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• (Journal Article) Adolescent schoolgirls' experiences of menstrual cups and pads in rural western Kenya: a qualitative study

  01.01.2015
  Poor menstrual hygiene management (MHM) among schoolgirls in low income countries affects girls' dignity, self-esteem, and schooling. Hygienic, effective, and sustainable menstrual products are required. A randomized controlled feasibility study was conducted among 14-16-year-old girls, in 30 primary schools in rural western Kenya, to examine acceptability, use, and safety of menstrual cups or sanitary pads. Focus group discussions (FGDs) were conducted to evaluate girls' perceptions and experiences six months after product introduction. Narratives from 10 girls' and 6 parents’ FGDs were analysed thematically. Comparison, fear, and confidence were emergent themes. Initial use of cups was slow. Once comfortable, girls using cups or pads reported being free of embarrassing leakage, odour, and dislodged items compared with girls using traditional materials. School absenteeism and impaired concentration were only reported by girls using traditional materials. Girls using cups preferred them to pads. Advantages of cups and pads over traditional items provide optimism for MHM programmes

• (Journal Article) Putting the men into menstruation: the role of men and boys in community menstrual hygiene management

  01.01.2015
  This paper examines how men and boys have an essential role in effective menstrual hygiene programmes and describes an initiative to engage men and boys in Uttar Pradesh, India. Cultural norms around menstruation are rooted in gender inequality and compromise women's ability to manage menstruation hygienically and with dignity. While there has been significant progress in developing comprehensive approaches to menstrual hygiene management (MHM), the role of men and boys in supporting menstrual hygiene has been lacking. In India, WaterAid and Vatsalya have targeted men and boys to address this gap in a programme that started in December 2011. Groups of men and boys were established and sensitized. Male teachers and masons were also trained to provide MHM services in school. Regular monitoring of software and hardware components, focus group discussions with male and female community members, and analysis of attendance registers has been undertaken to assess the emerging outcomes of the programme. As a result of the initiative, men and boys have begun to talk about menstruation more freely and are better able to support the MHM needs of women and girls within the household, community, and school.

• (Journal Article) Developing games as a qualitative method for researching menstrual hygiene management in rural Bolivia

  01.01.2015
  The onset of menstruation has proven challenging for girls in school, with absenteeism, missed class time, reduced participation, teasing, fear, shame, and risky adaptive behaviours among the most commonly noted impacts in many settings. In 2012, Emory University and UNICEF conducted a multi-country formative study to gain a global perspective of girls' experiences. A compendium of tools was created to ensure investigation of common themes across all settings. This paper describes the process of adapting the focus group discussion (FGD) tool for Bolivia into a board game as a method to ease girls' discomfort discussing menstruation and elicit richer data. We describe the development of the menstrual hygiene management game, including structure and strategies for adapting FGD questions that increased interaction, stimulated detailed responses, and diversified participatory activities. A discussion of lessons learned will highlight elements of success and areas for improvement in future game adaptations. The paper discusses games as a research method for other topics and their applications for programme design, monitoring, and skills-based learning.

• (Journal Article) Learning, acting, and learning (LAL) research on schools' menstrual hygiene management (MHM): Pakistan

  01.01.2015
  UNICEF Pakistan adopted a conceptual framework for global qualitative research to advance their ongoing exploratory research work on menstrual hygiene management (MHM) in 2013-14. The findings of qualitative research informed the design of certain interventions in schools to improve MHM. These interventions were implemented as action research so that the benefits of these interventions can be studied. Qualitative research gave an in-depth understanding of girls' needs and their preferences to address MHM-related issues. Data analysis of qualitative research helped a team of sanitation practitioners and social scientists in understanding different factors influencing MHM in girls' schools. A few simple and focused interventions were hence designed and implemented. Six weeks after the implementation of hard and soft activities on the ground the results were studied. Results showed significant improvement in MHM conditions in girls' schools. Girls and teachers welcomed the initiatives and there were indicators for future sustainability. Areas of improvement were also noted by UNICEF before taking these interventions to scale. This research was documented as ‘learning, acting, and learning’ (LAL: literally meaning ‘Red’ in the local language, Urdu) research.

• (Journal Article) Unpacking the policy landscape for menstrual hygiene management: implications for school WASH programmes in India

  01.01.2015
  Menstrual hygiene management (MHM) relates to how girls and women manage their monthly period, and require access to information about menstruation, clean and safe menstrual absorbents, and amenities and facilities such as toilets and water, and waste management to maintain hygiene. In general MHM is poor in India, with low levels of knowledge and many misconceptions, varied use of menstrual absorbents, and unhygienic practices among adolescent girls. With almost 50 per cent of school age girls enrolled in schools, creating a conducive environment in schools to promote MHM is imperative. This policy scoping exercise examines how select policy initiatives implemented by the Government of India address MHM, especially in the context of schools. This document review found that adolescent girls are a focus of most policy initiatives addressing MHM, with a focus primarily on the hardware (i.e. infrastructure, sanitary napkins) or software (i.e. health education) components. Most programmes are implemented at the school level, though guidelines for implementation are not always explicit. Programmes suggest convergence with other government programmes, yet operationalization of convergence mechanisms is lacking.

• (Journal Article) Towards a sustainable solution for school menstrual hygiene management: cases of Ethiopia, Uganda, South-Sudan, Tanzania, and Zimbabwe

  01.01.2015
  African schoolgirls face considerable challenges as a result of the real biological phenomenon of menstruation and its management. Menstruation is seen as a secret and is regarded as taboo. As a result girls are not receiving adequate support from home, schools, or the community. They are left on their own to address the challenge which consequently affects their school performance. Development interventions that deal only with the supply of materials cannot resolve the problem in a sustainable manner. We need to have a comprehensive approach that can improve: knowledge, attitude, and practice of girls, parents, and the community; sanitary materials supply; the policy environment; and the physical infrastructure. The issue of menstrual hygiene management is gaining recognition as part of the development agenda for improving girls' school participation. But there is little research and few practical case studies have been conducted to inform policy and practice. SNV Netherlands Development Organization is addressing menstrual hygiene under its WASH in School programme in Asia, Africa, and Latin America. This article highlights baseline survey findings of the current menstrual hygiene management practices in the project areas of Ethiopia, South Sudan, Uganda, Tanzania, and Zimbabwe and recommends the approach piloted.

• (Journal Article) Uncovering the challenges to menstrual hygiene management in schools in Mali

  01.01.2015
  There is limited information on girls' menstrual hygiene practices and experiences at school in francophone sub-Saharan Africa. We conducted qualitative research to determine the challenges faced by school-aged girls in Mali, a culturally diverse and largely Muslim country. Research activities were conducted in eight urban and rural schools across the Sikasso and Koulikoro regions, including in-depth interviews with 26 girls and key informant interviews with 14 teachers and school directors. Results describe girls' practices for managing menstruation at school, their support systems and information channels, and their voiced recommendations for school WASH and education improvements.

• (Journal Article) Mainstreaming menstrual hygiene management in schools through the play-based approach: lessons learned from Ghana

  01.01.2015
  The study objective was to identify and document the effectiveness of the play-based approach in promoting menstrual hygiene management (MHM) in schools and share lessons learned. The study used a mix of study approaches including qualitative and quantitative techniques. The writer carried out an exploratory evaluation on the promotion of MHM activities as part of WASH in Schools programmes in 120 public schools in Ghana. Comparison was drawn between 60 schools currently using the play-based approach in promoting MHM, and 60 other schools which are not using the play-based approach. Data were gathered through interview, focus group discussions, observation, and from field level reports over a six month period. The study showed that there is much potential in play-based approaches, which could accelerate and sustain the implementation of MHM in schools. More teachers and school children participate in and demonstrated considerable knowledge and were confident discussing MHM. The play-based activities also served as point of attraction for the primary school children. The study indicated positive attitudes in boys towards menstruating girls and improved personal hygiene among adolescent girls.

• (Journal Article) Menstrual hygiene management: education and empowerment for girls?

  01.01.2015
  This paper discusses the recent attention of the water, sanitation, and hygiene (WASH) sector to resolving the menstrual hygiene crisis for young girls in developing countries. Menstrual hygiene management (MHM) interventions, including the use of sanitary pads, education, and awareness, and where possible separate, sanitary toilets, are identified to have far-reaching impacts on the education and empowerment of girls. Field research conducted in Ghana's Northern Region indicates a pronounced socialized, sexualized understanding and experience of menstruation among young girls and their families, school teachers, and local NGOs. Unfortunately WASH initiatives only allow interventions to manage menstrual hygiene, leaving the young girls and others in their social settings to deal with the larger subset of sexuality issues. We argue that opening the dominant discourse of a medicalized concept of menstruation to other meanings and experiences will have significant implications for the education and empowerment of young adolescent girls.

• (Journal Article) At the nexus of investment and development: lessons from a 60-year experiment in SME impact investing

  01.12.2014
  Mennonite Economic Development Associates (MEDA) was launched as an investment club in 1953 when a group of North American Mennonite business people joined together to support the development of communities in Paraguay, Uruguay, and Argentina. With their business background, this group of early ‘impact investors’ determined that they would provide loans to small to medium enterprises (SME) in order to catalyse sustainable economic growth. They offered the loans as high-risk venture capital and mitigated the risks with the provision of business coaching and technical assistance. Since those early days, MEDA and the SME investment fund managers which it has co-founded (Microvest and Sarona Asset Management) have continued to make impactful investments and to work towards a common development goal, ‘to help people help themselves’ (Fretz, 1978 : 19). This paper presents a case study of the 60-year ‘MEDA experiment’, (Fretz, 1978), describes specific activities and innovations, and identifies MEDA's learnings that have emerged from this SME investment experience.

• (Journal Article) New approaches to MSME lending: challenging traditional credit assessment models in electronic cash-flow environments

  01.09.2014
  Micro, small, and medium-sized enterprises (MSMEs) play a critical role in economic growth and wage employment in both developed and developing economies, yet significant obstacles remain in unlocking the potential of these businesses - especially as regards access to credit. A confluence of three new market trends is reshaping longstanding efforts to overcome this dilemma: 1) increasing access to real-time, 'electronically verifiable' cash-flows; 2) the mining of cash-flow data to reveal insights into repayment likelihood beyond that discoverable in traditional credit analysis; and 3) the adoption of financial technology and certain principles of microfinance lending - most specifically uncollateralized lending and frequent incremental repayment - to meet the funding needs of MSMEs. This paper explores the interrelationship of these trends and contends that, together, they enable suitably empowered financial institutions to originate and manage short-term, unsecured loans to formal MSMEs on a profitable and scalable basis.

• (Journal Article) How commercial banks can offer financial products to SMEs for investing in energy efficiency

  01.09.2014
  Energy consumption can account for up to 50 per cent of the total business costs for small and medium-sized enterprises (SMEs). Investments targeting energy savings provide a quick way for a small business to gain a cost advantage. Well-designed energy efficiency projects often show positive cash flows relatively quickly and allow for the projects themselves to pay back investments (and loans). Globally, there is a significant untapped potential to reduce energy costs. Demand-side market failures relate to lack of information. Supply-side market failures relate to limited access to finance for energy efficiency investments. Sustainable energy finance facilities (SEFFs) address this financing gap and provide access to technical advice for SMEs and banks. The success of SEFFs has demonstrated that commercial banks can bridge the sustainable energy financing gap by: 1) understanding the opportunity to improve their clients' cost structures using the right communication approach; 2) leveraging existing information from their own loan portfolio combined with publicly available information on the energy performance of technologies; 3) ensuring dedicated staff have project finance skills and that contracts are suitably tailored; 4) gaining access to energy expertise; and 5) having access to a list of high energy performance technologies.

• (Journal Article) Identification of the potential opportunities, barriers, and threats within the sector in taking up sanitation as a business: rural sanitation in Nkhata Bay District (Malawi)

  01.07.2014
  Private sector participation in sanitation marketing provides a great opportunity to improve rural sanitation access. Although a number of opportunities for private sector participation within the sanitation sector exist, there are numerous barriers and threats to taking up sanitation as a business. This Note from the Field identifies these opportunities, barriers, and threats in Nkhata Bay District, a rural area of Malawi. These insights emerge from a wider research project entitled ‘Private sector participation in the delivery of sanitation and hygiene services’. This note provides background information on the research project on private sector participation and the project location. It goes on to describe the data collection process and present two examples of business activities in the district sanitation sector, before listing the opportunities, barriers, and threats identified and the recommendations that emerge from them.

• (Journal Article) Building frontline market facilitators' capacity: the case of the ‘Integrating Very Poor Producers into Value Chains Field Guide’

  01.06.2014
  Utilizing the case of the Integrating Very Poor Producers into Value Chains Field Guide, the article provides its strengths (extensive tools and worksheets, case studies from recovery and development settings) and limitations (very brief overview of market systems, only focuses on the implementation phase of market development, only focuses on integrating the very poor into markets). The knowledge assessment results of two workshops lead the author to question how much is learned in workshop settings. The online survey showed that the most used section of the Field Guide was ‘Linking Very Poor Producers with Buyers & Suppliers’. The 70 per cent experiential, 20 per cent from others, and 10 per cent formal ratios regarding learning led the author to recommend more on-the-job learning. Extensive feedback from the users provided lessons on improved tool design and capacity building for tool users. The article concludes with a number of recommendations: frontline workers need written guides; translate guides; include a monitoring and evaluation system; get organizational commitment to build frontline market facilitators' capacity; more research into the different methods of building capacity (workshops; written guides; a monitoring and evaluation system; and online and in person training events are likely the most effective combination).

• (Journal Article) Roads for water: the unused potential

  01.04.2014
  Roads are generally perceived as infrastructure to deliver transport services, but they are more than that. They are major interventions in the hydrology of areas where they are constructed - concentrating runoff and altering subsurface flows. At present, water-related damage constitutes a major cost factor in road maintenance. Using ongoing research from Ethiopia, this article argues to reverse this and turn water from a foe into a friend and integrate water harvesting with road development. Optimized road designs are required - better planning of alignments, making use of road drainage, road surfaces, and river crossings, but also capturing freshly opened springs and systematically including developing storage and enhanced recharge facilities in road-building programmes. Equally important are inclusive planning processes that are sensitive to the multi-functionality of roads but also to the potentially uneven distribution of benefits and the diverse livelihood impacts. There is a need for closer integration of watershed and road-building programmes. With 5.5 million kilometres of roads in sub-Saharan Africa alone, and road building continuing to be one of the largest public investments, the potential of roads for water harvesting is great.

• (Journal Article) Value chain development for rural poverty reduction: A reality check and a warning

  01.03.2012
  Over the past decade, the value chain development approach has increasingly been adopted by governments, donors, and NGOs to reduce rural poverty. The design of related interventions often assumes that poor households: 1) have sufficient resources to effectively participate in value chain development; 2) do not face substantial trade-offs when using these resources; and 3) are able to assume higher risks when reinvesting capital and labour. However, insights from our own experiences and the literature show that these assumptions often do not reflect the realities and the needs of the poor. We argue that value chain development with poor and vulnerable populations, particularly in rural areas, requires additional conceptual frameworks, analyses, and interventions. In particular, we encourage donor agencies and development practitioners to adopt an asset-based approach to the design, implementation, and assessment of target value chains and to identify the non-market interventions needed for enabling particularly disenfranchised groups to meet the minimum asset thresholds for their successful participation in value chain initiatives.

• (Journal Article) Sustaining school hand washing and water treatment programmes: Lessons learned and to be learned

  01.10.2011
  In Nyanza Province, Kenya, a sustainability evaluation of 55 pilot primary schools 2.5 years after the implementation of the Safe Water System (SWS) intervention revealed that programme activities were not successfully sustained in any of the schools visited. The most common criterion met was drinking water provision. We identified six enabling environment domains: financial capacity; accountability; technical feasibility and availability; community support; school leadership and management; and student engagement. While these domains pertain to the sustaining of the SWS activities in schools, they are likely to be applicable in creating an enabling environment and serve as proxy indicators for other school water, sanitation, and hygiene initiatives as well.

• (Journal Article) Is soapy water a viable solution for handwashing in schools?

  01.10.2010
  Despite the known health benefits of washing hands with soap, global handwashing rates are low. In Nyanza Province, Kenya, a follow-up of 55 pilot primary schools three years after the implementation of a safe water and hygiene intervention revealed that only 2 per cent (one school) provided soap for handwashing on the day of the assessment. After identifying barriers to soap provision, SWASH+ partners piloted a handwashing intervention using powdered soap mixed with water to create soapy water in place of bar soap in 11 schools. The first six months of unannounced visits showed high uptake (10 schools). A one-year follow-up visit revealed a decrease of soapy water use (four schools). This paper discusses the soapy water intervention, initial and follow-up monitoring findings, potential sustainability drivers of handwashing programmes in rural primary schools and next steps.