Empower Girls in Uganda with Menstrual Health

Your contribution to Days for Girls’ Empowering African Girls with Health & Education project has made a difference in the lives of women and girls in multiple regions across the African continent. Our recent monitoring, learning and evaluation (MLE) in Malawi indicates that DfG programming had a markedly positive impact on the menstrual health knowledge, attitudes, confidence and experiences of school-age girls. We are pleased to share some of our findings in this report.

Evaluation data was collected using the DfG Malawi MLE survey tool which includes both qualitative and quantitative questions. The surveys were administered before the education session (pre-test), and after the education session (post-test). Girls were also asked to participate in an additional post-survey regarding their menstrual health experiences 3-4 months after they had received and used their DfG Kits. We surveyed a total of 1,083 students from ages 11-23 (median age: 16 years) across seven districts. 

High Level Results

1. DfG programs improved students’ knowledge of menstrual health and SRHR issues. Prior to DfG training, the majority of students scored as having Average knowledge of MH topics. After DfG training, 56% of students scored as having Good knowledge of MH – increasing from just 8.5% in the pre-test. There were even 91 students who scored perfectly on their post-test, an impressive demonstration of all they learned during the training. 

2. DfG programs helped to increase students’ confidence surrounding the topic of menstruation. After DfG education, we saw a 13% increase in the number of students who felt comfortable discussing menstruation with an older family member and a 27% increase in the number of students who felt comfortable discussing menstruation with a teacher. This latter detail is essential, as teachers are often an important source of support and information for students throughout puberty. 

3. DfG programs heped to cultivate more positive attitudes surrounding menstruation among participants. For example, we saw:

• A 31% decrease in the number of students who agree it is okay to tease a girl just because she is on her period. This indicates an important positive shift in peer-to-peer relationships and social norms surrounding menstruation. 
• A 67% decrease in the number of students who agree that menstruation should be kept a secret, indicating that our programs have helped to remove taboo around this topic. 
• A 49% decrease in the number of students who agree that a girl is dirty during menstruation. This indicates that DfG programs are helping to cultivate an environment where girls are viewed (and view themselves) as healthy, capable and included, regardless of their periods. 

4. DfG Kits helped to improve the overall menstrual health experiences of girls compared to before they had access to DfG Kits. Prior to receiving a DfG Kit, the majority of girls listed disposable pads, cloth or towel scraps or another form of washable pad as their most commonly used menstrual materials. Three months after distributing the Kits, we completed a survey with a sample of 520 girls who received them. We saw that the girls demonstrated strong knowledge of how to use their pads safely and properly, with the majority changing their pads every 1-4 hours, and 75% reporting that they always allow their pads to dry completely in the sun after washing to sanitize them.

Across the board, the vast majority of students (96% or more) agreed with the following statements:

• When I use my DfG Kit I feel comfortable
• When I use my DfG Kit I feel confidents that period blood will not leak onto my clothes.
• With my DfG Kit I feel comfortable and confident about being at school when I have my period.
• I feel comfortable participating in sports and other physical activities during my period.

Girls shared additional feedback on their experience using DfG Kits:

• “With the help of the DfG kits, we are able to attend all classes through the term” 
• “Before DfG kits were introduced we had very unhealthy means [of managing our 
• periods] but we are now confident in our health using these kits” 
• “The DfG kits are very portable, soft and easy to carry.” 
• “DfG kits enable us to walk with comfort.” 
• “I love my Days for Girls pad because it doesn't leak and it's dignified.” 
• “Without beating about the bush, I love everything in the DFG Kits.” 

Overall, our evaluation data indicates that DfG programs in Malawi have had a positive impact on the menstrual health knowledge, attitudes, confidence and experiences of girls who participate in our programs. We are thrilled at the opportunity to continue engaging with these communities to meet the needs of additional women and girls, and to grow our impact. We are confident that our findings in Malawi will greatly influence our work throughout the continent. Thank you for your part in this progress toward menstrual equity for school-age girls in Africa!

In 2021 and 2022, Days for Girls (DfG) Uganda partnered with CARE International with support from European Union Civil Protection and Humanitarian Aid to meet the menstrual health needs of women and girl refugees in Uganda. Refugees and IDPs around the globe navigate unique menstrual health challenges including lack of privacy and gender-friendly washrooms, inadequate menstrual supplies, lack of information, and stigma (check out our 2020 webinar report to learn more).

To empower communities in addressing these challenges, DfG Uganda engaged with residents at two major settlements, Kyangwali and Kyaka II. We began by meeting with community leaders in the zones to explain DfG’s goals and gather their feedback, garnering support. These community leaders raised awareness and improved community acceptance of our programs, which tackle a highly stigmatized issue. After this, we used a train-the-trainer model where DfG Uganda staff trained community volunteers in the camp to become DfG-certified menstrual health educators. During COVID-19 lockdown, when large gatherings were not possible, these volunteers played a crucial role in meeting menstrual health needs door-to-door. 

Through this approach, DfG Uganda reached 5,000 refugee women and girls with:

• DfG washable menstrual pad kits – a quality, durable, and reliable menstrual health solution.
• DfG Ambassador of Women’s Health education – a learner-centered, holistic menstrual health curriculum that provides women and girls with the information they need to manage their periods with knowledge, confidence, and positivity.
• DfG’s MH emergency preparedness training, which equips women and girls with the skills they need to sew their own additional washable pad liners in times when they may not be able to access manufactured menstrual products.

When an unexpected influx of asylum seekers arrived from Congo, DfG provided an additional 1,030 kits for CARE International to distribute, along with MH education, as individuals arrived to the camps.

DfG Uganda also engaged with men and boys in the camps, who play a crucial part in eliminating menstrual stigma and supporting women and girls in their communities to manage menstruation with health, safety, and dignity. We reached 1,500 men and boys with DfG Men Who Know education, which provides men and boys with information about menstruation and sexual and reproductive health, breaks down stigma, and activates them to become allies for gender and health equity.

This work was made possible in part by the generosity of GlobalGiving contributors – thank you for helping to empower women and girls in Uganda!