From 1 to 4: MHM and sanitation indicators rise in Khulna's schools


Teachers and students in schools are starting to change their perceptions about menstruation and hygiene. No longer an uncomfortable topic in a school in Khulna, Bangladesh, Afroza Bulbul, teacher, said that menstruation is now viewed a health issue.

Through SNV’s urban sanitation approach – Urban Sanitation and Hygiene for Health and Development – SNV staff and partners are raising school administrators’ and teachers’ awareness and skills in menstrual health management (MHM) in secondary schools across Khulna. Together, they are imparting strategies to question and transform gender norms, and to promote sanitation and good hygiene behaviour [1].

Beyond awareness raising and training activities, SNV also links up schools with MHM service delivery agencies, e.g., NGOs and private organisations to make sure that appropriate menstrual materials and supplies are available.

Nargis Fatema Zamin, Deputy Director of Children and Women Affairs from Khulna district, said that as a result of SNV’s and other NGOs’ MHM activities, ‘the government has introduced hygiene corners and sanitary napkins in schools… but disposal of menstrual materials continues to be a major concern.’

Enabling proper MHM in schools

Previously, Khulna Division’s school monitoring checklist simply designated one indicator for toilet/ sanitation management. Nowhere was menstrual hygiene management mentioned. Factors that enable sanitary and hygienic practice were not visible.

Due to SNV’s intensive advocacy  and behavioural change communication (BCC) activities with the secondary and higher education departments of Khulna Division, the school monitoring checklist has been revised. Today, the checklist has grown to 32 indicators, with one indicator devoted to menstrual hygiene management.

Sanitation-related indicators include:

  1. Student toilets are clean

  2. Running water and a handwashing station with soap is available

  3. MHM-specific: a) sanitary pads are available in case of emergency, and b) there is a suitable corner for girls’ hygiene practice

  4. Septic tanks are emptied once a year

The student council leadership, parents and teachers have also been engaged in reinforcing menstrual hygiene management messages and services. Within the council, students play the role of ministers, such as the minister or health or the minister of environment. Similar to the students, parents are engaged in knowledge management, mentoring, etc.

Student plays the SNV snakes and ladders BCC game to learn about sanitation.

Student plays the SNV snakes and ladders BCC game to learn about sanitation.

Up close and personal: SNV snakes and ladders BCC game.

Up close and personal: SNV snakes and ladders BCC game.

Guiding enforcement

But getting menstrual health management and sanitation written in policy and legislation – although hard-won – do not automatically translate to systems change. For example, several MHM-enabling policies have already existed for years.

  • The National Education Policy (2010) that promotes gender-segregated toilets in school as one strategy to decrease dropout rates.

  • The Ministry of Education directive issued in 2015 for secondary schools, madrassas and other educational institutions to provide gender-segregated and improved toilets, and soap, water and waste bins; and to appoint female teachers to educate girls on menstrual health.

  • The Government’s Water and Sanitation Sector Development Plan (2011-25) that sets out the need for gender-appropriate WASH facilities; MHM guidance for students and teachers; and the provision for the supply and disposal of MHM materials.

Rules for engagement need to be enforced appropriately. To this end, SNV has been providing implementation support to some schools in the Khulna district.

So far, 110 schools in Khulna have been reached, with a total student population of 63,000. Of this number, 35,500 are girls.

Written by: Masud Rana

[1] SNV conducts regular formative research studies and learning moments to ensure that its behaviour communication change methods are based on evidence and remain relevant. In 2019, SNV in Bangladesh completed the 2019 study, ‘Behaviour Change Communication in Sanitation Practices in Secondary School under Khulna City Corporation.’ The study highlighted limited knowledge and lack of safe and private dumping places as impediments to girls’ menstrual hygiene management.