Health Communication Campaign on Menstruation among Adolescent Girls in Uganda

Keeping Adolescent Girls in School – Every Week of Every Month

Forum for African Women Educationalists - Uganda (FAWE U)

Shared Vision

Acceptance, understanding regarding menstrual hygiene needs

Knowledge regarding natural body changes and proper management of personal menstrual hygiene

Appropriate, adequate sanitation facilities in schools and communities

Increase in attendance rate, completion of school for adolescent girls

Current Situation

Poor menstrual hygiene is a significant contributor toward school absenteeism and drop-out rates for girls

Menstruation is a taboo subject

Stigma associated with menstrual cycle

Limited and false knowledge

Feelings of shame and confusion

Low self-esteem among girls

Current Situation

1 in 10 school-age girls either skips school or drops out entirely due to

embarrassment or lack of sanitation (UNICEF, 2005)

No discussion and limited information makes menstruation shameful,

something to hide and is ignored in families, schools and communities

(FAWE U, 2003)

Current Destination

Without a change in course: Limited education among females

Continuation of gender inequality

Little progress for communities and country

Continuation of taboos, stigmas

Self-esteem and rights for girls and women will remain low, yet accepted

Overall health of women will suffer as education, knowledge is positively associated with health status

Girls and women will be at risk for infections, discomforts

Significant negative implications on mental health of girls, women

Constraints

Menstruation as a taboo subject, not openly discussed

Myths, beliefs, and attitudes

Knowledge, education among adults on menstruation is limited

Little emphasis on education for girls in general

Poor infrastructure, facilities in schools

Few hygiene supplies available

Funding, resources allocated to problems with immediate high mortality (infectious diseases, etc)

Economy, poverty

Root Cause and Target Audience

Problem Statement: Lack of understanding and knowledge of the female reproductive system, menstruation

and menstrual hygiene needs within communities

Selected Audience:Adolescent girls – to

increase knowledge of menstruation and personal hygiene

management

Strategy Design

Use of the Theory of Reasoned Action

Behavior: Practicemenstrual hygienemanagement, stay

in school

Current attitudes about menstruationamong girls and community members

Subjective norms of responding to menstruationand menstrual hygiene needs among girls and

the community

Confidence, support, knowledge

Key Benefit

Benefits of learning about natural body changes, menstruation and proper menstrual management

include:

Gaining confidence in self

Staying in school after learning hygiene management

Reduce risk of infections

Open dialogue with family/friends

Dispel myths, inaccurate beliefs

Gain support

Reduce social stigma in community

Objectives

1. Increase knowledge of menstruation by 60% among adolescent girls

2. Improve management of personal menstrual hygiene among girls by 40%

3. Reduce drop-out/absentee rate among girls by 40%

4. Over half of girls will have discussed menstruation or their menstrual hygiene needs with mother/maternal figure or friend

Media Channels for Communication

Utilize Community Based Approaches

Begin campaign with:Drama acted out in schools and communities on menstruation

Followed by:Group discussions among adolescent girls within schools and communities

Media - Drama

Drama to be performed in schools/communities prior to group discussions

Adolescent girls, parents, teachers to attend

Participation from Ugandan women on development and direction of drama

Performed by native women

Entertaining and empowering in message

Drama – Masani’s Story

Masani 12 year old girl Poor rural community First in family to attend school, loves it Dreams of being a nurse Begins menstruation Family not supportive, no discussion Self-conscious, afraid to talk to friends Begins to dread school when menstruating Embarrassed, feels like a failure Skips school to avoid feeling shame,

humiliation Grades begin to suffer, can’t catch up on

schoolwork Feels helpless to change situation

Drama

Drama based on Masani’s story, but develop further into how she learned about natural body changes and ways to care for herself. The drama will demonstrate her increase in confidence with this knowledge and staying in school.

Main Character: Masani, 12 year old school girl

Message: Normalize menstruation

Goal: Gain Confidence

Color: Green/purple for common logos and phrases in

promotions

Phrase:

It’s Natural, It’s Normal, It’s You! You Can Stay in School, Every Week of Every Month

Media - Posters / Pamphlets

Discussion/education meetings to take place in schools/communities among adolescent girls following drama

Small media useful in disseminating information

Encourages peer education

Encourage community women/mothers to assist with groups, education and discussions

Poster (Example)

“Monthly bleeding is a natural body change for every school girl, even

me!”

You are like Masani!It’s Natural, It’s Normal, It’s You!

You Can Stay in School, Every Week of Every Month

Keeping Adolescent Girls in School –Every Week of Every Month

Pamphlet: Basic Discussion Card (Example)

The Female Reproductive System The Menstrual CycleAround the ages of 10-15, hormones begin to be released from different parts of the body to prepare a girl for pregnancy. Every month, the body will discard blood that will pass through the vagina. This is a completely natural body change for every school girl.

How long will it last?The menstrual cycle usually happensevery 28 days. The time that a girlwill experience bleeding will be fromabout 5-7 days. Usually, bleeding maybe more heavy in the first few days and then become lighter.

How to properly care for yourself

It is important to haverags or pads that youcan wear to collect theblood that will be passing.Try to wash these out a couple times a daywith soap. Also be sure to wash your body with soap. This will help to keep you healthy and reduce the odor from the blood.

It’s Natural, It’s Normal, It’s You!You Can Stay in School, Every Week of Every Month

Menstruation: A Natural Body Change For Every Girl

Keeping Adolescent Girls in School – Every Week of Every Month

Timeline – Year 1Activity Apr

2008

May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr 200

9

Establish advisory committee in FAWE

Advisory Committee mtgs

Identify needs/audience

Focus group mtgs toidentify constraints &opportunities

Determine campaign strategy &develop evaluation plan

Recruit women to participate with drama – development, acting

Develop drama for target audience

Create small media materials with assistance from native women

Test materials/drama onaudience – redesign

Contact schools/communities to schedule drama & discuss ways to distribute/hang signs/pamphlets

Perform dramas

Distribute materials/discussions

Monitor and evaluate

Timeline – Year 2Activity Apr

2009

May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr 201

0

Establish advisory committee in FAWE

Advisory Committee mtgs

Identify needs/audience

Focus group mtgs toidentify constraints &opportunities

Determine campaign strategy &develop evaluation plan

Recruit women to participate with drama – development, acting

Develop drama for target audience

Create small media materials with assistance from native women

Test materials/drama onaudience – redesign

Contact schools/communities to schedule drama & discuss ways to distribute/hang signs/pamphlets

Perform dramas

Distribute materials/discussions

Monitor and evaluate

Budget

Budget for Lead Organization (FAWE U)

Item Explanation CostOffice supplies for focus groups, mtgs, audience testing

Pens, paper, etc $500.00

Salaries 2 p/t staff over 2 year period $40,000.00

Material design for small media

Local or professional design of materials

$1,500.00

Printing of small media Posters / pamphlets / info cards $3,000.00

Writers for dramas Set against Masani’s story $1,000.00

Materials for dramas Costumes, set items $1,000.00

Drama groups Actresses, participation in development

$20,000.00

Transportation Between schools, communities $2,000.00

Evaluation Materials/people/items needed to monitor communication program

$5,000.00

Misc. $1,000.00

TOTAL COST OF PROGRAM $75,000.00

Evaluation of Campaign

Desired Initial ResultsAdolescent girls:I. Learn about the female reproductive system and

menstruationII. Learn appropriate methods to care for

themselves during menstruation

Primary Indicatorsi. Number of dramas givenii. Number of group discussionsiii. Number of adolescent girls attending

dramas/discussions

Evaluation of Campaign

Desired Intermediate ResultsI. Increase knowledge of menstruation by 60%II. Improve management of menstrual hygiene by

40% (skill development)III. 50% of girls discuss menstruation, needs with

another female (adjust attitudes, beliefs)

Primary Indicatorsi. % of girls demonstrating increase in knowledge

on surveyii. % of girls applying taught skills as stated in

survey

Evaluation of Campaign

Desired Sustainable ResultsI. Girls discuss with friends/family menstruation

and management of needsII. Decrease in drop-out, absentee rate among girls

Primary Indicatorsi. Shift in social norms re: menstruation and

management as determined by surveysii. Number of drop-outs, absences among girls

determined through school records

Lessons Learned

Audience segmentation is crucial, know your audience

Limiting communication to one key benefit, although it it tempting to list all of them!

Importance of testing messages to determine desired effect

Allowing the vision to be beyond the imagination, don’t limit your thinking to what “might” be possible based on resources available

Must sacrifice in order to focus the message

Use of behavior theories essential to communication strategy

Use of P-Process very helpful to systematically guide the campaign

Thank you!

It’s Natural, It’s Normal, It’s You!You Can Stay in School, Every Week of Every Month

Keeping Adolescent Girls in School – Every Week of Every Month