition is the need for adequate water, sanitation and hygiene(WASH) services. With girls spending half of their days in school, it is imperativethat these services are also available in school settings to enable girls to attendschool during their monthly period and to maximize their education.Usable toilets and handwashing facilities in particular are necessary for girls tomanage menstruation in schools. Aspects of MHM are integrated within the existingSustainable Development Goal (SDG) target for WASH in Schools, under SDG target4.1.a. This target aims that all schools meet the basic service levels for WASH,meaning that they have drinking water from an improved source available;gender-segregated toilets that are usable (accessible, functional and private);and handwashing facilities with water and soap.In the Philippines, as of 2016, the JMP reported that 50% of schools in thePhilippines meet the basic service level for drinking water, 39% of schools reachthe basic service level for sanitation and 46% of schools meet the basic servicelevel for hygiene. To continue to improve these figures, in 2016, the PhilippineDepartment of Education (DepEd) issued the National WinS Policy (DepEd Order 10,Series 2016). Through this policy, all schools are mandated to implement importantaspects of MHM, amongst other WinS aspects.DepEd conducts annual monitoring to track progress of schools implementingthe WinS policy. The baseline was conducted in School Year 2017/2018, with twothirds of public schools, about 30 000 schools, participating. The second roundof WinS monitoring was conducted in School Year 2018/2019, with three quartersof schools, about 35 000 schools, participating.This report shows the available data from these two rounds of monitoring whichis relevant for MHM.WATERSANITATIONHYGIENEHEALTH EDUCATION

KEY INSIGHTSMENSTRUAL HYGIENE MANAGEMENTHAS IMPROVED IN THE PHILIPPINES INTHE FIRST TWO YEARS OF IMPLEMENTATION.Almost all aspects of MHM improved from baseline tofollow-up. This rapid improvement could indicate thatresponding to the baseline survey drew the attentionof schools towards which aspects they should changeto improve their school. In this way, the monitoringsurvey can serve as a technical guide. Following thebaseline data collection, many schools were able toallocate resources to improve MHM. This would alsoindicate that the national standards for MHM outlinedin the DepEd WinS policy are feasible for schools to implement on their own the resources available to them.SCHOOLS ARE SHOWING MORE IMPROVEMENTSIN AREAS WHICH REQUIRE LESS INVESTMENTIN INFRASTRUCTURE AND WHERE THEY CANUSE EXISTING RESOURCES.There were rapid improvements in availability oftrash bins and wrapping materials; as well as simpleimprovements to toilets (locks, lighting, ventilation).Whereas, improving student-toilet ratio, makingwashing facilities available in female toilets andproximity of toilets to classrooms require higherinvestment and have not improved over the firsttwo years of monitoring. This would indicate thatinitial interventions on MHM can focus on incremental improvements where schools can use existingresources. These initial improvements can alreadymake an important change to the ability of girls tomanage menstruation in schools.SCHOOLS WERE ABLE TO MAKEA DRASTIC IMPROVEMENT IN THEAVAILABILITY OF SANITARY PADS.The proportion of schools reporting sanitary padsnearly doubled between baseline and follow-up.The drastic improvement in this indicator over a shorttime indicates that the standard is within the existingmeans of the school and that the WinS policy mandating schools to ensure availability of sanitary padswas effective to incentivize action.INFRASTRUCTURE CONTINUESTO BE A BARRIER FOR MHM.Despite such impressive progress in the Philippines inthis short time period, schools still struggle to improveinfrastructure needed for MHM. The pupil-toilet ratiofor girls was one of the few indicators which worsenedover the monitoring period. Construction of additionaltoilets is often outside the control of the schools andrequires more significant investment, often beyond thecapacity of the school community. These infrastructure improvements will need longer-term planning andinvestment from higher levels of the education sector.WINS MONITORING MHM WATER AVAILABILITYTABLE 1. WATERAVAILABILITYSchool Year 2017/2018School Year rySchoolsSecondarySchoolsTotal no. of schools ›25,6404,94628,9146,091Availability of waterin schools63.6 %60.0 %72.4 %71.4 %17.8 %13.6 %15.6 %11.7 %23.9 %23.4 %22.0 %22.4 %23.9 %23.4 %59.4 %63.3 %› only certain daysof the week› only certain hoursin a day› all school hoursMost schools have water forcleaning available at all times andwater availability improved fromthe baseline to follow-up. While thisimprovement is promising, more thanone third of schools still do not havewater available during all schoolhours. This presents a challengefor menstrual hygiene managementin the Philippines, where water isneeded for flushing and cleaning oftoilets and for personal hygiene.

WINS MONITORING MHM SANITATION FACILITIESTABLE 2. SANITATIONFACILITIESSchool Year 2017/2018School Year rySchoolsSecondarySchoolsTotal no. of schools ›25,6404,94628,9146,091Average number ofstudents per functionaltoilet for female101.6121.4123.2125.8All functional toiletsare secure, private andhave door with lock79.8 %84.2 %85.2 %87.7 %› all functional toilets69.3 %77.3 %77.9 %84.3 %› all functional toilets have70.9 %78.3 %78.4 %84.0 %All exclusively femaletoilets have wrappingmaterials and trash binsfor used sanitary pads30.5 %59.4 %46.9 %60.4 %Exclusively female toiletshave a washing facilityinside the toilet53.9 %74.8 %40.1 %68.1 %Detached toilets for girlswithin view of schoolbuilding and people42.6 %65.7 %47.2 %66.1 %have lightingadequate ventilationThe pupil-toilet ratio for girlshas increased since the baseline,meaning that more girls are sharinga single toilet. Both the baselineand follow-up figures do not meetthe national standard of 1 toilet for50 learners.Despite these challenges with thequantity of toilets, the quality offunctional toilets improved from thebaseline, with a higher proportionof schools reporting that all functional toilets having lighting andadequate ventilation. In addition,there was also an increase in theproportion of schools where allfunctional toilets were secure andprivate with a lock. This aspect oftoilet privacy is particularly important for menstruating girls.Most secondary schools reported tohave wrapping materials and trashbins for sanitary pads in all femaletoilets, with little change betweenthe baseline and follow-up surveys.In elementary schools, availabilityof these materials has improvedsince the baseline, with nearly half ofschools reporting to have materialsin all female toilets at follow-up.There has been a notable decreasein the availability of washing facilities inside female toilets, in bothelementary and secondary schools.This location of the washing facilitiesis important for menstruating girlswhen they need to wash their bodiesinside the toilet cubicle.Interestingly, in the category ofsanitation, availability of toilets hasNATIONALSTANDARD1 TOILET FOREVERY 50 GIRLS1 TOILET FOREVERY 50 BOYSnot improved yet schools are makingefforts to make improvementswhere they can. While improving thenumber of toilets may be challengingfor individual schools to take on withlimited resources, it is promisingto see that smaller improvementswhich affect the experience of thechild – like privacy and availability oftrash bins and wrapping materials –have been initiated by participatingschools. This finding further supportsthe concept that schools are moreable to make incremental improvements using their own resources asan initial step.

WINS MONITORING MHM AVAILABILITY OF SANITARY PADSFIGURE 1. ACCESS TO SANITARY PADS IN SCHOOLELEMENTARYSCHOOLS72,5 %37.7 %SECONDARYSCHOOLSAccess tosanitary padsat least inone ofthe areasSchool CanteenSchool Canteen30.1 %19.2 %63.7 %55.6 %School ClinicSchool Clinic29.4 %17.4 %Guidance Office11.6 %24.5 %13.1 %Class Adviser / Teacher Laboratores61.3 %46.0 %SCHOOL YEAR2017/201848.0 %30.7 %Guidance Office5.4 %85.1 %46.2 %Access to sanitary pads increaseddramatically between baseline andfollow-up. The proportion of schoolsreporting availability of sanitary padson school grounds nearly doubled.In Secondary Schools, sanitarypads are most commonly availablein the school canteen, whereas inElementary Schools, sanitary padsare available from the class advisoror teacher laboratory.SCHOOL YEAR2018/2019Class Adviser / Teacher Laboratores53.8 %37.6 %SCHOOL YEAR2017/2018SCHOOL YEAR2018/2019THE PROPORTIONOF SCHOOLSREPORTING AVAILABILITYOF SANITARY PADS ONSCHOOL GROUNDSNEARLY DOUBLED.Total no. of schools: elementary schools 25,640 (SY 2017/2018), 28,914 (SY2018/2019);secondary schools 4,946 (SY 2017/2018), 6,091(SY2018/2019)WINS MONITORING MHM ACCESS TO INFORMATION ON MHMTABLE 3. ACCESS TOINFORMATION ON MHMSchool Year 2017/2018School Year rySchoolsSecondarySchoolsTotal no. of schools ›25,6404,94628,9146,091Has information on properdisposal of sanitarynapkins in girls toilet )56.9 %60.7 %70.1 %74.4 %› for teachers34.5 %33.5 %46.0 %45.2 %› for students37.0 %36.4 %48.6 %49.4 %Has rest space for girlswith menstrual discomfort32.3 %50.0 %47.2 %63.9 %› bulletin board11.9 %16.7 %16.7 %27.0 %› classrooms30.7 %28.2 %36.9 %37.4 %› toilets15.2 %19.7 %22.6 %33.2 %Has IEC materialson Menstrual HealthAreas where IEC materialsfor MHM are availableInformation for the proper disposal ofsanitary napkins is available in mostelementary and secondary schoolsand has improved over the first yearsof monitoring. However, informationon menstrual health tailored forteachers or students is availablein less than half of schools. Theclassroom is the most common placewhere these materials are available.Availability of rest spaces for girlswith menstrual discomfort hasimproved over the monitoringperiod. This improvement may bedue in part to the ability of schoolsto use existing resources to makethis possible. A rest space does notnecessarily imply large investmentsin infrastructure, but space used forother purposes can also be allocatedfor children to rest.