Graduate School of Development Studies
Pubescent girls’ menstrual experiences and implications
for their schooling: A Ugandan case study
A Research Paper presented by:
Nalubega Fatuma Matovu
(Uganda)
in partial fulfillment of the requirements for obtaining the degree of
MASTERS OF ARTS IN DEVELOPMENT STUDIES
Specialization:
CHILDREN AND YOUTH STUDIES
(CYS)
Members of the examining committee:
Dr. Auma Okwany (Supervisor)
Dr. Kristen Cheney (Sceond Reader)
The Hague, The Netherlands
November, 2011
Disclaimer:
This document represents part of the author’s study programme while at the
Institute of Social Studies. The views stated therein are those of the author and
not necessarily those of the Institute.
Research papers are not made available for circulation outside of the Institute.
Inquiries:
Postal address:
Institute of Social Studies
P.O. Box 29776
2502 LT The Hague
The Netherlands
Location:
Kortenaerkade 12
2518 AX The Hague
The Netherlands
Telephone:
+31 70 426 0460
Fax:
+31 70 426 0799
ii
Acknowledgments
The research process has been very demanding and challenging but it has
enriched my understanding from a global perspective. My gratitude goes to my
supervisor Dr. Auma Okwany for your professional support and guidance, and
my second reader Dr. Kristen Cheney, who is also my convenor, for her timely
professional guidance which all proved to be so much resourceful to this
paper.
I thank the head teachers of all the study schools who gave me instant
permission to carry out the study in their schools. I also appreciate the study
participants for answering all the questions posed to them despite
menstruation being a sensitive issue.
Many thanks to my family, My Husband for taking care of our children in my
absence, my children Eid Aslam and Amir Kyambadde for their patience
I thank the Netherlands Government for the financial support through
NUFFIC scholarship.
And lastly gratitude goes to my friends who helped me conceptualise this
research.
iii
Contents
List of Tables
List of Figures
Abstract
vi
vi
viii
Chapter 1 Introduction
1.1 Background
1.2 The need for Gender Parity in Education
1.3 The Menstrual Dilemma
1.4 Relevance and Justification
1.5 Articulation of Research Objective and Questions
1.6 Methods of Data Collection
Primary Data 6
Study Area 7
Study Sample 7
1.7 Ethical Considerations.
1.8 Structure of the Paper
Chapter 2 Definitional and conceptual issues
2.1 Menarche and Menstruation
2.2 Right to Education
2.3 Participation in Education
2.4 Educational Exclusion
Chapter 3 Menstruation and girl’s participation in school:
Debilitating Experiences for urban poor and rural girls
Menstrual induced Absenteeism
3.1 Social and cultural constructions of menstruation and their relation
with girls schooling
3.1.1 Menstruation, a taboo or a blessing
3.1.2 Attitudes of teachers toward menstrual studies
3.1.3 School curriculum
3.1.4 Male prejudice
3.1.5 Hygiene perceptions during menstruation
3.2 Psychological and physical issues surrounding menstruation and
their impact on girls participation in education
3.2.1 Sanitary protection during menstruation.
3.2.3 Age and place of menarche
3.2.4 Menstrual discomfort: Signs or symptoms of menstruation
3.2.5 Preparation and communication before and during the
menstrual experience
3.3 The scope and limits of existing support systems
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1
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2
2
3
5
5
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10
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15
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3.3.1 Water and toilet facilities
3.3.2 Disposal mechanisms
3.3.3 Institution of senior women teachers in schools
3.3.4 Support systems existing at the household level
Coping strategies for girls
25
27
28
28
28
Chapter 4
Cross cutting variables and how they relate to
menstruation in hindering girls schooling
4.1
Poverty
4.2
Education achievement of Parents
4.3
Menstrual impact on mobility- Distance to school
4.4
Double Jeopardy for Disabled girls.
4.5
Domestic workload
30
30
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31
32
32
Chapter 4 Chapter 5 Conclusion and Implications for Policy
34
4.1 5.1 Summary of Findings and Policy Implications
34
5.1.1 Institutional Systems- In School Structures
34
A)
Lack of protection materials
35
B)
Lack of an accommodating Curriculum
35
C)
Lacking Infrastructure
36
D)
Absence of a systemic system to monitor school attendance 37
4.2 5.1.2 Community systems/Government systems
37
A)
Presence of excluding policies
37
B)
Government depending on other stakeholders efforts and
keeping a blind eye
38
4.3 5.1.3 Family support systems.
39
A)
Poverty
39
B)
Increased workload for girls at puberty
40
C)
Myths and taboos that surround menses
40
4.4 5.2 Conclusion
41
Appendices
42
References
Error! Bookmark not defined.
Appendices
Error! Bookmark not defined.
v
List of Tables
Table 1.1 Age and place of menarche per setting
Table 1.2 Signs, symptoms and other discomforts during menstruation
Table 1.3 Source of menstrual information
Table 1.4 No of girls per school and the number of toilets and washrooms
Table 1.5 Occupation of parents of the study population
Table 1.6 List of schools
Table 1.7 Place of menarche
Table 1.8 Sample Questions in semi structured Interviews
21
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43
List of Figures
Figure 1
Menstrual induced absenteeism
14
14
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Acronyms
CRC
FAWE
FGD
MDG
MoES
NGO
UNDRC
UNESCO
PE
PIASCY
RTE
STU
UNICEF
Convention on Rights of a Child
Forum for African women Educationalists
Focus Group Discussions
Millennium Development goals
Ministry of Education and sports
Non Government Organisation
United Nations Declaration on Rights of a child
United Nations Educational, Scientific and Cultural
Organization
Physical Education
Presidential Initiative on AIDS Strategy for Communication to
Youth (Uganda)
Right to Education
Straight Talk Uganda
United Nations Children’s Fund.
vii
Abstract
This study explored the physical, social and cultural experiences
surrounding menarche and menstruation of teenage school girls between the
ages of 8 and 15. The study sought to understand the relationship between
menstruation and girls education and its organised under different themes:
Emotional, physical and psychological, social and cultural constructions of
menstruation, and social and scope and limits of existing support systems both
at institutional community and household levels. Four schools were
purposively selected from Wakiso district, Uganda which has both rural and
urban poor settings. A sample of 40 girls was purposively selected keeping in
mind the rural and urban poor divide. Data was collected using focus group
discussions (FGD), semi structured interviews and observation which were
used to get information to answer the research question. The findings
confirmed the connection between girls schooling and menstruation and it
was revealed that menstruation affects girls participation especially in the rural
schools. This connection was realised from the different feelings, concealment,
embarrassment fear, shame and sometimes anxiety towards menstruation. This
is more so because the situation in rural areas is worse in terms of menstrual
management than in urban poor areas which in turn led to among others to
discrimination, stigmatisation which lowered the self esteem of these girls
which all interfere with their confidence and feelings hence bringing a negative
impact to their schooling. Areas for policy promising better education
participation for girls were identified which included
provision of
environmentally and pocket friendly sanitary towels, improvement of school
infrastructure and hygiene and providing menstrual education to school girls.
Keywords
Menarche, Menstruation, Exclusion, Educational participation
viii
Chapter 1
Introduction
1.1 Background
Uganda just like many African countries has made numerous efforts to ensure
universality of education as required under the International and National laws
in furtherance of its duty to fulfil respect and promote these rights and also as
a Millennium Development Goal (MDG) framework of 2015. Notable efforts
are exemplified with the introduction of Universal Primary Education (UPE),
in 1997 to ensure education for all at primary level, which led to an upward
surge in enrolment levels. In the report presented by the Ugandan Minster of
Education in Addis Ababa in 2006, since the introduction of UPE, the
enrolment has risen from 3 million to 7.3 million (MoES-Report 2006a).
Despite the gross enrolment, a big gap still remains with girls’
school retention and gender disparities persist especially in performance,
classroom participation, access to school facilities and general education
attainment (Muhwezi 2003: 7). UNESCO estimates reveal that 54% of the
thirty three million children not attending school are girls. (UNESCO 2008: 3).
Participation in schooling for both boys and girls is highest in lower primary,
lower in upper primary, Secondary and lowest in Tertiary (Stromquist 1989:
142). Hence, free education does not necessarily get all children to school and
more effort is required to address the problems that facilitate the presence of
the gender gap (Atayi 2008: 16).
A study by the ministry of education across ten rural districts in
Uganda revealed that girls’ completion rate through primary level has remained
as low as 29%compared to 38% of boys hence this calls for interventions
geared towards gender equity in Education. In West and Central Africa, only
48.2 per cent of the children enrolled in first grade survive to the final primary
grade. The comparable survival rate for countries in Eastern and Southern
Africa is 64.7 per cent. Factors like poor sanitation act as causations to such
disparities (UNICEF 2009: 1)
As girls progress through the primary school, puberty also sets in
and brings with it menstruation especially girls between the ages of 8-14 which
have proven to be a challenging barrier to girl child Education (Oster et al.
2011: 4). Menstruation and its accompanying physical, psychological and
hygiene requirements has implications towards their education participation in
regard to access, retention, attendance and final completion (McMahon et al.
2011: 1). This explores menstrual related experiences in both rural and urban
poor settings in Wakiso District.
1
1.2 The need for Gender Parity in Education
The right to Education is a fundamental Human right whose
enjoyment is an entitlement to every child1. The Ugandan constitution under
article 30 and 34 entitles Ugandan children to Education as of right and places
the responsibility of ensuring that children are educated to the state and the
parents. Pubescent girls are therefore are entitled to enjoy this right and any
impendent to their enjoyment amounts to a violation. Girls also need to be
educated due to the numerous benefits from female schooling. Despite the
improvement in enrolment levels mentioned earlier, a UNESCO2 study of 157
countries revealed only one out of three countries have reached gender equity
in both the primary and secondary section.
Some studies have highlighted the importance of educating girls to the
tune of assuring the positive economic influences if girls’ education is priotized
(Levine et al. 2006: 128). Compelling evidence accumulated over the last 20
years using both quantitative and qualitative methods has led to an almost
universal recognition of the importance of focusing on girls education as part
of the broader development policy and one of the best investments available
(Hume 2009: ibid 2006: 128)3.
Indeed studies have noted that with education, there is an increase in
women’s bargaining powers in a family, improvement in health of the whole
family and schooling of children, postponing marriage age, decrease fertility
levels (Klasen 2000: 11), low criminal participation, reduction in poverty
(Roby 2009: 343), increase in productivity of the work force, stabilizing
population growth general financial wellbeing of communities (Hume 2009),
assurance of breaking a pernicious cycle of ignorance and poverty since
women encourage education of their own siblings (ibid: 2009). Further, a
World Bank study of 100 countries found that when women gain 4 years of
education, on average fertility per woman drops by about one birth (Klasen
2000:7) hence smaller manageable families (Bellew et al. 1992: 54). However,
despite the gross enrolments in education, girls still lag behind in terms of
participation because many barriers stand in their way to access, retention and
completion (Chung 2001: 2)
1.3 The Menstrual Dilemma
This study was framed after recognition of a literature gap in
studies connecting menstruation to girls schooling and also in peoples’
understanding and awareness of such an issue in relation to the overall right to
educational participation. It is evident that a few studies have pointed to a
connection between menstruation and girls educational attainment (Sommer
Universal Declaration of Human Rights (UDHR)
(UNESCO 2010)
3 http://global.factiva.com/ha/default.aspx
1
2
2
2009; World Bank 2005) , but numerous studies rarely mention menarche and
menstruation as a barrier to girls’ education, despite the fact that the cycle has
presented itself as a serious concern especially in regions which are poverty
stricken. Mitchel 2006 in Kirk (2006: 2) acknowledges this by highlighting the
little or no mention of the relation between menstruation and girlhood studies.
Hence rigorous research has been conducted to conceptualize the relationship
between poor menstrual management and girls’ educational participation. Kirk
further used the (UNICEF 2005) estimates to emphasize that about 1 in 10
school-age African girls do not attend school during menstruation, or drop out
at puberty because of the lack of clean and private sanitation facilities in
schools (ibid 2006: 11)
In this study, I focus on the “menstrual dilemma”, and reveal how the
onset and consequent menstrual cycle presents a problem to girl child
education. Encumbrances to girls’ education participation are discussed as per
the findings. Linda Scott has shown that when free sanitary protection is
provided to girls, there is a sharp drop in absenteeism4. Where there are no
sanitary towels, girls usually resort to use of old clothes as shields for menstrual
blood which puts them in constant fear of leakages and the embarrassment
that follows.
Girls’ menstrual discomfort, -back pains, swelling, cramping, mood
swings and, itching also cannot pass unnoticed. As Eruke in (Kirk 2006:4)
states whereas girls in developed countries generally have access to a range of
general and specific painkillers, access to such becomes a nightmare for girls
living in the poverty stricken countries. Numerous studies have also cited
Stigma and discrimination related to menstruation as a hindrance to girls
educational participation (ibid 2006: 4).
The existing studies on barriers to girls’ education tend to
apportion less attention to sanitary towels and other variables that surround
menstruation yet are an important factor that needs to be addressed if girls are
to fully enjoy their right to education. Since the research is about girl’s
education, emphasis was put on the level of exclusion occurring in both
settings which would bring us to concluding remarks about girl’s participation
in schooling.
1.4 Relevance and Justification
The importance of educating the girl child presents the need to
make in-depth studies and suggestions relating to hindrances to girl child
education that although important, are less emphasized by scholars. Although
the Right to Education (RTE) may seem an obviously enjoyed right, this is not
always the case. Some studies allude to Uganda as an achiever towards access
to primary education by indicating that primary level enrolment increased from
2.6 million in 1995 to 7.4 million in 2008, but not all enrolled children graduate
4
Oxford university professor
3
from primary5. Failure to recognise the intricacies impeding girls schooling is
reported in a UN report as a major gaffe committed by most developing
countries which instead put more emphasis on enrolment than attendance and
completion in addition to ignoring the processes through which access,
attainment and achievement can be reached (Craissati et al. 2007: 2).
Despite the fact that few studies have mentioned menstrual hygiene as a very
important aspect (Kirumira 2004), numerous studies have made a connection
between menstruation and education participation. Even with the near gender
parity in schools, adolescent girls’ participation in schools is generally very poor
especially in sub-Saharan Africa (UNICEF 2006). The less the children and
mostly males know about menstruation and it’s naturally the more they will
stigmatize girls experiencing menstruation which encourages secrecy. This
silence and lack of information makes menstruation a shameful subject to
tackle not only for adolescent girls but also for some parents and relatives and
hence it is ignored both at home and in schools (Kirk 2006: 2). I found that
such behaviours lead to low self-esteem for menstruating girls, subsequently
this feeling is also taken into the class where schooling pupils spend most of
their day time, this may lead to less participation in the educative activities that
take place at school hence leading to lower grades which in turn discourage
girls.
Although in the current research, I found girls to be missing up to
4 school days, a study conducted by Oxford, research indicated that postpubescent girls were missing up to five days every month due to inadequate
menstrual care (World Bank 2005). During the second phase of the trial,
sanitary pads were provided to the girls along with education about
menstruation and hygiene. Six months along, the study found that the girls
were missing significantly less school than before the test and on average, the
rate of absenteeism was cut by more than half (Knox 2010:3)
Similarly as (kirk 2006: 10) reports, a meeting by UNICEF revealed
that if separate and decent toilet is not available to girls, girls’ education
participation may be hindered). Parents are more likely support their daughters
schooling if they are sure of their safety and protection hence leading to fewer
dropout rates as girls reach the adolescent stage (ibid 2006: 11). Lack of girl
user friendly toilets, lack of water, and lack of proper sanitary facilities, stigma
and discrimination remain salient variables that need to be addressed in order
for children to fully enjoy their RTE. This may be done by exploring the
impact of menstruation on girls schooling which the main objective of this
study. This study seeks to contribute to the already existing literature on girls’
exclusion for schooling by analysing the menstrual experiences of 456 girls and
highlight the connection with education participation.
Uganda Bureau of Statistics-2009.
6 5 drop out girls is included.
5
4
1.5 Articulation of Research Objective and Questions
There is a strong relationship between girl child education and
menstruation as suggested by numerous studies (Kirk 2006; Sommer 2010),
this paper seeks to examine the interplay between menstruation and girls’
educational participation in Uganda. Specifically this research has the following
objective:
“To assess the role menstruation (a visible sign of puberty), in defining
girls participation in education and to identify institutional/community/family
support systems and their implications for policy”
To achieve the above objective, I asked the following questions.
Main question: What role does menstruation play in defining girl’s
participation in education?
Sub questions:
1. What are the social and cultural constructions of menstruation and how do
they relate to girls schooling?
2. What psychological and physical issues surround menstruation and what is
their impact on girls’ participation in education?
3. What is the scope and limits of existing social support systems available for
school girls during menstruation?
1.6 Methods of Data Collection
I purposively selected four schools, 2 from the rural setting and
two from the urban poor setting all from different villages in the district as per
the district lists with the help of the District Education officer. One school
from the urban poor setting was a boarding school selected to capture the
experiences of girls who do not have to move to and from school, and the rest
of the schools were day schools. Both rural schools were day because it is hard
to find a boarding school in the rural setting. Those schools found in rural
areas and are high standard and utilised by children who come from well to do
families. These could not be used as examples because they are very few and
accommodate children from the urban areas. Three schools were mixed
religions schools. One of the schools is Muslim oriented and was selected
because Islamic religion has more restrictions on women during menstruation
and hence will give us a better picture with the religious constructions of
menarche. However not all girls from the Muslim oriented school were
Muslims but efforts were made to interview Muslim girls and get their side of
the story. The experiences of these girls cannot be used to make generalisations
because of the diverse social economic and cultural diversity in the district but
will be used to inform further studies and policy related to girls schooling.
5
Primary Data
Qualitative research tools were used to get information that helped
answer the research questions. A focus group discussion (FGD) was used as an
initial tool to select pubescent girls who seemed more knowledgeable about the
area of my research. By knowledgeable I mean children who had experienced
menarche and who were able to speak out about it and also those who seemed
interested in the research topic. A question checklist that was used to guide the
FGD was prepared in advance and used in both the FGD and the structured
interviews. FGD was used because research has shown that people feel more
empowered and supported when in a group and with peers compared to one
on one discussion (Uskul 2004: 670). FGD helps to get a deeper and more
meaningful understanding of participants’ views and experiences, how they feel
about a particular topic, and their beliefs and understanding of a problem in
question. However menstruation being a sensitive issue not all girls felt
confident discussing in a group as this was evidenced later by confessions of 10
girls. Asking sensitive questions in a group is problematic and raises ethical
questions hence the alternative to use one on one interview in which the girls
felt less tense and open in answering the questions. For purposes of getting a
useful sample, before the FGD the purpose of the research was clearly
explained to the girls and reassurance given to them that the information given
to the researcher will not be used in any way detrimental to them.This FGD
helped to identify girls that were already going through the menstrual process
and also get views and expectations of those that have not reached that stage
of puberty. These girls formed a sample group that later participated in the indepth semi structured interviews, a few boys, five girls that dropped out of
school, 4 senior lady teachers, 4 head teachers 5 parents and 2 District
Education officials. Structured interviews as a research tool was chosen
because it is usually recommended where sensitive topics are the area of study
(Frey & Fontana 1993) in (Chang, Y.T. 2009). Three FGDs were carried out,
two with the girls and one with the parents that I managed to contact.
The FGDs and the in-depth structured interviews were carried out
in designated class rooms with the authorization of the head teachers during
day time. In one of the rural schools, the interviews were carried out from
under a mango tree as all the class rooms were occupied during the time of the
visit. Although it would have been a good idea to know what the male students
think about menstruation, due to time limitations, they were not interviewed.
However during the interviews, they seemed interested in knowing what is
going on in the girls’ only meeting, so efforts were made to ward them off
with other assignments so that girls would feel free to discuss the issues put to
them. With the help of the head teachers and the senior women teachers, I
explained the purpose of the research and why it was necessary for them to
participate in the study.
For assurance of evidence on the status and quality of hygiene and,
characteristics of usage, observation was employed with the help of an
observation guide for comparison purposes among the four schools which
findings further enriched my conclusions.
The semi-structured interviews were carried out using guiding preset questions that were intended to highlight the issues such as age of
6
menarche, experiences during menstruation, and hygiene issues among others.
Open ended questions were asked such as “what are your experiences during
menstruation, which major discomforts do you face etc. in order to detect the
effect on these experiences to girls schooling. Sources of data collection like
government reports and previous studies in relation to this topic were also
used.
This survey does not intend to make any generalisations because it
is not a representative of Uganda as a whole, its only intended to understand
the impact of menstruation on girls schooling in both the rural and urban poor
settings which are the largest social settings in Uganda using the selected
schools as a representative sample and also using the access attendance
retention and completion as indicators of participation.
Study Area
Wakiso is one of the 112 districts in Uganda created out of Mpigi
district with a total population of close to 1.3 million and a total land area of
1710.45sq km7. It engulfs Kampala city and so bears a lot of metropolitan
district characteristics. The district comprises of 3 counties, 21sub-counties, 1
municipality, 14 towns and 704 villages. There are a total of 1,221 primary
schools with 974 Private and 249 under government-UPE. The information
got from the district website places primary enrolment for the district at
183,290 and this mass enrolment has put pressure on Government to build
more classrooms in order to accommodate the large numbers of pupils
enrolled. Currently, the pupil teacher ratio is 53:1, pupil’s classroom ration
52:1, pupil latrine stance ratio is 70:1, and the district has some of the best of
the best secondary schools in the country. Despite this, primary school
completion rates are reported to have been increased from 29% to 81% by
2006 but the District still has limitation with regard to absenteeism and school
dropouts8.
Educational focus in the district was mainly put on enrolment
levels failing to note completion and retention rates and the factors that
hindered school participation. A district report in 2008 notes that sanitation in
most parts of the district remains very poor which poses a very big challenge to
both education and health of community9.
Study Sample
I selected 40 girls selected from a total of 120 girls that took part in
the FGD. Ten from each school selected from primary five to primary seven
well within the age bracket of 8 -15. Following the FGD, only 40 between the
ages of 8-14 were selected with 20 from each social setting. Senior female
teachers, head teachers, 5 parents, and 5 girls who had dropped out of school
Uganda Bureau of Statistics
www.wakiso.go.ug
9 Wakiso District Report 2008.
7
8
7
were also part of the study group. The sample was purposively selected since
the purpose of the study was to identify issues related to menstruation that
affect girls Education. Consequently only primary school girls could be
selected since the experience of menarche is nearer to them than older girls
and hence would give clearer and more precise memories of such experiences.
Regarding the selection of both rural and poor settings, it was based on the
fact that approximately 90% of the Ugandan population lives in rural areas and
hence majority of the schools are located in rural areas (MoES 2006:4)
However poverty has led to vast migrations from the rural to urban settings
creating a population of urban poor. I found it pertinent to study both these
settings to give me a better understanding of girl’s menstrual experiences from
different backgrounds.
1.7 Ethical Considerations.
Institutional permission for the interviews was expressly sought
from the respective head teachers. This involved informing the teachers about
the purpose of the study, the confidentiality, voluntariness regarding
participation and the fact that no allowances were available for giving the
required information. For comfort, the girls were selected with the help of the
head teachers and the senior women teachers. Efforts were made to ensure
that the girls felt free and at ease as possible. At the beginning of the
interviews, girls were informed of confidentiality and anonymity issues.
Findings of this study were transcribed without mention of names apart from
the names of the schools that participated which was done with the consent to
the respective authorities. During the interviews, it was clearly explained to the
participants that they were being recorded but only for the study purposes and
nothing else and they were also informed about the choice to withdraw from
participating if they wished.
1.8 Structure of the paper
I partitioned the research into five chapters with the first chapter
introducing the study and giving the background to the research issue. It
analyses the situation in the research area and also details the methods which
were employed to get the requisite information. The second chapter provides
the conceptual frame that is used and it explores concepts like exclusion,
participation and a right to education which are used throughout the paper to
situate the findings within the research topic. Chapter three and four present
the findings in two distinct settings. First the menstrual related experiences
which are directly linked to menstruation are discussed and analysed and
chapter four gives the other experiences that may be indirectly related to
menstruation but equally important for the analysis. Chapter five identifies
areas for policy implications and suggests possible interventions to cub the
effect of menstruation to girls schooling. The paper ends with a conclusion in
which a comprehensive synopsis is given summarising the findings in a critical
manner. Although the research is highly qualitative and cannot be used as a
foundation for statistical analysis, it contains rich data that explains the issues
surrounding menstruation that hinder girl’s participation in education.
8
9
Chapter 2
Definitional and conceptual issues
To assess the role of menarche and menstruation in defining girl’s participation
in education, I use three concepts to guide my analysis and discussion detailing
their effect: exclusion, participation and right to education. I argue that
menstruation limits girl’s participation in schooling and consequently leads to
exclusion due to different experiences that they have to endure. These include
but not limited to discrimination, stigmatisation, low self-esteem, physical
discomfort and shame. I explore these experiences in both the rural and urban
school settings.
2.1 Menarche and Menstruation
Menarche is the first menstrual period, or the first menstrual
bleeding (Sharma et al. 2008: 125) which is part and parcel of growing up for
girls and women and arrives at different times for girls from different social
contexts and backgrounds but the common ages are 1110 and 1211. Marvan
states that menarche is an embodied event that “dramatically signals the
transition from girl to woman; it is a highly salient and intensely experienced
event, and a turning point in female development” (Lee 2009: 617). Myths and
misinformation regarding menarche and menstruation are very common
among adult males and females. Religious and cultural myths sometimes
become part of female’s lives and despite being socially constructed are
communicated to the girls around puberty stage (Moore 1995: 89).
An example is the belief that menstrual blood is ‘dirty’ (Schooler
2005: 324) not putting into consideration other virginal discharges that may not
be menstruation. Such attitudes heighten embarrassment and shame thus
impacting negatively on girls’ self-esteem (Rembeck et al. 2006: 707). In the
current study, especially for participants from the rural setting, mothers of the
girls had already explained to girls about their adulthood status on menarche.
Often, facilities for proper sanitation during menstruation are absent both at
school and within the households and calls for research into this area to
advocate for better menstrual management.
2.2 Right to Education
All people ought to have the opportunity to experience an
education or training as of right (Otero et al 2005), from childhood until the
end of life, to enjoy the integrity of its normative content that consists of a
complex of rights and to any means and conditions for its realization
(Monteiro 2010:1989). Several human rights conventions have mentioned the
10
11
In this current study, I found the average age of menarche to be 11.
In Sharma et al 2008:125, menarche age is reported to be at 12 in India
10
RTE as a civil right and notable is the Universal Declaration of Human rights
(UDHR 1948 Article 26) which ensures a universal right to free and accessible
education, directed to the full development of human personality and it gives
parents a prior right to determine the type of education that is to be given to
their children. Indeed the RTE is a fundamental empowering right essential in
bridging the basic capabilities and the exercises of civil political economic and
social rights (Awortwi and Okwany 2010: 138).
Although this may seem an obviously enjoyed right, many children
seem to be missing this right because they barely make it to secondary
education. As mentioned earlier, there was a 4.6 million increase in primary
school enrolment in 2008 (Uganda Bureau of Statistics 2009) but the
completion rates were much lower than enrolment levels. This negative trend
is facilitated by many factors which may include but not limited to poverty,
repetition rates, and cultural beliefs, academic achievement of parents, distance
to school, lack of scholastic materials and most importantly for this study lack
of proper facilities during menstruation. Elements such as lack of girl user
friendly facilities, water, sanitary facilities for use during menstruation remain
salient variables that need to be addressed in order for children to fully enjoy
their RTE.
The Convention on the Rights of the child (CRC) in addition to providing for
the RTE12 obliges states to respect the general principles under in: best
interests’ principle, non-discrimination and participation. Under Article 28,
1(a), state parties have to recognize to child’s RTE on the basis of equal
opportunities by making education compulsory and available free for all. This
necessitates inclusive policies to be instituted by governments and various
stakeholders in order to reach the MDGs.
2.3 Participation in Education
Participation in education means active involvement of children in
the stage of decision making regarding their educational issues so that they are
to some extent in charge of the process13, but for purposes of this study,
participation takes on a different dimension to involve taking part or having a
share in education to give children an opportunity to develop their talent and
abilities to full potential14 since it is both a necessary process and an outcome
(Craissati et al. 2007: 55). Participation means that an individual has had the
opportunity to experience an education or training opportunity (Otero et al
2005). The Convention on Rights of a Child introduces participation as the
core principles that should underlie implementation of each provision of the
convention. Quoting a report by Save the children in defines children’s
participation as “involving boys and girls in decisions about their lives and the
lives of their family and community and larger society in which they live” (Save
CRC (Articles 2, 3)
CRC
14 UNICEF Factsheet
12
13
11
the Children 2006) For Save the Children, the core purpose of children’s
participation is to empower them as individuals and members of civil society,
giving them the opportunity to influence the actions and decisions that affect
their lives. To this end education is meant to provide children with a chance to
develop their potential and confidence through gaining skills and making
informed decisions.
Participation in education is evidenced from different indicators: access,
attendance, completion, enrolment, achievement and years of education
attained (Stromquist 1989: 144). If all these have a down bit then it may be that
some children are not enjoying their right. All the above can be summarized as
the person’s opportunity to experience an education or training opportunity.
For purposes of this study, I will use access, attendance and completion as
benchmarks to assess education exclusion of girls.
The term child friendly schools is applied in a UNICEF report in
the bid to the realization of a holistic and inclusive education, this involves an
assurance that all children have access to quality education and are nurtured in
a child-friendly environment where they can develop their full potential
(UNICEF 2009: 3) A child friendly environment includes among others
adequate sanitation which may determine children’s retention and completion
of school. The dimensions below are used to measure the friendliness of the
school environment in the area of sanitation:
(1)How safe the schools are as places for learning and how completely they provide an
overall gender sensitive environment that is conducive to learning
(2)The availability of adequate environmentally sustainable facilities, services and
supplies that support the needs of the whole child and also of all children; (UNICEF
2009:4).
If girls are not provided with a favourable schooling environment,
they may be excluded from enjoying their right and participation. Consistent
with Lewis’s findings, exclusion leads to stigmatisation and discrimination from
mainstream activities, such as education (Lewis and Lockheed 2008: 6) Girls
are excluded from fully participating in school activities and programs because
they have to nurse or handle certain hindrances or discomforts in form of
social , physical and social encumbrances.
2.4 Educational Exclusion
Education exclusion may emanate from immutable factors, such as
gender, ethnicity, and race, and contributes to low educational participation for
girls (Lewis and Lockheed 2007:14). Menstrual experiences may well fall within
gender and these go to great lengths to exclude girls from mainstream
activities, such as education (ibid 2007: 11). Hallman and Roca state that- the
primary requirement for social inclusion is a safe, supportive space where
children can interact with peers and mentors (Hallman et al 2007: 2). In
addition, the menstrual dilemma is accelerated by attitudes of both pupils and
teachers with the latter expected to take up the role of parents when at school
which is often by passed. (UNICEF 2005) estimates that about 1 in 10 school12
age African girls do not attend school during menstruation, or drop out at
puberty because of the lack of clean and private sanitation facilities in schools
(Kirk 2006: 7).
Exclusion often times leads to a deprivation for example being
unable to relate to others and to take part in the life of the community is a loss
and may also lead to other deprivations either directly or indirectly hence social
exclusion (Sen 2000: 17). The exclusion referred to in this paper was what Sen.
termed as ‘Passive exclusion’ where by a group of people is deprived on some
rights through social processes which are not intentional (ibid 2000:15). Girls
are usually excluded from enjoying some rights due to the fact that they have
to go through a natural process of menstruation. This exclusion falls within the
passive category because not a lot of emphasis has been put towards
menstruation as a barrier to girl’s education as most countries in the South
have been so engrossed in enrolment levels putting other school debilitating at
a disadvantage.
Exclusion is further described as a way of analyzing how and why
individuals and groups fail to have access to or benefit from the possibilities
offered by societies and economies (Rogers 1995) in (Atwortwi and Okwany
2010: 137) The socially excluded are those who receive inadequate support
from public institutions and whose opportunities remain constrained due to
structural and cultural factors (Lewis and Lockheed 2008: 11). Indeed the lack
of structural elements like lack of good infrastructure and cultural attitudes
towards menarche and menstruation indirectly leads to exclusionary tendencies
towards girls schooling. Further, Exclusion as a product of menstruation stems
from the several social physical and cultural experiences i.e. insufficient sanitary
facilities for protection during menstruation, the discomfort that comes with it,
cultural beliefs/myths about menstruation in different social contexts, lack of
adequate toilets, limited water supply and soap the low self-esteem associated
with menstruation and the support systems in place to address the situation.
Due to social exclusion some groups get marginalised and
discriminated against from social and economic entitlements that are supposed
to be enjoyed by all, the right to education falls among these. Numerous
studies indicate a severe education disadvantage from multiple sources of
exclusion: girls from impoverished families, girls from tribal, ethnic, or
linguistic “minority” communities, girls living in remote settings, and girls from
lower castes are less likely to participate in education and more likely to stay in
school only briefly if they enrol at all (ibid 2008: 8). Since it is established that
menstruation presents tormenting experiences for girls, there is need to explore
these and use the exclusion lens to situate their impact on girls schooling both
in rural and urban poor settings.
13
Chapter 3
Menstruation and girl’s participation in school:
Debilitating Experiences for urban poor and
rural girls
Menstruation is managed differently according to cultural, social and economic
contexts (McMahon et al. 2011: 1). Hence I found it important to explore
menstrual experiences for both the rural and urban poor settings.
Menstrual induced Absenteeism
Although the number of pupils missing school due to menstruation
was very low in urban poor setting, it was higher in the rural settings. If the
study was only carried out in the urban poor setting may be we would have got
the same conclusion as (Oster et al. 2010) in a study carried out in 4 villages in
Nepal where it was found that menstruation has a minimal impact on school
attendance. But worth noting that in this area, girls had access to sanitary
towels and the families were not so impoverished. In the current study,
surprisingly, all senior lady teachers reported menstrual induced absenteeism,
more in the day than in boarding schools reason being that in the boarding
school, girls were forced to attend class even if they felt so much
uncomfortable. Most girls showed negativity about this action citing that they
are not so productive and cannot concentrate to their normal capacity due to
the general discomfort.
The table below shows the number of pupils that have ever missed school due
to menstruation.
Figure 1
Menstrual induced absenteeism
Source: Own construction from number of participants missing school due to menstruation
14
3.1 Social and cultural constructions of menstruation and
their relation with girls schooling
Much as the issue of cultural constructions of menarche and menstruation did
not arise so much in the interviews with the pupils, a few pointers were
mentioned by the teachers and parents. The issues varied from, menstruation
being a taboo, and hygiene concerns, to the reactions of male pupils and
relatives towards the whole menstrual experience.
3.1.1 Menstruation, a taboo or a blessing
Despite the fact that many societies are doing away with negative
attitudes of menstruation, such tendencies still exist especially in areas where
they are perpetuated by religion and culture (Costos 2002: 50). Due to social
constructions that surround girl’s menstruation, the period is regarded as a
signifier to womanhood and some parents indeed had informed this to their
daughters and sometimes it brought scary feeling to the girl’s because they
didn’t know what to expect.
I remember noticing red mark in my underwear and when I showed it to my mother, she said I
was not a child anymore and I had become a woman. And she said I had to be careful because
I could pregnant.
This implies that, today they are children, if they get periods the
next day, then they are women. A similar finding was reached at by Bailey and
Wetz in (Lee 2009: 616) where they mention that at the onset of menstruation,
girls begin producing themselves as women in compliance with and sometimes
in resistance to contemporary messages about gender. Girls were made aware
of the cultural labels attached to menarche and these often make them feel like
they are going through a private dirty process. Rightly stated by (Bartky 2002)
in (ibid 2009: 617), the changes at menarche are constructed through language
and practices loaded with signifiers of cultural meaning. Girls from the rural
setting were more aware of the cultural constructions than those from the
urban settings. Its indeed true that much as the instance of looking at
menstruation as a taboo is fading in most western countries, many countries in
the south still have this perception (Kirk 2006:1) as is the case in this study.
Different cultures attach diverse beliefs to menstruation. Some
reach an extent of specially labelling it as “the curse,” “on the rag,” “weeping
womb,” “bloody scourge,” “the red plague,” “under the weather,” and “being
unwell.” (Costos 2002: 49) which all have affiliated Uganda names i.e. the
“Red”. Just like in the findings by Marco Betti (WaterAid Report 2009: 2), girls
reported being prevented from cooking and serving food citing dirtiness and
impurity. Such beliefs are very common to African cultures where the onset of
menstruation is viewed as a taboo (bad omen). Specific to the Ugandan
example, in addition to exemptions from cooking food, girls are banished from
the countryside during the periods and also are not carrying newborns. One
girl from the current study shared that in the absence of her parents; her
brothers chose to have jackfruit for dinner to food prepared by her because
they had learnt about her menstruation. Such an action from male relatives
presents an embarrassing situation for the girls and it is worsened if the girls
15
and some of her brothers attend the same school, as a matter of fact she
cannot feel free not only in class but also outside class as she will always be
thinking whether her brother informed anyone about her situation. The
situation may be a bit different if it was an only girl’s school but still, we have
seen instances where fellow girls have made fun of an accident victim. This is
consistent with a finding by Kirk where a soiled uniform provoked ridicule
from both boys and girls thereby placing the girls at higher stigma and
discrimination experiences (Kirk 2006: 6). Such restrictions present avenues for
stigma and discrimination from both boys and girls.
As Felicia Odamme rightly stated in (Knox 2010) that “when you
have your menses, the male relatives will not even like to eat your food”15. In
addition to boycotting food prepared by girls in their menses, some girls felt
that society looked at them differently if they got their menses early. A
particular girl who got her menses at 8 shared that girls from the
neighbourhood told her that menarche is an indicator that someone has started
‘seeing’16 boys. The same finding was mentioned by Houppert in (Lee 2006:
617) where she quoted some girls who menstruated early as being labelled
promiscuous. Much as such a label is not very common, it exits and it usually
lowers the self esteem of girls which tampers with their active involvement in
different engagements at school. From these findings I conclude that
menstruation is not taken as a normal occurrence by most girls and boys but a
secret event that needs to be concealed. With such tendencies in pubescent
girls will always feel insecure when in their periods hence lowering their
participation in their day today lives.
3.1.2 Attitudes of teachers toward menstrual studies
As mentioned in my earlier assignments, the stigma and
discrimination that surrounds menstruation is made worse by the sex and
attitudes of the teachers. Although some studies have hinted on negative
attitudes from female teaches as well (Porter 2007: 201), a more widely known
assumption is that female teachers may understand faster if the girl needs to
use the toilet which may not be the case with male teachers (Kirk 2006: 3).
In this study, I found female teachers being given the responsibility
of enlightening girls about menstruation. This is indeed similar with the
perceptions of 2 of the male head teachers who were sceptical about sharing
menstrual information with girls. Although one of them tried to find refuge in
the rules and regulations of PIASCY17, he had no justification for this
whatsoever. Its true female teachers are very few in most developing countries
but where they are, they help encourage girls (Bellew et al. 1992: 56) and build
their confidence. The sex of the teacher becomes even more useful at
15
Borrowed from my previous work. 4311 Assignment
Means in this context, sexual involvement with boys
17 PIASCY program limits the level of engagement with female pupils so that’s why they are sometimes
hesitant to discuss that topic
16
16
menarche, usually there is fear and anxiety for some girls and others may
become hysterical and this may be best understood and handled by female
teachers. If such situations are not handled well as is the case with most rural
schools which have a small percentage of female teachers, girls may decide to
miss school during this period18.
3.1.3 School curriculum
The Ugandan primary school curriculum does not encompass
menstrual studies specifically presenting a complexity for young girls who need
to be prepared for this period to avoid surprises and shocks. Due to this, girls
are systematically excluded from enjoying their RTE. As clearly stated by
Okwany: “Progress towards achieving Universal primary completion remains a
challenge ,as large numbers of children remain unserved or under served by the
rigid and exclusionary school system” (Atwortwi and Okwany 2010:133)
Indeed this is true for most developing countries, borrowing the
example used by (Shukla and Hora 2004) in (Kirk 2006: 8), the biology text
books in government schools attended by girls in suburban slums of Mumbai,
India contain sexless bodies and make no reference to menstruation or
reproductive health, leaving girls and boys ignorant about the topic. Most
school programs focus on the biology of menstruation and rarely tackle the
physiological, financial and physical aspects of the cycle which would rather
help girls and boys to know about their sexual maturation and how to handle
its to minimize effects to education.
In the primary schools curriculum, teachers are expected to teach
puberty but it was surprising that many girls especially from the rural setting
had never heard their teachers mention menstruation in the science classes.
Teachers agreed that much as menstruation is part of puberty studies, they
rarely go into its details. True to this, some girls reported that before menarche
they were wondering where exactly the blood will come from. Although the
girls from the rural schools had some information about this issue before
menarche; their counterparts from the urban rural setting were very naive.
Puberty and sex education is not a topic that is freely discussed at home so we
would expect that teachers would take their role and enlighten girls about this
stage and sooth their anxieties.
One teacher in the urban poor setting shared that:
“ I teach the whole class about puberty and sexuality, i teach them to be careful not to
have sex for fear of pregnancy but i leave the menstruation bit to the senior woman
teacher because she usually has sessions with these girls”
Assignment 4311.Girls Education Exclusion: How menstruation hinders girls schooling. A Ugandan
case study 2011.
18
17
A class teacher interviewed from the rural setting found it unimportant
teaching girls about menstruation because he knows that their female parents
tell them about this topic and also prepare them so it would amount to double
work if he repeated the same.
3.1.4 Male prejudice
The embarrassment surrounding menstruation is a somewhat
universal phenomenon, found in most cultures of the world and with many
associated code words, euphemisms and phrases used as linguistic substitutes
(Bharadwaj and Patkar 2004: 8). Despite the presence of minimal empirical
evidence of boys feelings and thoughts about menstruation (Chang 2011:2),
among the findings of this study is that indeed boys usually make fun of girls
when in menstruation if such a fact gets to their knowledge. Sometimes boys
get to know when girls keep sweaters around their waists which action they
can’t stop because they always are in fear of unnecessary accidents. Most girls
shared that they always avoid instances that would let the males know that they
are going through menstruation not even their fathers.
When i experienced menarche, i did not want anyone to know, not even my mother was
ready with pad i had got from my sister i felt it was so ashaming. i most of all was cautious about my brothers, if they got to know, i would be ‘dead’.
Fear of ridicule from boys makes girls lose confidence and this is more
shameful in case of an ‘accident’ Indeed two reported as follows:.
I got my periods when i was in class got up when the uniform was all red and i heard one boy say ‘
‘oyo yekoonye akagere’ 19 I froze and even failed to walk out of class.
I will never forget the day when all boys were not talking to me in class for a whole term saying that
am dirty just because i had got a menstrual accident once.
The male feelings about menstruation are driven by stereotypic notions and
lack of knowledge about menstruation. The fact that menstruation is seldom
discussed freely within the male presence increases negative expressions among
the boys which consequently affects girls emotionally. Related to the above is
the ignorance of fathers and brothers and all male relatives who are naïve
about the topic. Due to this ignorance, menstruation is taken and understood
as a mystifying weakness of women rather than a biological and normal
recurring experience of life for post-pubescent girls and women (Kirk 2006)
which notions stigmatise girls.
3.1.5 Hygiene perceptions during menstruation
Having looked at the wanting hygiene standards in the different
school settings, a conclusion can be drawn that girls are not clean during this
period especially the rural girls. Indeed one participant was in her periods and I
19
meaning that she has gone into her periods
18
smelt a bad odour, later she shared that she is in her periods and I understood
the source of the foul smell. Menstrual blood itself is not dirty as most girls
have been led to believe (BharadwaJ and Patkar 2004: 8), it only becomes dirty
if not managed properly. Girls reported sensing a feeling of desertion from
friends and male counterparts because they had bad odour coming from them.
This is due to fact that girls sometimes girls reuse these pieces of cloth without
washing them due to water scarcity (Oster 2010: 4) Inspite of some girls being
clean during this period, society blends them as unclean because of the
constructions about menstruation. Similar to a study by (Rembeck et al. 2006:
707) reported by (Lee 2009: 617) some girls felt that menstruation is a period
and sign of impurity and that this attracted resentment from fellow pupils
hence lowering the girls’ confidence.
3.2 Psychological and physical issues surrounding
menstruation and their impact on girls participation in
education
Good menstrual hygiene is very important for the good health and education
of women. The educational gender disparities mentioned in the introduction
are caused by factors such as poor sanitation (UNICEF 2009:1)
3.2.1 Sanitary protection during menstruation.
Similar to Shukla’s findings, pieces of cloth are always substituted
for sanitary towels as shields for menstrual blood (Kirk 2006: 3). A study
among adolescent girls in Nepal revealed that 98% of the girls from the study
sample used cloths for protection (Oster 2010: 4). In the current study’s
findings, in the urban poor schools, 8 out of ten girls could afford to have
sanitary towels. Despite the comfort associated with modern sanitary towels,
most girls from the rural setting could not afford sanitary towels. Even in the
urban setting, some parents provide few packets which can’t take the children
through all the cycles20
In the rural setting, most girls use old clothes and old newspapers,
only one out of 10 girls could afford sanitary towels. Two girls nearly dropped
out of school because they were tired of the embarrassment. As evidenced by
this and many other studies (Kirk 2000) use of rags is common in low income
settings. Some girls shared that during their periods, they could not attend
school because they did not trust the protection. Fear of accidents worsens the
discomfort in class and girls keep thinking about instances when their uniforms
will be soaked with blood and the consequent fear of humiliation, stigma and
discrimination. One girl who is out of school reported that during her menses,
she didn’t attend school for four days per month in fear of embarrassment and
she totally lost interest since the parents were less interested in her schooling
20
From a girl in boarding school
19
and they always preferred that she stays at home and helps with the domestic
chores.
Two girls from the rural school reported to have used papers from
old books as protection and this made them feel very uncomfortable in class.
This tallies with a research conducted in Ghana by Alliance for African
Women Initiative (AFAWI) which found that after provision of sanitary towels
to school girls for a year the girls no longer felt low during their periods and
that could participate freely in class. Lack of proper sanitary protection makes
girls hate the experience of menstruation and most especially during schooling
as different authors have identified a retrospective connection between
menstruation and school absenteeism.
Some mothers from the rural setting mentioned shared why they would rather
prepare clothes for their children than buying sanitary towels.
Sometimes i fail to get money to buy paraffin for the ‘Tadooba’ (Local lanten) and salt for our
soup, how can i get money for sanitary towels. One towel can buy 15 Sackets of salt.
From the findings, a clear divide between the rural and urban settings in
relation to sanitary access is evident, the latter being less disturbed by lack of
sanitary towels because their parents are in a slightly better financial position in
relation to the girls from the rural schools. Constant fear of leakages instigates
silence in and outside class, consequently affecting girls’ performance. This
leads to class repetition thus discouraging schooling and leads to final. A study
by Kirk and a study carried out in Southern Sudan all point to the fact that
menstruating girls may hesitate to go up to the front of the class to write on
the board, or to stand up as is often required for answering teachers’ questions,
due to fear of having an ‘accident’ and staining their uniforms (Kirk 2006:6).
This brings irregularities in school attendance and may even lead to eventual
dropout.
Perceptions about use of modern hygienic sanitary towels
In the Rural areas, parents had concerns about sanitary towels
being environment unfriendly so they would rather use the rags so as not to
spoil their land from which they get their livelihood. Mama kit project21
provides free sanitary towels but parents intentionally hide them from the girls,
apparently because they are environmentally unfriendly and make their gardens
infertile. With such attitudes and feelings, mothers are less likely to avail their
daughters with sanitary towels even if they had some little money that can be
put aside for sanitary towels.
21 Mama Kit project - A life-saving package of clean supplies given to mothers before
delivery.2 pairs of gloves to prevent bacterial infections and HIV ,2 new razor blades
to cut the umbilical cord ,1 bar of soap ,2 gauze pads for cleaning the eyes of the
newborn,8 sanitary towels for the mother ,9 oz of cotton wool ,1 polyethylene sheet.
20
3.2.3 Age and place of menarche
Despite the different menarche experiences, studies have shown
the significance of age and preparation in defining the future of the cycle,
problematic, shameful or an embarrassment (Lee 2009: 616). It was clear from
the findings that rural girls experience menarche earlier than those from the
rural schools. A girl who started her period at 8 from the urban poor setting
reported a sense of fear when she saw stains in her underwear and she says she
will never forget that day because she didn’t know what to do.
Some studies have related this divide to the general health,
nutritional intake and physical exercise (Chung et al 2001: 20) Girls from rural
areas usually eat fresh foods and also walk longer distances to get to school
which makes their bodies very active and hence postponing the age of
menarche. Nine girls from the urban setting experienced menarche below the
age of 10 while in the rural urban setting, one girl had experienced menarche
before the age of ten, and the lowest age of menarche was 8 compared to ten
in the rural schools. Similar to some studies, the current findings show that
most of the girls from both settings experienced their first periods at the age of
11. The lowest age of menarche in urban poor setting is 8 and in the rural
setting its 9 years. The average age of menarche for girls in rural settings is 11
while that for girls in the urban poor setting is 9.5. This implies that girls in
urban poor settings reach puberty faster than those in the rural settings. If girls
menstruate earlier there is a lot of fear and ridicule from peers of both sexes
because menstruation is equated to sexual maturation. Table 1.1 shows the
ages and place of menarche as described above.
Table 1.1
Age and place of menarche per setting
Setting
Rural setting
Age of menarche
11
12
9
Number of girls
12
7
1
Urban Poor setting
8
9
11
10
3
3
11
4
Source: own construction
Most of the girls in the urban poor settings started their menses at school while
those in the rural settings experienced menarche at home A few experienced
menarche from neither school nor home. Please see appendix 2
The place of menarche is very important as it affects girls if they have to
experience their first period in an unfriendly environment. If a girls experiences
menarche in an unfriendly place chances are that she will always remember the
21
experience and still the first experience determines the feelings on the consequent
cycles.
3.2.4 Menstrual discomfort: Signs or symptoms of menstruation
Stomach ache, dizziness, back pains, swelling of some parts,
fatigue, cramping, mood swings, itching, abnormal duration of the cycle,
vomiting, loss of appetite, are some of the discomforting experiences reported
in addition to emotional feelings at menarche such as embarrassment, stress,
shame, confusion, and sometimes shock since some of them had never heard
about it. These influence their activities in and outside class which
consequently influence their education participation. A few girls especially
from the rural schools were excited and relieved because their mother had told
them that it is a vital stage to womanhood. This was very common amongst all
participants apart from two who said they did not feel any pain at all
I felt a lot of pain in the lower abdomen and my sister told me that its like the pain
women go through when giving birth (Rural School)
Menarche was too painful and i feel that its unfair for girls to go through such pain
while the boys don’t go through anything (Urban poor setting)
Girls from the urban poor schools were better off in dealing with the pain
because they could access pain killers from senior women teachers. Notable
however is that they were not allowed to miss class because of this pain and
they would just go to class even if they were not comfortable. I found girls to
be missing school because of such painful experiences and in the rural schools
no one cared if they attended school or not for whatever reasons.
I remember the first time i got my periods, there was no female teacher at school, only male
teachers, was feeling a lot of pain and i had to sleep in one of the buildings that were still
under construction. When the pain reduced i ran home. I didn’t attend school for 3 days but
no one asked. (Rural school)
Sometimes i feel like i should stay in the Dormitory because i feel so dizzy when in my
periods but the school matron cannot allow me
The findings revealed same symptoms experienced by all girls only that the
rural girls seemed stronger because they were always encouraged and soothed.
Despite this they reported that it is most times a painful experience. These are
both physical and psychological and they are detailed in the table below.
Table 1.2
Signs, symptoms and other discomforts during menstruation
Physical
Psychological
Headaches
pain in lower abdomen
Sadness, Stress
Mood swings general weakness
22
fever
Backache
fear
Lack of interest in home and school
activities
General weakness in body
Excitement, relief
Blurred vision
dizziness
Source: own construction
The discomforting and problematic experience of girls during
menstruation disturbs girl’s participation in class and co-curricular activities t at
school. These feelings make girls miss homework and more importantly school
not due to their own making but because of menstruation. As Ifeyinwa and
Eruke in (Kirk 2006: 4) state whereas girls in developed countries generally
have access to a range of general and specific painkillers, access to such
becomes a nightmare for girls living in the poverty stricken countries where
even food cannot be afforded. Often times girls in the rural area resort to use
of traditional medicines encouraged by their mothers to sooth the pain and
this is sometimes hard because it is hard enough to get boiled drinking water
,it’s harder reserving some for medicine mixtures.
3.2.5 Preparation and communication before and during the menstrual
experience
Most of the girls from the urban poor setting learnt about
menstruation from their peers and sisters but those from the rural schools
learnt about menstruation from their mothers. Twelve girls reported to have
been prepared by their mothers who gave them sanitary protection in form old
clothes in preparation for menarche. This implies that rural parents are more
free discussing sexual related issues with their children than parents from urban
settings which action promotes silence about menstruation. Indeed
Information received from the DEO revealed that most girls have learnt about
menstruation from leaflets provided by Straight Talk Uganda (STU) which
have all information about puberty and reproductive health issues22.
Table 1.3
Source of menstrual information
Source of information
Mother
Female relative
Sister
22
Number of Girls
15
10
7
DEO Wakiso District
23
Teachers
Peers
Father
Others23
2
4
1
2
Source: own construction from information given by participants
Although some studies point to the fact that female students in
Africa still feel shy telling someone about menarche and menstrual periods
(Kirk 2006:2), a different trend exists among almost three quarters of the girls
in rural schools and half from the rural schools because they reported that they
didn’t feel shy at all telling their parents about menstruation. Girls from the
rural schools reported that menstruation is a normal occurrence and their
parents and relatives don’t see it as a big deal. In the rural schools, 5 girls
reported that their menarche was reported to family members and special
meals were taken on that day. Asked about their feeling about this, they shared
that they are not free with it but it’s just the way it’s supposed to be done. The
presence of so many specific stories of concealment indicates that secrecy
surrounding menarche is still a feature of many young women’s experience of
first period (Lee 2009: 621). Much as the practice of telling the whole family
may not be a welcome gesture for most girls, looking at it from another angle,
it helps girls feel more confident about menstruation.
The evident feelings of concealment they showed during the
interviews may sometimes be eased by such actions hence they stop seeing
menarche as a plague that should be kept away from the whole family,
especially the male population. Everyone in their families got to know about it.
Three of these girls came from the Ganda culture24 while 2 came from the
Ankole culture25. A few girls reported hearing their sisters mention that
menarche is like a social cleansing and that when you go to menarche; it’s a
pathway to adulthood (ibid 2009: 616). These findings are consistent with the
findings from different studies that have found that women and girls usually
get these mixed feelings about menarche and it depends sometimes on the
knowledge at menarche (Uskul 2004: 671)
3.3
The scope and limits of existing support systems
There are structures already in place but are not tailored to facilitate girls in a
special way. Under this theme these are identified and gauged to explore their
scope of friendliness to menstruating girls.
One from a science text book and the other from her father
From central Uganda
25 From Western Uganda
23
24
24
3.3.1 Water and toilet facilities
The importance of water, sanitation and hygiene for health and development is reflected in MDGs: to halve, between 1990 and 2015, “the proportion of people without sustainable access to safe drinking water and basic
sanitation” (Brocklehurst 2010: 482) Indeed water is a very important element
in regard to hygiene and its lack may lead to serious health problems which
may not only hinder girls from schooling but also may lead to continuous illnesses. Only one school from the urban poor setting had access to water from
a protected source and reservoirs to tap rain water using underground water
tanks. Children from this school reported to have no problem what so ever
with water for showering during the menstrual cycles and even for normal use.
On the other hand, one of the schools from the rural urban setting
had did not have a clean water source. Children had to fetch water from a
nearby well which is not protected at all. Girls from this school reported hardship in fetching water while menstruating and the water they get is not enough
for their cleaning. I found worse situation in the rural schools as there were
only empty water tanks used only in the rainy season. The importance of water
was echoed by Burrows in (Maimaiti 2010: 12) when he stated that:
“Lack of adequate water and sanitation both at home and school prevents menstruating girls
from attending school when menstruating leading to exclusion. Girls have a sense of being unclean when there is little clean water to wash themselves, and this can lead them to stay away
from school. Also there are rarely private facilities at school where girls can go to the toilet or
wash the rags they use during their periods. They can also pick up infections if the water they
use to wash rags is dirty, leading to more time off school” (Burrows et al. 2004: 14)
Without water, proper hygiene cannot be ensured and absence of water the
fewer the toilets, the less hygienic the facilities are (MoES 2006: 30).These get
in the path of girls schooling hence lower completion rates.
Presence of inadequate toilet facilities is worse in the rural schools. Only one
school that I visited had proper toilet and washroom facilities conducive for
girls when in their periods. In this school, the toilets were well constructed
with cemented floors which allowed easy maintenance a total opposite of what
was observed in the three schools. There is a roaster for cleaning toilets and
since water is not a problem, it is always easy for them to clean them. One of
the participants from one of the rural school which had cemented floors reported as follows:
We clean the toilets once a week during General cleaning time, we don’t use any cleaning materials like omo and jik because we are not given. we use only water and the smell is too much
In addition to that, the toilet stances are not enough for the girls. From the
table below in both rural schools, over 700 girls are expected to use 2 toilet
rooms. This is a big number and in a way contributes to unhygienic practices
of resorting to bushes for girls to ease themselves and in the event that they
have to change their towels. In one of the schools, girls had to share with boys.
25
Table 1.4
No of girls per school and the number of toilets and washrooms
School
Number of Girls
A
B
C
D
596
400
750
870
(Urban poor)
(Urban poor)
(Rural)
(Rural)
Toilet and bathroom
Stances for Girls
7 and 7
5 and 4
2 one and non
2 and non26
Source: Own construction from information got from school lists.
Separate and clean toilets are required if sanitation is to be girl child
friendly since boys and girls have different sanitary needs. A study in Bangladesh showed that single sex toilets could increase school participation among
girl children by as much as 15% (Biotech Week 2009). According to the findings, girls’ only toilets and wash rooms with clear specification as to use were
found in only one school. In this school too, washrooms for girls were far
from those of boys and the girls felt secure while bathing or even while changing their towels a trend that was absent in the other school. This makes life
very uncomfortable for girls and relates to the finding by UNICEF (2009: 1)
that revealed that many rural schools in Uganda do not have the minimum sanitation facilities that are needed for school and that having a sex separated toilets/urinary as the least available sanitary facilities would have kept more girl
students in school as that offers some kind of comfort in that should (she)
need to, she has access to toilet and disposal facilities. Some girls reported
missing school due to the pain and uneasiness citing that they are not in position to understand what the teachers are teaching.
Much as the girls in boarding school were missing less days, it is
worth mentioning that they reported that in such days when the discomfort is
too much, going to class is equivalent to staying in the dormitory because they
do not understand anything. It is indeed true that some girls reported being
stuck with only one sanitary towel per day for fear of changing towels in a very
dirty environment. If school toilets with privacy and facilities for menstrual
hygiene are absent in schools, sporadic attendance and eventual dropout may
follow (Brocklehurst, C 2010: 482) hence leading to girl’s exclusion from
school participation.
School dropouts are related to lack of adequate facilities for menstrual hygiene
(Ramela 2006: 572) These insufficient facilities not only forces girls to miss
school but also leads to consequential abandonment of school because with
There are no washrooms in the rural schools because they are day schools. If a girl got an accident at school and she
needs to wash, she had to go to nearby bush.
26
26
the general toilets, Girls are in constant fear and therefore free to change their
sanitary towels without concerns of being sneaked on by boys
However worth mentioning is the fact that although some toilets
from the second urban school were hygienically lacking, the stances were more
and could than in any of the rural schools which in addition to being in a very
poor sanitation state, they were very few and could hardly accommodate the
high number of pupils. This tallies with the primary schools sanitation and
hygiene report from the Ugandan ministry of education and sports where lack
of privacy and hence compromised facility utilization, and that almost 1 in 6 of
primary school toilet facilities had no doors and two thirds of those with doors
could not lock from inside27 . Further findings from this report pointed to the
fact that sanitation situation was better in urban schools than in rural
schools.To this end, some Girls reported using bushes as changing avenues not
mentioning the risk involved in such actions. To avoid all these hurdles, some
girls especially from the rural schools choose to stay at home from the day they
suspecting that the cycle is going to start until the day when it is completely
finished. This inevitably leads to poor performance of the girl child, eventually
leading to over repetition of a class which makes girls hate school and
consequently dropout. An estimation by the United Nations Children's Fund,
points to one-in-ten school-age African girls skipping school during
menstruation or drops out entirely (Atayi et al 2008: 5)
3.3.2 Disposal mechanisms
Despite the fact that one school had a well fixed incinerator, the
general disposal method reported and observed in the four schools is toilets
with some few cases disposing sanitary material in school dustbins and gardens
at home the latter being used by mainly those from the rural setting. Some girls
claimed that they ignorant about use of the incinerator although the head
teachers claimed that all girls were sensitised about its functioning. So the
common avenues were latrines similar to a finding in (Bharadwaj and Patkar
2004: 10) where the general practice that people are comfortable with was
found to be toilets or rubbish bins. Despite knowledge of environment
consequences of disposing used pads in latrines, there was no alternative
disposal method hence reports of cases of littered used rags in the school
gardens and compound. Where the girls were using cloths as protection,
reports of re usage were common so they just had to find enough water to
clean their tissue. In the rural settings still, girls were advised to always burry
the used up cloths because blood is always seen as sacred and a platform for
witchcraft. Although this myth improves hygiene, animals always unearth them
and thus seen by the males prompting ridicule which promotes embarrassment
and low esteem for girls.
27
Ministry of Education and sports: Sanitation and Hygiene in primary schools in Uganda School
sanitation survey RFP/UGDA/05/015, Child Health department centre, Makerere University. February
2006
27
3.3.3 Institution of senior women teachers in schools
Three schools had senior women teachers whose roles are to advise
the girls in problems that may arise due to their femininity. Indeed the two
senior lady teachers that were interviewed gave a clear indication of problems
faced by girls during menstruation with articulacy hinting to the fact that they
occasionally engage with these girls. However it is worth mentioning that these
teachers are not specially trained to train girls in that field. In one of the
participant schools, a senior lady teacher instituted was actually the
mathematics teacher. No form of training was given to her.
3.3.4 Support systems existing at the household level
The respondents for this study were mainly from two regions28
where culturally, female relatives prepare girls for issues regarding their bodies
and teach them how to prepare for certain changes that come with puberty.
This puts them at an advantage because these cultures have the institution of a
“senga” which symbolises a female relative usually an aunt who is given the
responsibility of teaching girls about puberty and all the changes that come
with it. However only 10 girls reported to have got information from such
relatives. In relation to the overall number of respondents this is a big number
and hence strengthening such an institution is worthwhile. It is through this
socialisation with ‘senga’ that girls acquired knowledge and skills which would
play a great role in shaping her attitudes towards menstruation (Muyinda et al.
2001: 353).However over time due to the global changes, the ‘senga’ institution
has become so inactive and there are no efforts of rejuvenate it. Although it
still exists it is too weak to make an impact which is very detrimental to
especially the rural girls who sometimes do have a chance associate with senior
women teachers.
Further some girls reported having separate rooms from their
brothers but most of them reported that they shared rooms with their male
relatives. Infact some girls from the rural urban setting shared that they have
one room which is also shared with the parents. This does not give space for
the girl to feel free when in her periods and hence may feel insecure cleaning
herself and preparing in time to move to school. One of the girls reported that
one time she could not go to school because her brother kept being at her side
when she wanted to wear her sanitary protection and by the time they left, it
was late she could not go to school anymore.
Coping strategies for girls
This study portrays lack of proper menstrual management as key
factor influencing girls’ education participation. Although a review of critical
literature done as background study for this research reveals quantitative
evidence of girls missing school due to lacking sanitary facilities, a lot of
28
Central and Western
28
qualitative research has pointed to this fact hence girls are discouraged from
attending school due to inadequate facilities like toilets and water (Birdthistle et
al. 2011:26). This presents a need to understand how girls manage to go
though the menstrual experiences in situations where water, toilets, sanitary
towels are lacking and where there are still some negative constructions of
menarche and menstruation.
In order to minimize the effects of menstruation, in both rural and
urban settings, girls tend to come up with mechanisms to cope with both
physical and psychological menstrual experiences. Girls tend to strap sweaters
around their waists (Lee 2009: 616) or even try to avoid wearing clothes with
light colours that can easily reveal accidents. However note should also be put
on the fact that girls may not be able to tie sweaters around their waists when
they are asked to do tasks like fetching water (both at school and at home)
because the sweaters will keep falling. Some girls mentioned that they play and
interact less with their peers because they have a belief that if you don’t move
around a lot, you will have light flow of blood and hence cannot cause any
unnecessary accidents. In order to deal with the pain, they use clothes soaked
in hot water to relieve the pain. The girls in the urban poor setting reported
using these in the safety of their dormitories while those in the rural settings
had to wait until they go home. The hot water strategy was reported by the
girls from urban setting as a good alternative to painkillers. Furthermore the
girls reported that during the menstruation, they would rather stay at home
instead of getting embarrassed with the accidents. In the rural setting girls
reported moving with an extra cloth which they change during the break to
avoid leakages
Further girls try to limit the ridicule from boys by ensuring that
they only change their sanitary tissues in the breaks and not any other time
because usually boys take note of the number of times a girl asks for
permission. This is consistent with the findings in Lee’s study where girls were
reported to change their protection only during class breaks (Ibid 2009:616). In
addition girls always keep their change tissues in places where they cannot
easily be seen. One girl reported:
One time, i accidently dropped my pad in class, boys started asking if i was in ma periods and i
was embarrassed
Furthermore, in situations where the hygiene is very bad, girls have resorted to
use of nearby bushes as avenues for changing their tissues when need arises.
This was reported by close to seven girls which puts them at risk of accidents
in the bushes and also putting their security at stake. Despite the fact that girls
try to devise means of dealing this occurrence, to some it is embarrassing and
hence choose to stay at home during those periods to prevent all this hustle
hence their exclusion from schooling.
29
Chapter 4
Cross cutting variables and how they relate to
menstruation in hindering girls schooling
Girls menstrual experiences are also influenced other variables which intersect
to worsen the occurrence.
4.1
Poverty
Poverty intersects with many variables related to girls schooling and
menstruation is no exception. Most girls from the poor urban setting live in
rented houses in the slums of the city. As seen from the table showing the
status of parents, their parents are not in a very good financial standing and so
most of them could only afford a few rooms. Commensurate with the findings
by Paul Shelock in (Bharadwaj and Patkar 2004: 7), it can be very difficult for
menstruating girls to live in the same congested rooms as the rest of the family.
In the rural settings, almost half of the girls reported living in separate
bedrooms but for the other half, the situation was similar to that of the urban
poor children.
More so poverty remains a cross cutting issue that hinders girl child
education. Countries like Uganda adopted the Universal primary school
program but it should be noted that other scholastic materials are equally
challenging especially where a family is living below the poverty line (Atayi
2008: 17). In some instances parents have sold off their valuable items in order
to keep their children in school and when these deplete children consequently
drop out (Okumu et al 2008: 15). The table below shows that most of the
parents are farmers and big number of them are business people. But worth
noting is that the retail business that they engage don’t give high returns to
enable parents to buy sanitary towels for their children.
Table 1.5
Occupation of parents of the study population
Occupation of
parent/guardian29
Number of
Girls
Farmer30
Business31
18
12
29
The parent who pays for the school dues of the child was considered
All these were from the rural setting.
31 Includes market vendors, retail shops
30
30
Teachers (Primary)
Teachers (Secondary)
Secretary (MoES)
Nurse
Taxi Driver
Taxi conductor
2
3
1
2
1
1
Source: Own construction
In the same vein, many parents in the rural urban setting reported that they can
hardly afford clothes to put on so definitely cannot provide appropriate
sanitary protection in form of pieces of cloth. Although most girls from the
urban setting reported that they don’t have a problem with accessing sanitary
towels, the respective senior women teachers reported otherwise. They insisted
that parents rarely give enough sanitary towels for their children despite them
being put on the end of term school circular as a very vital requirement. This
all signifies poverty which inhibits parents from providing protection for
proper menstrual management. To make matters worse for the rural girls, The
cloths that the girls use have to be changed constantly because they get soaked
very fast. In some areas cloth is scarce and the impoverished women can only
afford two pieces This means each night the rag will be washed, with the hope
that it will be dry by morning (Knox 2010) but this may not be possible at
some homes lack washrooms and girls have to wait until late to shower in the
open at night.
4.2 Education achievement of Parents
Educated parents would usually want the children to emulate their
example and the reverse is partially true for uneducated parents although due
to a lot of awareness and advocacy and the provision of free education, the
latter group of parents is being phased out. The education level of the parents
is very crucial in girl’s education achievement (Roby et al 2009). The findings
revealed that most of the parents from the rural settings are farmers and hence
are in position for get little income. But not should be put to the fact that subsistence farming in Uganda is not so rewarding. Further parents who are educated are more likely to engage in other income generating projects, for example a parent who is a teacher may have more knowledge about poultry and
hence may be in position to get more income.
4.3 Menstrual impact on mobility- Distance to school
Worth mentioning is the distance between children’s homes and
schools (UNESCO 2005a) This has greater effect to girls schooling because in
addition to caring and preparing other siblings for school, girls always first do
some domestic work such as collecting water , garbage clearance and cleaning
of the house, as a routine. This makes them reach school very late and also discourages their education interests (Atayi et al. 2008: 21). As was mentioned on
the website for a grass-root project, in rural areas of Uganda, including Wakiso
31
District, less than 50% of children under 18 years old are within a reasonable
distance to attend a local school32. Although may be envisioned as a less significant factor, it is actually very crucial. A research in Egypt revealed that the
construction of a school within one kilometer of the community settles increased enrollment for both boys and girls to a tune of 94 and 74 percent respectively (El Gilany et al. 2005: 151). This trend is more evident in rural
schools which also have other contextual problems such as greater risk involved during the way to school however short. Studies about Ugandan education have shown that the “nearby” schools are about 3 kilometers from children’s homes. This may fuel poor performance and girls will repeat class more
often which later makes them loose morale completely and may dropout. Indeed, in a study carried out in Peru, 20% of the girl of the girls reported washing rags and mobility restrictions as the main reason for missing school (Oster
2010: 7).
4.4
Double Jeopardy for Disabled girls.
It is the ministry of educations’ policy to include disabled children
in the mainstream schools but many a time, the infrastructure and general
facilities are not changed to suit these girls. This makes them be in a worse of
position when it comes to menstruation. Although no particular disabled girl
was found in my findings, while interviewing one of the parents this came up
as a big problem because she had a disabled daughter in another school. These
girls are punished twice such that in addition to sanitation facilities being poor,
they are not good for them when in menstruation. These girls need privacy and
good hygiene because they may fall or get in contact with dirty floors. Despite
the presence of the School facilitation grant which is meant for encouraging
head teachers to report the special need of disabled children including
sanitation needs (MoES 2006: 8) at present there is little that has been done to
cater for them. The toilet were all dirty and wet, on further research I came to
understand that boys usually urinate against the wall in the instead of targeting
the latrine hole.
4.5 Domestic workload
Many cultures in Uganda emphasize children helping their parents
when they grow up, from my own experience, sometimes this help does not
stop with the family only, but this help has to be extended to the community at
large. In a research by Chung and others revealed that a woman who helps her
family and her neighbours in the community is considered a role model and
held in high regard (Chung et al 2009: 25) Notable however is that children
carry out different roles while giving this help because of the gender
stereotypes attached to roles which are labelled feminine and masculine. This
indeed manifested its self when the girls reported that they help their parents
with a lot of domestic work some times before and after school because they
32
http://theglobalplayground.org
32
are expected to do so. Girls from the rural setting reported being over loaded
with work before they are allowed to come to school. It is only 5 girls who did
not do any work before coming to school. Such domestic workload includes
but not limited to washing dishes, working on the farm33, cleaning dishes,
cleaning the house and washing clothes. The situation is made worse when
children are in their periods because then it becomes a double burden for girls.
This is so because sometimes they are faced with the numerous discomforts
that have already been mentioned and they have to take on their roles. One girl
from the rural setting shared that:
I remember a time when i was in my periods, i had to clean the dishes, sweep the compound, and shower
all my siblings before i could go to school. By the time i reached class i was so tired and in a lot of pain. i
could not concentrate in class and indeed i didn’t no learn anything that day.
Some parents interviewed confirmed this by mentioning that the girls have to
help them with the work at home because they need their help. In fact some
rural parent shared that their daughters just get spoilt from school and hence
see no use sending them to school because after all, they are never going to
make it beyond primary seven. This confirms Anderson’s hypothesis that
higher priority is placed on girls’ domestic workload than their academic
performance (ibid 2009: 30).
Poor performance and constant absenteeism are fuelled by such all
variables mentioned above because they lead to girls repeating class which in
turn kills their self esteem and confidence and may eventually drop out
(Levy1971: 50). Although these challenges hit the rural children most, the
situation is not so different from what happens in the urban poor settings.
33
Although farm work is mainly for boys, girls always have to chip in times of harvest when more labour
is required.
33
Chapter 4
Chapter 5
Implications for Policy
Conclusion and
The main objective for this research is ‘to assess the role menstruation (a
visible sign of puberty) in defining girl’s participation in education and to
identify institutional/community/family support systems and their implications
for policy which objective was reached by asking the role of menstruation in
girls’ education participation. This chapter will highlight the possible
interventions according to the research objective and will later give a
concluding remark.
4.1 5.1
Summary of Findings and Policy Implications
The findings reveal that several menstrual experiences served to
exclude girls from schooling and that girls from different social contexts are
affected differently34. Menstruation impedes girls from enjoying their RTE and
hence lack of the menstrual management structures calls for better policy
interventions which may lead to gender parity in schools. Studies on girls’
schooling have to be linked with action points at Institutional, community and
family levels as arenas for reform in menstrual management. Government
ought to always be at the forefront of these polices such that girls issues are
mainstreamed at a macro level which may later have a trickledown effect in the
lower structures. In order to achieve full participation of girls schooling,
priority to girls’ issues must be exercised so that resources are geared towards
feminine policies. In order for the gender gap in education to be closed,
government and other stakeholders have to assume full responsibility of
ensuring participation of girls in schooling. There is also need for further
research into effective, culturally acceptable and sustainable interventions that
look at girls’ education beyond enrollment. In this chapter the policy issues are
presented based on the objective of the paper as stated above.
5.1.1 Institutional Systems- In School Structures
Institutional problems like infrastructure, instruction methods at school and
content of puberty studies emerge as a debilitating factors not considered in
policy making may have adverse effects to girls schooling making girls’ modest
management of personal hygiene an imposing if not impossible challenge.
Indeed may choose to miss school during their menses which leads to a
drawback on lessons learnt at school (Porter 2007: 27).
34
Girls from rural areas are affected the more
34
A)
Lack of protection materials
Policy proposition: Provision of free/subsidized and environmentally
friendly sanitary towels in very poor households
This and many other studies (Costos et al. 2002: 50 ) have
identified fear of accidents as a crucial concern for menstruating girls and
women which puts availability of sanitary protection and menstrual
management techniques on the government agenda. Lack of protective
materials was found to have a big influence on girls’ school attendance and
completion. Lack of sanitary towels implies that girls will keep missing school
if they do not have proper protection. Although NGOs are providing free
sanitary protection to some selected areas of the district, a concerted effort
between government and the community would yield better results because
then government would be able to address issues of consumerism35 attitudes
that may come up in the process and try to balance them. This is because the
consumerism attitudes may prove hard to sustain most families are poverty
stricken. To minimise the effects of consumerism tendencies and to increase
availability of sanitary protection materials, my suggestion would be for
Government to work out a policy of providing free or subsided sanitary towels
and also initiate programs to educate families on how best to use these towels
in order to bypass the environmental concerns that some parents had and still
have about use of sanitary towels. This action may in a way reduce accidents at
school, improve girls participation in school activities, and consequently school
absenteeism resulting into reduced dropout rates.
B)
Lack of an accommodating Curriculum
Policy proposition:
School Curriculum adjustment
Similar to the findings by (Moore 1995: 89), most girls had premenarche knowledge but their understanding of the occurrence is so limited.
As discussed earlier, providing girls and boys with information and skills would
empower them with knowledge concerning menstruation and it would better
prepare girls for this stage. This is consistent with Dioro and Munro’s findings
that menstrual education was advocated for as a pathway to enlighten pupils
about reproductive health issues (Chang et al. 2011: 1). But schools embrace
puberty studies only to the tune of studying the different body parts without
explaining the different puberty signs and often times menstruation is left out
entirely.
It would therefore be very useful if instruction guides that include
menstruation in puberty studies are developed to allow teachers (both male
and female) know how they can handle such topics and prepare the children
35
Consumerism refers to a an order which can be social or economic where by the desire to purchase
goods and services is fostered systematically
35
well for both menarche and menstruation. Male teachers should be advised to
eschew their own feelings and prejudices about sexuality and reproduction
studies (Chung et al 2009: 34) for better schooling experience for pupils. Much
as there seems to be rationale to teaching girls about menstrual studies
separately36, such an act perpetuates secrecy about menstruation and eventually
increases the stigma towards the girls. It would be a very good policy if boys
and girls were educated about puberty studies together.
Related to the above is the use of guidance and counselling sessions as a way of
preparing these girls for the numerous puberty signifiers. Such strategy was
raised in (Porter 2007) where they were held to such sessions to be very helpful
at primary level. It would be a good strategy to include this in the weekend
program for schools through forming learning groups facilitated by trained
senior women teachers. Because some girls reported that they cannot move
freely to the rest rooms to change their towels during class, more frequent
breaks should be introduced. In the current study the interval between lunch
and end of lessons is three hours which seems a bit long for someone who is
already discomforted by menstruation. I therefore recommend a two hour
interval between breaks
Related to the above is the time of physical education (P.E). Girl’s
menstruation is seldom considered when carrying out rigorous exercises. Some
girls shared that this period is the hardest for them because not all teachers are
flexible when they give menstruation as a reason for non participation in the
exercises. Reducing the time when these can be done and allowing
menstruating girls to miss or engage in less rigorous activities would be a good
course of action which would in turn allow girls to have no worries during
period.
C)
Lacking Infrastructure
Policy proposition: Provide water and gender sensitive toilet facilities
Lack of sanitary facilities and water was singled as a barrier to
pubescent girls schooling. The findings revealed that in addition to not having
enough rooms for girls, there is lack of gender sensitivity in the way the toilets
are constructed. Only two schools had separate toilets for girls and in one
school where there is this demarcation, they are so close for comfort. In the
rural setting this is absent and usually girls do not have privacy. In the settings
where toilets are lacking may be improvement in tap water systems would help, or
even assisting schools build water reservoirs such that they are in position to harvest
water where an option of running water in not possible. This would improve hygiene
for girls and hence improve their esteem since some of them were often worried that
may be they are not smelling well because of no water available for baths. Such Hence
36
Menstruation a private matter for girls
36
a minimum of infrastructure would work miracles for girls. In the rural settings where
the problem of water really hits hard, an option of water tank construction both at
schools and in homes will be well welcomed. The government of Uganda in
collaboration with the Non government sector has tried to do construct water takes in
schools through projects like the WASH campaign but those are the few. Many of the
schools are not yet reached due to lack of resources.
D)
Absence of a systemic system to monitor school attendance
Policy proposition: Establish a structure that follows up absenteeism at
school
None of the schools could provide attendance roasters to enable
me observe ascertain the trend of absenteeism of these girls. It is indeed true
that teachers and parents especially from the rural urban setting do not care to
follow up when children do not attend classes. From my interaction with the
participants, I am tempted to conclude that some girls may not feel a lot of
discomfort but just miss school during menstruation because it is the order of
the day. Parents have to be motivated to encourage their daughters about this
natural occurrence and ensure that they attend school if they are not feeling
well. Teachers also need to follow up on the days missed by the pupils such
that there are no instances of missing and hiding under the menstruation
umbrella. It would further be helpful if the government intervened and availed
attendance sheets even to the schools that are very deep in the villages so that
teachers can always keep track of pupils that are not attending school and
ascertain the reasons why. If menstruation came up in may be the teachers
committee meetings then appropriate polices to reduce this would be discussed
4.2 5.1.2
A)
Community systems/Government systems
Presence of excluding policies
Policy proposition:
Inclusive policies and programmes
“The primary requirement for social inclusion is a safe, supportive space where children can interact with
peers and mentors”37
Despite attempts to provide more effective educational responses
for all children (Ainscow 2008: 20) , little is being done towards a menstrual
management policy that will ensure that girls who are experiencing
menstruation participate in the same way as other children in Uganda. A
gender sensitive educational policy is required to ensure full access.
37
(Hallman et al 2007:2).
37
An inclusive policy points to a policy geared towards eliminating
social exclusion based on religion, social class and gender, among others and it
is a embedded in the belief that education is a human right and foundation for
a more just society. For purposes of this research, poor infrastructure, attitudes
in community etc are all variables that lead to exclusionary tendencies for girls.
Ainscow mentions the notion of inclusion as being concerned with, among
others, all groups vulnerable to exclusion (Ainscow 2008: 17) and in this case
menstruating girls fall within in that category. In the current research, I will
encourage inclusion policies that are aimed eradicating discriminatory
tendencies that make menstruating girls vulnerable to exclusion from
participating in education. For the Ugandan example, there are programmers
initiated by the non government sector towards gender parity in education but
emphasis is put on the enrollment. However, the Promotion of Girls
Education scheme (PGE) has ensured girls inclusion in schooling by focusing
on their retention and performance at school. Through this scheme, latrines,
classrooms and houses for senior women teachers plus water reservoirs were
built which consequently avail a solution to some of the problems that
intersect with menstruation to impede girls schooling. Another good example
of a program geared towards inclusion of girls in schooling is a USAID project,
Equity in the classroom which promotes participation of pupils in the
classroom. If such a project would include a menstrual element such that girls
in their menses are encouraged more and their self esteem heightened, may be
it would make a big difference. Furthermore a UNICEF Project of child
friendly schools38 has ensured sanitation stands in schools. With such
interventions and policies, girls will be in better position to deal with the
menstrual ‘dilemma’.
B)
Government depending on other stakeholders efforts and
keeping a blind eye
Policy proposition: Government support for NGO menstrual related
activity
As Governments expenditure is spread thin and the few resources
are being competed for by the different sectors, the Ugandan Government has
failed to offer services to address the menstrual needs of the girl child. This
was evidenced by comments of the Commissioner for education at the
Ministry and the District Education Officer (DEO) who hinted on the lack of
menstrual management activities at District level but mentioned knowledge of
some non government interventions that have really helped in the area of
sanitation. Specifically he commended NGOs like Voluntary Action for
Development (VAD), Community Involvement in Education (CIE), DSW
38
A UNICEF funded project aimed at promoting girls education through advocating for friendly
learning environment
38
Uganda, Straight talk Uganda, and Nnabagereka Development Foundation
which as shared by Gender focal person at the district, have all made
numerous efforts to make the menstrual experience better for girls. Although
this involvement was only evidenced in one study school, the NGO presence
and impact shows the advantages of having the Non government sector
interventions. Such efforts are very much required but the Ugandan
government does little in supporting these organisations, more so if
government identifies an issue that is well handled by the NGO sector; it
focuses priority to other issues39. The option then would be to create
institutional structures that would allow shared responsibility between the
government, private sector and civil societies/NGOs.
Indeed there are advantages of NGO involvement because some
find avenues for marketing their products and at the same time helping these
young girls’ access sanitary facilities. Such a strategy worked for Tamrands, Inc.
an American company that deals in sanitary products which used production
of Educational materials, educating children about menstruation and at the
same time making them aware of the availability of such products (Costos
2002:50). However the government has to set up boundaries to safeguard the
interest of the local people visa vie the interests of private investors whose
main aim is to instil a consumerism culture in the communities so as to create
future markets for their goods. Further, such partnerships with non
government entities have been reported to have yielded positive results in the
area of social progress in Pakistan, Bangladesh and Malawi (Chung, C.E. 2001:
44). Such partnerships should be explored by Government to design menstrual
related health programs for adolescents. It is true that the Governments
especially from the global south have to re focus on issues like menstruation
and mainstream it in any Gender related policies that are in place for better
sustainability.
4.3 5.1.3
Family support systems.
Family support systems influence girls’ menstrual experience because girls
spend most of their time at home. It makes it important to identify and
strengthen structures at home that would better their experience.
A)
Poverty
Policy proposition: Poverty Eradication strategies.
Evident from especially the schools in the rural setting, poverty is a
limiting factor towards provision of adequate support during menstruation.
The poverty that needs to be eliminated is both at household level and at
community level. Encouraging small scale income generating projects for
households has proved very useful in other contexts and I am sure it will have
39
Other NGOs like UPHOLD and STRAIGHT TALK have also helped dissemination of menstrual
related information.
39
the same effect in the current context if exploited. The findings disclose that
most parents are in subsistence Agriculture which does not give good returns
according to the financial situation in Uganda. A move to Government to
strengthen farmers’ cooperatives so that they are able to improve their returns
from agriculture might help reduce the poverty effect. With this parents may
be able to provide cloths and sanitary towels to their children.
B)
Increased workload for girls at puberty
Policy proposition:
Decrease in girls domestic workload
As mentioned in Chapter 4 section 4.5, as girls get nearer to
puberty their domestic workload increases because they are believed to be
women and no longer children. Menstruating girls face double punishment if
they have to do all the domestic chores the same way as when they are not
menstruating. This situation becomes worse if they have to go to school which
are often times far away for the rural context. Girls would participate more
effectively in class if they were so worn out and at the same time experiencing
discomforts due to menstruation. Decreasing this workload is a better option
such that leniency is shown to these girls and some work is given to boys or
managed by the parents themselves. A suggestion to increase or initiate
awareness campaigns in places where they are absent would immensely benefit
girls. It would be very helpful if this advocacy is targeted towards families and
the communities at large educating them about the benefits of educating the
girl child using the leaders as trainers and examples. In a study by Rugh and
Bossert’s in (Chung et al 2001: 43) revealed that educational models
incorporating community participation may be useful in increasing the
education changes of disadvantaged groups as girls. I will use that example to
suggest a policy to involve community leaders so that they have a sense of
ownership of such a project for better results since they know their
communities better than anyone. This is consistent with a finding in ((ibid 200:
43) that a social campaign is more successful if it has an action plan prepared
by a representative group. So it would be a result oriented strategy if issues
pertaining to girl’s education and menstruation are discussed in village
meetings so that parents, although not high achievers in Education are made
aware of the advantages of girls schooling and hence would learn to always
give it priority to the different work that they load these girls with.
C)
Myths and taboos that surround menses
Policy proposition:
Advocacy regarding puberty and menstruation
History has shown menstruation being regarded as a taboo topic
(Costos 2002:49) and this stems from the fact that it is not looked at as a
natural occurrence but a socially constructed one. The myths and taboos make
40
the menstrual experience worse for girls and hence lose their self esteem as
girls and others regret being born girls consequently limiting their full
participation in educative activities at school. It indeed true that one of the
respondents hinted at loathing being born female because males were over
bullying her because of an accident When girls go through such experiences
they lose the courage to go on with their studies because they feel that life is
being unfair to them. A campaign to sensitize families and communities against
unreasonable cultural myths would help in changing culturally driven attitudes
that make menstruation a taboo in society. Advocacy through the existing
social structures like the families, community heads would be very effecting in
curbing the effect of the myths and cultural beliefs that surround menstruation.
Such attitudes towards menarche and menstruation are not being attended to
as perhaps they should have (Chang 2011: 2). Addressing the root cause and in
this case by disseminating knowledge about sexual and reproductive health
education may minimize the emotional and psychological impact of these
attitudes.
The above highlighted policy propositions if followed up with concrete
actions would go a long way in eliminating girls social exclusion from
schooling due to menstruation and lay foundations for gender parity in
schooling.
4.4 5.2
Conclusion
Menarche and menstruation are significant events in girls’ lives as
they progress through puberty. The need to have good menstrual management
facilities is key in preparing them for menstruation. The government and the
non-government sector ought to see to the elimination of the institutional,
community and family encumbrances that intersect with menstruation to make
a girls education experience a dilemma. Different stakeholders need to follow
policies with concrete actions. For example, there is need for government to
sensitise people about the social and cultural constructions of menarche to
make it better experience for girls, Psychological and physical barriers have to
be handled in order to lessen their impact on girls schooling, and the existing
social structures have to be strengthened so that girls to create a better learning
environment for girls. Schools as key avenues for reform need to consider
changes in curriculum and infrastructure. Further the possibility of forming
girls clubs which constant monitor the sanitation infrastructure would be a
great action towards gender parity in schooling. Menstrual studies should be
integrated in puberty studies in the science classes to reduce shocks and
discomforts associated with menarche. Similar to findings by Bharadwaj (2004:
11), poor menstrual hygiene and management emanates from the beliefs and
attitudes with in schools and the community and is worsened by other factors
like poverty and lack of supporting infrastructure The menstrual management
approaches have to deal with the physical, emotional and cultural aspects in
order to have meaningful impact and this can well be done if its spearheaded
by Government as a key stakeholder. Since a great percentage of feelings like
embarrassment, concealment and secrecy are mainly fuelled by male presence,
there is need to sensitise them about menstruation and its normality. Further,
41
informants about menstruation like teachers, mothers, should always be
encouraged to convey positive messages to pubescent girls so that realistic
expectations are transferred to them (Rembeck 2006: 713).
On the whole, comprehensive interventions geared towards dealing
with menstrual-related barriers to education are needed in order to eliminate
the exclusionary tendencies that arise due to menstrual experiences.
Appendices
Appendix 1
Table 1.6
List of schools
No
School
42
1
Kibuli Modern School
2
Kasengejje Primary School
5
Lubiri Nnabagereka Primary School
4
Masooli primary school
Source: Wakiso district schools list.
Appendix 2
Table 1.7
Place of menarche
Setting
Rural
Place of menstruation
School
Home
On way to school
Number of girls
8
11
1
Urban poor40
School
14
Home
3
In the garden
2
Source: Own construction - Information given by participants
Appendix 3
Table 1.8
Sample Questions in semi structured Interviews
Participants
Pupils
Guiding questions


Tell me about your school, are studies going on well
Are there any problems you find that limit your schooling?
One of the students from the Urban poor setting did not remember her place of
menarche
40
43





















Parents






How and when did u learn about menstruation?
Is menstruation among them?
At what age did you start menstruating?
Do you remember menarche, what was your experience
with it?
Did you tell anyone about menarche, who?
How long is your cycle?
How did you feel when you started menstruation and
how do u feel now when you menstruate monthly
What are the indicators that you are going to your periods
Do you feel any pain or discomfort when you go into
menstruation, elaborate?
Are you happy when you get your periods, Why?
Dou you get sad when you get your periods, Why?
Do you attend school when menstruating?
Do you find it easy to participate in class during menstruation
Do you concentrate in class during menstruation?
Do you engage in co curricula activities like sports during
menstruation?
What type of sanitary protection do you use during
menstruation?
In cases where sanitary towels can be accessed, what
are the alternatives used?
How do you dispose off your sanitary towels, rugs etc,
are you happy with the disposal facilities?
Attitudes of male relatives, are u free with them during
your periods?
When was your worst menstrual cycle, what happened?
Who buys sanitary towels for you?
What is your Education Level?
Are you able to provide for your child the necessary materials when menstruating? If so what?
Does your child miss school during menstruation? If yes
why?
Do you think missing school affects their final grades
What do you think would be the solution to this problem?
Approximately how many days do the girls miss per
month/per term?
44
Teachers








Other key
informants for
local and central
Government





Are you able to through observation to know that a girl
is in her menstrual time?
How do you handle her in regard to class participation?
Have there been instances where girls have come to you
with problems of lack of sanitary towels?
What has always been your reaction in situations like
that?
Are there instances that you know of when girls have
missed school because of menstruation?
How do you handle girls during menstruation?
Are you availed with some medication to give to girls in
case they feel any pains during this period?
Who avails these drugs, are they enough
What do think are the key factors that hinder girl’s education
Do you think Menstruation has an impact on girl’s participation
Are their interventions to curb menstrual impact on girls
schooling?
Have got any instances of girls dropping out because of
menstruation
How is menstruation managed in schools?
Source: Own construction
Notes
Explore real life case studies
Number of toilets in School, number of bathrooms
Observe usage of toilets and washrooms
Check the hygiene status of the latrines and washrooms.
45
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