Heart Friends, Pad Boxes, and 'Bread': The social ecology of girls' menstruation in two Nairobi slums 公开

Abstract

There is a great deal of research on menstrual hygiene in Kenya, compared to other countries in Sub-Saharan Africa. However, very little research has been conducted on menstrual hygiene in urban slums. The Kenyan government created a new policy providing menstrual pads to public schools in low resource areas, but few studies document the difference between girls' experience of menstruation at public schools with government pad provision compared to private schools without it. We conducted qualitative research with girls and teachers in two Nairobi slums to understand the factors influencing girls' experience of menstruation at school. We found that public schools had more WASH facilities available, but access was not equitable across the student body. Individual, social, physical, and societal factors influenced girls' ability to manage their menstruation at school. Key findings included that Muslim students practicing ablution were unable to use certain toilets at both public and private schools, and teachers used language that encouraged gender inequality for girls. Targeted data collection focusing on specific segments of school populations that may be neglected is necessary to create a complete depiction of access. Furthermore, implementers must devise new programs incorporating menarche into sexual and reproductive health curricula encouraging gender equity.

Table of Contents

Chapter 1: Introduction 1

Problem Statement 2

Research Objective 2

Purpose and Significance Statement 3

Chapter 2: Literature Review 4

Importance of Adolescence 4

School Settings and Gender 5

Menstrual Hygiene Challenges 7

Menstrual Hygiene and Religion 12

Menstrual Hygiene in Slums 12

Menstrual Hygiene in Kenya 13

WASH and Education in Nairobi Slums 16

Menstrual Hygiene in Nairobi Slums 18

Conclusion 18

Chapter 3: Manuscript 20

Contribution of Student 21

Abstract 22

Introduction 23

Methods 26

Study Setting 26

School Selection 27

Research activities 28

Data Collection and preparation 30

Analysis 31

Ethics 31

Results 32

Socio-ecological Model for Girls Experience of Menstruation at School 34

Individual Factors 35

Social Environment 39

Physical Environment 42

Societal Factors 44

Chapter 4: Conclusion and Recommendations 56

Appendices 68

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Education, Health Environmental Health
关键词	Menstruation Adolescence Puberty Sanitation Kenya Rape Reproductive Health Sexuality
Committee Chair / Thesis Advisor	Freeman, Matthew, Emory University
Committee Members	Caruso, Bethany, Emory University Andes, Karen, Emory University Ellis, Anna Sofia Swanson, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs International Non-governmental organization (e.g., CARE, Inc.)

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