Building a sustainable model to promote menstrual, sexual and reproductive health (MSRH) amongst secondary school girls in Tanzania
Lead Research Organisation:
Mwanza Intervention Trials Unit
Department Name: UNLISTED
Abstract
A girl's education impacts her health, the health of her future family, and her future economic potential. The growing evidence of this positive association has strengthened international resolve to improve educational opportunities for adolescent girls. Evidence from East and Southern Africa has shown that girls' participation in schools is severely hampered by menstrual, sexual, and reproductive health (MSRH) issues. In particular, young girls lack the knowledge, menstrual management products, water and sanitation facilities in schools, and social support to manage their menses. Pervasive bullying by male students and staff adds to the high levels of shame and anxiety surrounding menstruation, and encourages girls to exclude themselves from school activities. Furthermore a 2017 Human Rights watch report stated that more than 8,000 girls in Tanzania are expelled from school each year due to pregnancy.
The long-term aim of this research project is to improve health and development outcomes among girls in Tanzania and beyond by developing a sustainable and scaleable intervention to improve girls' health and wellbeing. The aims of this project directly relate to the majority of Sustainable Development Goals including: number 1 (end poverty), 3 (good health and wellbeing), 4 (quality education), 5 (gender equality), 6 (clean water and sanitation), 10 (reduced inequalities) 11 (sustainable cities and communities), 13 (climate action), 16 (peace, justice, and strong institutions) and 17 (partnerships for the goals).
The project is a partnership between two leading research institutes (one in the UK and one in Tanzania), a Tanzanian-based international NGO, and the local government authorities within two northern regions of Tanzania.
The overall aim is to develop a scaleable comprehensive MSRH intervention within Tanzanian government structures to improve MSRH practices and perceptions and the overall school climate to ensure the psychosocial wellbeing and optimal school participation and performance of secondary school girls.
This will be achieved through 3 specific objectives:
1) To refine an existing NGO-led MSRH programme to better engage local governments, and enhance the school component through the engagement of boys, refinement of the pain management activities, and inclusion of water and sanitation facility improvement activities.
2) To work with government and schools to develop mechanisms to integrate the MSRH intervention within government schools.
3) To pilot the refined MSRH intervention to assess (a) feasibility (including cost per student, school and district), sustainability and acceptability and (b) effect on MSRH practice and perceptions and the overall school climate.
Our research project will directly benefit (i) Tanzanian adolescent girls and boys and their communities; (ii) teachers and school officials and (iii) local and national government. Our project will advance empirical knowledge and further develop theoretical dispositions on how holistic and embedded menstrual, sexual and reproductive health projects can impact on a girl's development. These findings will be beneficial to (iv) policy makers, (v) researchers and (vi) international/implementing organisations.
The long-term aim of this research project is to improve health and development outcomes among girls in Tanzania and beyond by developing a sustainable and scaleable intervention to improve girls' health and wellbeing. The aims of this project directly relate to the majority of Sustainable Development Goals including: number 1 (end poverty), 3 (good health and wellbeing), 4 (quality education), 5 (gender equality), 6 (clean water and sanitation), 10 (reduced inequalities) 11 (sustainable cities and communities), 13 (climate action), 16 (peace, justice, and strong institutions) and 17 (partnerships for the goals).
The project is a partnership between two leading research institutes (one in the UK and one in Tanzania), a Tanzanian-based international NGO, and the local government authorities within two northern regions of Tanzania.
The overall aim is to develop a scaleable comprehensive MSRH intervention within Tanzanian government structures to improve MSRH practices and perceptions and the overall school climate to ensure the psychosocial wellbeing and optimal school participation and performance of secondary school girls.
This will be achieved through 3 specific objectives:
1) To refine an existing NGO-led MSRH programme to better engage local governments, and enhance the school component through the engagement of boys, refinement of the pain management activities, and inclusion of water and sanitation facility improvement activities.
2) To work with government and schools to develop mechanisms to integrate the MSRH intervention within government schools.
3) To pilot the refined MSRH intervention to assess (a) feasibility (including cost per student, school and district), sustainability and acceptability and (b) effect on MSRH practice and perceptions and the overall school climate.
Our research project will directly benefit (i) Tanzanian adolescent girls and boys and their communities; (ii) teachers and school officials and (iii) local and national government. Our project will advance empirical knowledge and further develop theoretical dispositions on how holistic and embedded menstrual, sexual and reproductive health projects can impact on a girl's development. These findings will be beneficial to (iv) policy makers, (v) researchers and (vi) international/implementing organisations.
Technical Summary
The project addresses a critical evidence gap in how to comprehensively address menstrual, sexual, and reproductive health (MSRH) challenges of adolescent girls in Tanzania.
Poor MSRH is associated with subsequent psychosocial (high levels of shame, depression, anxiety) and physical (pain, increased risk of reproductive and urinary tract infections) ill health, and poor school outcomes (including poor performance, participation, and completion). Our Theory of Change builds on a model which was developed after a qualitative metasynthesis of 76 studies and over 6,000 women and girls. The model shows how the social and cultural context underpin social support, behavioural expectations, knowledge, and the physical and economic environment that affect elements of girls' menstrual experience, including practices and perceptions, confidence to participate, and menstrual-anxiety, all ultimately impacting on girls' mental and physical health and education.
The project will be conducted in four phases. An initial inception phase (Phase 1) will be followed by a formative phase (Phase 2) to iteratively refine an existing MSRH intervention and collaboratively design strategies to embed the intervention into government structures thereby promoting scaleability. In Phase 3 we will pilot and evaluate the refined intervention and implementation strategies using a before-after mixed methods design to assess (a) feasibility (including cost per student, school and district), sustainability, and acceptability and (b) effect on MSRH practice and perceptions and the overall school climate. In the final phase (Phase 4) we will collaboratively synthesise the research findings. Our phased project approach will enable us to develop a scaleable MSRH intervention that fits within Tanzanian government structures to improve MSRH practices and perceptions and the school climate to ensure the psychosocial wellbeing and optimal school participation and performance of secondary school girls.
Poor MSRH is associated with subsequent psychosocial (high levels of shame, depression, anxiety) and physical (pain, increased risk of reproductive and urinary tract infections) ill health, and poor school outcomes (including poor performance, participation, and completion). Our Theory of Change builds on a model which was developed after a qualitative metasynthesis of 76 studies and over 6,000 women and girls. The model shows how the social and cultural context underpin social support, behavioural expectations, knowledge, and the physical and economic environment that affect elements of girls' menstrual experience, including practices and perceptions, confidence to participate, and menstrual-anxiety, all ultimately impacting on girls' mental and physical health and education.
The project will be conducted in four phases. An initial inception phase (Phase 1) will be followed by a formative phase (Phase 2) to iteratively refine an existing MSRH intervention and collaboratively design strategies to embed the intervention into government structures thereby promoting scaleability. In Phase 3 we will pilot and evaluate the refined intervention and implementation strategies using a before-after mixed methods design to assess (a) feasibility (including cost per student, school and district), sustainability, and acceptability and (b) effect on MSRH practice and perceptions and the overall school climate. In the final phase (Phase 4) we will collaboratively synthesise the research findings. Our phased project approach will enable us to develop a scaleable MSRH intervention that fits within Tanzanian government structures to improve MSRH practices and perceptions and the school climate to ensure the psychosocial wellbeing and optimal school participation and performance of secondary school girls.
Planned Impact
A girl's education impacts her health, the health of her future family, and her future economic potential. The growing evidence of this positive association has strengthened international resolve to improve educational opportunities for adolescent girls. However, the physical and social environment of many schools across sub Saharan Africa can prohibit a girl reaching her potential. Young girls are ill-equipped and poorly supported to manage their menses. Poor menstrual health is associated with high levels of shame, depression and anxiety, pain, increased risk of reproductive and urinary tract infections and poor participation in school. The way in which our project proposes to improve the menstrual, sexual and reproductive health (MSRH) of girls will contribute to the achievement of the majority of the Sustainable Development Goals including: number 1 (end poverty), 3 (good health and wellbeing), 4 (quality education), 5 (gender equality), 6 (clean water and sanitation), 10 (reduced inequalities) 11 (sustainable cities and communities), 13 (climate action), 16 (peace, justice and strong institutions) and 17 (partnerships for the goals). Our proposed study leverages an opportunity for two well-established partners to team up with the local government authorities and a passionate, evidence-based non-government organisation in Tanzania to effect change in the MSRH of secondary school girls.
The results of this study are expected to have multiple impacts. The study will be the first in Tanzania to respond to the demands and interests of policy makers as well as other researchers for the production of rigorous evidence using well-designed and validated tools. It will also respond to calls for empirical data to capture the real costs of implementing in-school interventions by child, school, district and beyond. These results will also be of interest to policy makers in other African countries as they refine and update their guidelines and recommendations as to how to provide adequate support and health-related education to girls and boys in schools.
Our study will not only focus on the outcome of the intervention, but also on the processes required to implement to scale. The research questions will directly address current policy and implementation gaps in Tanzania and across the region regarding the process to scale up effective MSRH intervention in schools. The objectives build on a compendium of team experience of developing and testing context-sensitive and scaleable interventions.
The UK government recently pledged its support to end period poverty by 2030. Through our media strategy and close collaborations with the Cup Foundation we will support and drive efforts to raise awareness of the needs of girls all around the world, including the UK, thereby further supporting the UK and its development goals and leveraging multiple channels to increase the attention on MSRH challenges amongst international donors.
Ultimately, the results are expected to improve the health, well-being, and future opportunities of adolescent school girls through the combination of comprehensive MSRH education and kits that include a reusable product of their choice. The project will effect a positive change in the school climate through improved school water and sanitation facilities and by addressing pervasive bullying most often perpetrated by boys and school staff.
The research will provide an excellent opportunity for the capacity development of African researchers. Alongside propelling the promising trajectory of the African, female principal investigator, the project will also develop needed skills in under-represented research disciplines in Tanzania, such as health economics and implementation research. The project will also open up channels for further study for talented and driven African junior scientists, thereby strengthening the pipeline for African research leadership.
The results of this study are expected to have multiple impacts. The study will be the first in Tanzania to respond to the demands and interests of policy makers as well as other researchers for the production of rigorous evidence using well-designed and validated tools. It will also respond to calls for empirical data to capture the real costs of implementing in-school interventions by child, school, district and beyond. These results will also be of interest to policy makers in other African countries as they refine and update their guidelines and recommendations as to how to provide adequate support and health-related education to girls and boys in schools.
Our study will not only focus on the outcome of the intervention, but also on the processes required to implement to scale. The research questions will directly address current policy and implementation gaps in Tanzania and across the region regarding the process to scale up effective MSRH intervention in schools. The objectives build on a compendium of team experience of developing and testing context-sensitive and scaleable interventions.
The UK government recently pledged its support to end period poverty by 2030. Through our media strategy and close collaborations with the Cup Foundation we will support and drive efforts to raise awareness of the needs of girls all around the world, including the UK, thereby further supporting the UK and its development goals and leveraging multiple channels to increase the attention on MSRH challenges amongst international donors.
Ultimately, the results are expected to improve the health, well-being, and future opportunities of adolescent school girls through the combination of comprehensive MSRH education and kits that include a reusable product of their choice. The project will effect a positive change in the school climate through improved school water and sanitation facilities and by addressing pervasive bullying most often perpetrated by boys and school staff.
The research will provide an excellent opportunity for the capacity development of African researchers. Alongside propelling the promising trajectory of the African, female principal investigator, the project will also develop needed skills in under-represented research disciplines in Tanzania, such as health economics and implementation research. The project will also open up channels for further study for talented and driven African junior scientists, thereby strengthening the pipeline for African research leadership.
Organisations
- Mwanza Intervention Trials Unit (Lead Research Organisation)
- Department of Health and Social Care (Co-funder)
- National Institute for Medical Research, Tanzania (Collaboration)
- Liverpool School of Tropical Medicine (Collaboration)
- Kilimanjaro Christian Medical Centre (KCMS) (Collaboration)
- Kilimanjaro Clinical Research Institute (Collaboration)
Publications
Nakamanya S
(2022)
Social networks, mobility, and HIV risk among women in the fishing communities of Lake Victoria.
in BMC women's health
Sedekia Y
(2022)
Does a school-based intervention to engage parents change opportunity for handwashing with soap at home? Practical experience from the Mikono Safi trial in Northwestern Tanzania
in PLOS Neglected Tropical Diseases
Description | Beginning of dialogue to improve access to painkillers and menstrual product for school girls |
Geographic Reach | National |
Policy Influence Type | Implementation circular/rapid advice/letter to e.g. Ministry of Health |
Description | GRASP Network - Adolescent mental health |
Organisation | Kilimanjaro Christian Medical Centre (KCMS) |
Country | Tanzania, United Republic of |
Sector | Hospitals |
PI Contribution | Establishment of the network, scoping exercise of all adolescent mental health research programmes and implementation programmes in the country. Establishment of close connections with Ministry of health officials and UN agencies. Development of a protocol paper. Submission of an NIHR grant application. Identification and support of early career researchers. |
Collaborator Contribution | Establishment of the network, scoping exercise of all adolescent mental health research programmes and implementation programmes in the country. Establishment of close connections with Ministry of health officials and UN agencies. Development of a protocol paper. Submission of an NIHR grant application. |
Impact | 1. Protocol paper submitted to BMJ Open 2. Scoping questionnaire developed and implemented nationally 3. Abstracts submitted to local and regional conferences |
Start Year | 2020 |
Description | GRASP Network - Adolescent mental health |
Organisation | Kilimanjaro Clinical Research Institute |
Country | Tanzania, United Republic of |
Sector | Academic/University |
PI Contribution | Establishment of the network, scoping exercise of all adolescent mental health research programmes and implementation programmes in the country. Establishment of close connections with Ministry of health officials and UN agencies. Development of a protocol paper. Submission of an NIHR grant application. Identification and support of early career researchers. |
Collaborator Contribution | Establishment of the network, scoping exercise of all adolescent mental health research programmes and implementation programmes in the country. Establishment of close connections with Ministry of health officials and UN agencies. Development of a protocol paper. Submission of an NIHR grant application. |
Impact | 1. Protocol paper submitted to BMJ Open 2. Scoping questionnaire developed and implemented nationally 3. Abstracts submitted to local and regional conferences |
Start Year | 2020 |
Description | GRASP Network - Adolescent mental health |
Organisation | Liverpool School of Tropical Medicine |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Establishment of the network, scoping exercise of all adolescent mental health research programmes and implementation programmes in the country. Establishment of close connections with Ministry of health officials and UN agencies. Development of a protocol paper. Submission of an NIHR grant application. Identification and support of early career researchers. |
Collaborator Contribution | Establishment of the network, scoping exercise of all adolescent mental health research programmes and implementation programmes in the country. Establishment of close connections with Ministry of health officials and UN agencies. Development of a protocol paper. Submission of an NIHR grant application. |
Impact | 1. Protocol paper submitted to BMJ Open 2. Scoping questionnaire developed and implemented nationally 3. Abstracts submitted to local and regional conferences |
Start Year | 2020 |
Description | GRASP Network - Adolescent mental health |
Organisation | National Institute for Medical Research, Tanzania |
Country | Tanzania, United Republic of |
Sector | Public |
PI Contribution | Establishment of the network, scoping exercise of all adolescent mental health research programmes and implementation programmes in the country. Establishment of close connections with Ministry of health officials and UN agencies. Development of a protocol paper. Submission of an NIHR grant application. Identification and support of early career researchers. |
Collaborator Contribution | Establishment of the network, scoping exercise of all adolescent mental health research programmes and implementation programmes in the country. Establishment of close connections with Ministry of health officials and UN agencies. Development of a protocol paper. Submission of an NIHR grant application. |
Impact | 1. Protocol paper submitted to BMJ Open 2. Scoping questionnaire developed and implemented nationally 3. Abstracts submitted to local and regional conferences |
Start Year | 2020 |
Description | A Poster presentation at the University of North Carolina, Chapel Hill at the Water and Health Conference, an annual conference that provides a curated space where policymakers, practitioners, and researchers gather to review the evidence, interrogate the science, improve old and develop new approaches to address water-related public health issues |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | This was a poster presentation of baseline results from the PASS MHW (MSRH) project. The poster titled: Menstrual-related drivers of sub-optimal school attendance and participation among adolescent girls in NW Tanzania, focused on highlighting menstrual related drivers of sub optimal school participation. About 100 to 150 people had opportunity to view the poster and engage in discussion. |
Year(s) Of Engagement Activity | 2023 |
URL | https://waterinstitute.unc.edu/event/2023 |
Description | Analgesic distribution round 2 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | We returned to each PASS study school for a second round of distribution of analgesics, combined with a check-in with students and staff, and further engagement. |
Year(s) Of Engagement Activity | 2023 |
Description | Community event in Mawala village |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Public/other audiences |
Results and Impact | Community outreach and workshop event to engage, discuss menstruation, reusable products, and PASS dissemination |
Year(s) Of Engagement Activity | 2023 |
Description | Community outreach event in Mikocheni A village |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Public/other audiences |
Results and Impact | Community workshop and outreach event to discuss menstruation, available resources such as reusable products, and disseminate PASS results |
Year(s) Of Engagement Activity | 2023 |
Description | Cup Coalition Webinar |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Research Director Jen Rubli presented on applying research tools to organisational and programme monitoring, evaluation, and learning, using PASS as an example of using and adapting tools. |
Year(s) Of Engagement Activity | 2023 |
Description | During the Tanzania Menstrual Health and Hygiene Day on May 28th, 2023 in Dodoma, we made a short presentation to share lessons learned from the PASS (MSRH) baseline Study focusing on school girls' menstruation experiences including high prevalence menstrual pain, limited access to painkillers and menstrual products and how these acted as barriers to girls' school attendance and participation |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | The presentation was made to participants on MHH Day, which included key stakeholders, students and government representative including the Deputy Minister of health. As a results of this presentation, the Deputy Ministry promised to start dialogue with regional and district health offices to ensure that school girls have access to pain killers during mensturation while in school; He also form a special committee lead by the ministry oft Health to spearhead mobilization of pads for distribution to school girls in marginalized communities, this started the campain termed "My Pad My Health" |
Year(s) Of Engagement Activity | 2023 |
Description | Education session with masters of public health students |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Postgraduate students |
Results and Impact | The students from the Kilimanjaro Christian Medical University college were all enrolled on the Masters in Public Health. Half were medical doctors. In the session we discussed the broad spectrum of issues and impacts related to menstrual health and hygiene. The students were engaged and readily linked the lessons to their own activities and how they work with women and girls who menstruate. Two of them were keen to pursue their research in this field. |
Year(s) Of Engagement Activity | 2021 |
Description | Expert panelist on webinar discussing enabling environment for SMOs in Canada |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Research director Jen Rubli served as an expert during the dissemination webinar of a CanWaCH-funded study on enabling environments for SMOs in Canada, focussing on international cooperation. PASS was discussed as an example of enabling or inhibiting environment. |
Year(s) Of Engagement Activity | 2023 |
Description | Exploring ways to improve MSRH knowledge, school climate, and access to menstrual products for improved school participation among adolescent girls in secondary schools: an overview of the PASS project in Tanzania. Presentation made as part of Bergen Exchange 2022 menstrual health discussion |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Presentation allowed to share the work we are doing in Tanzania to inform discussion that was exploring potential areas of research collaborations with colleagues from University of Bergen |
Year(s) Of Engagement Activity | 2022 |
Description | Femme Menstrual Health Day Webinar |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | To advocate for improved menstrual health for all. Each year on menstrual health day, Femme international share a webinar to discuss their programme, and more importantly discuss the broader issues relating to MH. The aim is to increase the momentum to enable all menstruators to realise their menstrual health and SRH rights. Femme also strongly promotes reusable menstrual products with the aim to promote environmental sustainability. |
Year(s) Of Engagement Activity | 2021 |
Description | Formal Stakeholders engagement meetings with the regional and district leaders |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | As part of the engagement activities we held a series of workshops with Regional and District policy implementers as well as School administrators to introduce project activities and seek collaboration from various stakeholders. We got commitment to collaboration and feedback on how to further refine intervention components. |
Year(s) Of Engagement Activity | 2021 |
Description | Formative activities in Kilimanjaro and Mwanza |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Study participants or study members |
Results and Impact | Six secondary schools (4 in Kilimanjaro region and 2 in Mwanza) were involved in the activity. The participants in this activity included 6 school administrators, 55 teachers and 96 students (boys and girls). To get feedback about the intervention and assess MSHR needs in schools, we conducted 12 group discussion with students and 16 in-depth interviews and 2 group meetings with teachers to explore perceived impacts of the intervention and understand what worked well and what did not and document MSRH needs. We are used this information to refine the MSRH intervention. |
Year(s) Of Engagement Activity | 2021 |
Description | Heels4Pads Livestream Interview |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Director Sia Towo and Research Director Jen Rubli were interviewed in a one-hour livestream on Instagram. Partnering with Heels4Pads, we discussed menstruation, addressing menstruation in East Africa, and successes of PASS-MHW. |
Year(s) Of Engagement Activity | 2023 |
Description | Implementation progress and preliminary results from the baseline of the MSRH project: A presentation made to the Mwanza Intervention Trials unit Board of management meeting. |
Form Of Engagement Activity | Participation in an open day or visit at my research institution |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Baseline data showing high level of menstrual related pain and its impact on girls school participation generated desired discussion for unit to prioritized menstrual health research |
Year(s) Of Engagement Activity | 2022 |
Description | Improving access to menstrual products and pain management among school girls in Tanzania. A presentation made at the LSHTM's menstrual health Day event in May 2022 |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Was an online event attended by an array of stakeholders, supporting further discussion on menstrual health issues and its impact on health, school, work and quality of life of people who menstruate |
Year(s) Of Engagement Activity | 2022 |
Description | Initial engagement meeting with Regional and District leaders |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Policymakers/politicians |
Results and Impact | We conducted a series of meetings with regional and district leaders, including Regional Administrative Secretary, Regional Medical Officer, Regional Education Officer, Regional Coordinator for adolescent, Maternal and Child Health, District Executive Directors, District Education Officers, District Medical Officers. The purpose of these meetings were to introduce the project and buy in, seek permission from local government authorities to conduct project activities and identify independent steering committee member for the study. From these meetings we secured commitment for collaborations, including commitment from the Regional Coordinator for adolescent, Maternal and Child Health to be part of the steering committee. We also received permission letter to conduct the study in Mwanza region from the Regional Administrative Secretary and introduction letters from the District Executive Directors. |
Year(s) Of Engagement Activity | 2021 |
Description | International Day of the Girl Child - Nyamagana District, Mwanza |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Policymakers/politicians |
Results and Impact | Along with local and municipal government, schools, and other NGOs, Femme International contributed to the planning and participated in the event commemorating International Day of the Girl Child, raising awareness and advocating for gender equality and girls' rights. |
Year(s) Of Engagement Activity | 2022 |
Description | International Women's Day Celebration with WHO Africa |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Industry/Business |
Results and Impact | Winners of the 2019 Top 30 Health Innovators were asked to present an update on their work in advancing healthcare - I presented an update on Femme's work including the PASS project. |
Year(s) Of Engagement Activity | 2022 |
Description | Interviews with Twaweza intervention implementors |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Study participants or study members |
Results and Impact | As part of MSRH project formative study intended to refine MSRH intervention we conducted interviews with 5 (4 female and 1 male) Femme staff who implemented the original MSRH intervention. The purpose of this engagement activity was to explore their experience in facilitating school based Menstrual sexual and reproductive health education activities. During these interviews we were able to identify gaps in the current MSRH intervention, document lessons learnt which we used in the intervention refinement process. |
Year(s) Of Engagement Activity | 2021 |
Description | LSHTM school based intervention workshop presentation |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | The purpose was to present different school based interventions in order to understand points of synergy, identify and solve common challenges and strategies on the way forward for school based programming. We presented the PASS project in a number of these workshops and shared our rationale for working in a public private partnership to deliver interventions in schools and also our evaluation design. We believe that we created awareness over the challenges of expecting teachers to implement and engage with students on sensitive topics. |
Year(s) Of Engagement Activity | 2021 |
Description | MH Day 2023 Week Event |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | Awareness and educational activities around MH Day, including menstruation, addressing menstruation, seeking care, access to resources, and furthering partnerships. |
Year(s) Of Engagement Activity | 2023 |
Description | MHM Workshop at Kiusa Secondary School, Moshi |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | In partnership with medical students at Kilimanjaro Christian Medical College, in Moshi, the Femme team ran our Twaweza 2.0 programme for students at Kiusa Secondary School. The medical students assisted in responding to questions regarding potential diagnosis of menstrual-related disorders. One medical student demonstrated yoga poses that can help to relieve menstrual pain. |
Year(s) Of Engagement Activity | 2022 |
Description | Meeting with menstrual product provider ( AFRIpads) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Supporters |
Results and Impact | Provision of menstrual products to students participating in the study is one of the five components of the refined MSRH intervention. As part of this component the project will be providing the students with the kit containing reusable menstrual products. We held a meeting with AFRIpads leadership to discuss possibility and modality of accessing AFRIpads re usable pads. The meeting was attended by the project PIs and two senior representative from AFRIpads. As a result of this meeting AFRIpads committed to donate up to 1000 packets of re usable pads. |
Year(s) Of Engagement Activity | 2021 |
Description | Menstrual Equity Webinar |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Menstrual Equity Webinar: How the MHM Conversation is Evolving Presentation focussed on evolution of the menstrual sector and the role of research. PASS was used as a practical example of a research project centred on an NGO intervention, making it more realistic to implement, fund, and scale, and for other similar actors to implement. |
Year(s) Of Engagement Activity | 2021 |
Description | Menstrual Health Day with LSHTM Insta-live |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Postgraduate students |
Results and Impact | Femme presented and was available for questions related to menstrual health programming in Tanzania and Kenya. |
Year(s) Of Engagement Activity | 2021 |
Description | Menstrual Health day in Moshi |
Form Of Engagement Activity | Participation in an open day or visit at my research institution |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | Femme, in partnership with KCMUCo medical students hosted a full day of menstrual health related activities. The teachers realised the importance of partnering with outside facilitators to really enable the school children to feel free to ask questions and learn. Myths and misconceptions were discussed and addressed. |
Year(s) Of Engagement Activity | 2021 |
Description | Mwanza region SRMH partners meeting |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Meeting with all the sexual and reproductive health players in the region of Mwanza. This allowed us to talk about the the PASS project and to garner inputs as to the most pressing SRH needs within the community and region more broadly. The event sparked interest in the project and was an important engagement activity. |
Year(s) Of Engagement Activity | 2010,2021 |
Description | National Dissemination Meeting on Research Study in Understanding Menstrual Hygiene Management Situation Facing School Girls in Tanzania |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | This was a National Dissemination Meeting to share findings of a research undertaken by the Tanzania National Institute for Medical Research (NIMR) funded by UNICEF to Understand Menstrual Hygiene Management Situation Facing School Girls in Tanzania. The meeting brought together about 100 people including policy makers -- Ministers and senior officials from the Ministries of Health and Education and other key stakeholders in Menstrual health and hygiene. The meeting generated questions and allowed stakeholders to discuss how to prioritize school menstrual health and hygiene in order to improve girls school attendance and participation. |
Year(s) Of Engagement Activity | 2022 |
Description | Oral presentation at the East and Southern Africa Regional Symposium on Improving Menstrual Health May 2023, a virtual event was organized by the Africa Coalition on Menstrual Health (ACMH) with support from UNFPA, the United Nations sexual and reproductive health agency |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | The symposium brought together more than 500 participants from UN agencies, governments, development partners, and youth networks across Africa to discuss the latest challenges and opportunities in menstrual health. The participation in the conference allowed us to showcase how the PASS (MSRH) project has contributed to the knowledge base, and available tools and resources for menstrual health for menstrual health research in Tanzania |
Year(s) Of Engagement Activity | 2023 |
URL | https://menstrualhygieneday.org/events-3/eventslist/page/24 |
Description | Parent Meeting - Nkolati Secondary School |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Public/other audiences |
Results and Impact | Pre-workshop meeting with parents and caregivers. The aim is to inform them what will be taught, raise awareness of MSRH and resultant issues, discuss how they contribute to creating a more supportive environment for menstruating girls, and provide a forum to discuss issues. Typically the most time is spent on pain management, avoiding unwanted pregnancy, and menstrual cups. Parents and caregivers become much more aware of issues surrounding MH. We are able to tackle myths and misconceptions around virginity and the hymen, using pharmaceutical analgesics for menstrual pain management, and general restrictions or beliefs around menstruation. Once introduced to menstrual cups, both men and women tend to become excited at the many advantages, as well as willing to allow girls to use it. |
Year(s) Of Engagement Activity | 2022 |
Description | Parent meetings |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | As part stakeholders engagement, we held 4 parents meetings in the four study schools to introduce the school based MSRH intervention activities, get buy in from the parents and obtain general permission to involve students in the intervention. During these meetings we also discussed the contents of the MSRH curriculum for students and received feedback on the curriculum content. |
Year(s) Of Engagement Activity | 2022 |
Description | Partnership discussion with Australian Volunteers Tanzania Office |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Industry/Business |
Results and Impact | We have a partnership with Australian Volunteers, where we get professional volunteers, access to funding, platforms for dissemination. |
Year(s) Of Engagement Activity | 2022 |
Description | Presentation of Evaluation Methodologies at the First Monitoring and Evaluation Week in Tanzania, hosted by Tanzania Monitoring and Evaluation Association |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | PASS Project Manager Gladness Kampa presented a paper on integrating MEAL into programme activities. The presentation also served to raise national awareness of PASS-MHW. |
Year(s) Of Engagement Activity | 2022 |
Description | Social Media Posts - Instagram & Facebook |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Social media posts documenting PASS-MHW activities, participants' stories and experiences, and some of the impacts they experienced. Posts included photos, videos, and reels. Femme International has over 3,000 followers, and posts generally received at least 50 likes as well as comments and re-shares. |
Year(s) Of Engagement Activity | 2021,2022,2023 |
Description | Social media |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Social media posts on our activities, outcomes, important days, etc over the course of the year. |
Year(s) Of Engagement Activity | 2022,2023 |
Description | Stakeholders' workshops to disseminate and discuss findings from the PASS pilot project in district and school stakeholders |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Study participants or study members |
Results and Impact | We conducted several stakholder engagement meetings to share key results from the PASS (MSRH) project with teachers/school management committess, regional and district policy makers and implementers |
Year(s) Of Engagement Activity | 2023 |
Description | Tanzania Annual Environmental Health and Sanitation Conference |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Gladness Kampa, on behalf of Femme International and PASS-MHW presented our policy brief titled 'Double Duty: WASH Improvements for Menstrual Health and COVID-19 Prevention in Secondary Schools in Tanzania.' Based on formative findings, the policy brief outlines how specifically simple handwashing stations (two buckets, soap), of the type that are everywhere since COVID-19, will be installed in schools as needed in order to both enable girls to wash their hands with soap before and after using WASH facilities for menstrual management, and to promote hand-washing behaviours in schools in general. The policy brief was presented at Tanzania's annual WASH and sanitation conference in Dodoma, in 2021. It is attended by government officials at different levels, large NGOs such as UNICEF, smaller NGOs, and funders. Many questions about menstrual cups, a component of the intervention. |
Year(s) Of Engagement Activity | 2021 |
Description | Tanzania National Institute for Medical Research 31st Annual Joint Scientific conference, 17-19th May 2022 where two junior members of the project made oral presentations from the formative findings. The two presentations were: 1. Perceived impact of TWAWEZA, a menstrual sexual and reproductive health intervention: lessons for PASS-MHW formative study in Kilimanjaro region and 2. Menstrual sexual and reproductive health needs among students in Mwanza: preliminary findings from PASS-MHW for |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | We were able to support junior members of the project to attend and presented as part of capacity development commitment. The meeting provided opportunity to share findings from the MSRH formative research and receive feedback that further informed our MSRH intervention refinement and implementation |
Year(s) Of Engagement Activity | 2022 |
Description | Teachers and School administrators Workshops |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | We conducted 4 workshops for teachers and school administrators in 2 districts ( 1 rural and 1 urban) in Mwanza region. The participants were from 4 schools (2 from rural and 2 from urban districts respectively). These workshops were intended to discuss the details of the intervention components including the MSRH curriculum, WASH improvement and sustainability and modalities of storing and distributing common pain killers for management of menstrual related pain for school girls. From these workshops we received feedback on the various components of the intervention including how to implement each component of the intervention and school commitment to support the implementation. |
Year(s) Of Engagement Activity | 2022 |
Description | The Bergen Exchanges, an annual event that takes place in Bergen in August every year bringing together scholars and practitioners from across the globe seeking to understand how law serves as an instrument of change - and how it shapes and is shaped by power relations. A week of public discussions allow scholars examine strategic uses of rights and law and how legal institutions function as arenas for political contestation. The multi-disciplinary and international nature of the Bergen Exchang |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | s part of the conference, there was menstrual health and hygiene a panel debate which allowed the examination menstrual health and hygiene and gender and human right issue. This was followed by a workshop on menstrual health to discuss ways to address menstrual health comprehensively |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.lawtransform.no/2022-bergen-exchanges |
Description | The Millie Podcast: Ending Period Poverty and Breaking the Menstrual Taboo |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Femme presented a strong rationale for the supply and promotion of reusable menstrual products to mitigate the economic (and environmental impacts) of menstruation. |
Year(s) Of Engagement Activity | 2021 |
URL | https://millie.ca/blogs/podcast-1/florence-akara-ending-period-poverty-and-breaking-the-menstrual-ta... |
Description | Twaweza Workshop for Mwinuko Secondary School - Formative School |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | Mwinuko Secondary School served as one of the formative schools in Mwanza region during the formative phase of PASS-MHW. After PASS-specific activities were completed, the Femme International team returned and ran the Twaweza Programme with all students at the school. Although they did not receive Femme Kits, they did receive workbooks to support their learning and behaviour change. |
Year(s) Of Engagement Activity | 2022 |
Description | Twaweza Workshop with Form 1 Students - Nkolati Secondary School |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | The Twaweza 2.0 workshop was run for Form 1 students (29 girls, 35 boys) in Nkolati Secondary School. Forms 1 and 4 were not part of the project implementation activities, but still received the workshop at a later date so as to avoid interfering with project evaluation. Students received vital MSRH information and workbooks; additionally girls received a Femme Kit offering a choice of reusable product. |
Year(s) Of Engagement Activity | 2022 |
Description | Twaweza Workshop with Form 1 and 4 Students - Nyakabungo Secondary School |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | The Twaweza 2.0 workshop was run for Form 1 and 4 students (137 girls, 106 boys) in Nyakabungo Secondary School. Forms 1 and 4 were not part of the project implementation activities, but still received the workshop at a later date so as to avoid interfering with project evaluation. Students received vital MSRH information and workbooks; additionally girls received a Femme Kit offering a choice of reusable product. |
Year(s) Of Engagement Activity | 2022 |
Description | Twaweza workshop at Buhongwa Secondary School |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | Ran the Twaweza Programme at Buhongwa S.S. one of the formative schools for PASS |
Year(s) Of Engagement Activity | 2023 |
Description | Twaweza workshop at Bwiru Corner |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Public/other audiences |
Results and Impact | Ran the Twaweza Programme for participants at Bwiru Corner, distributed reusable menstrual products, dissemination PASS results |
Year(s) Of Engagement Activity | 2023 |
Description | Twaweza workshop at Nyakurunduma Secondary School |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | Conducted the Twaweza workshop at Nyakurunduma Secondary School for forms 1 and 4 who did not participate in PASS |
Year(s) Of Engagement Activity | 2023 |
Description | Twaweza workshop at Nyanza Primary School |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | Ran the Twaweza Programme for 318 boys and girls at Nyanza Primary School in Mwanza region, including distribution of reusable products |
Year(s) Of Engagement Activity | 2023 |
Description | Twaweza workshop for Nyamagana Women's Vocational Training Centre |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Public/other audiences |
Results and Impact | Conducted the Twaweza Programme for women and girls at the centre |
Year(s) Of Engagement Activity | 2023 |
Description | Understanding the Menstrual Health Landscape in East Africa: Kenya and Tanzania |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Webinar exploring the menstrual health (policy) landscape in East Africa. Jen Rubli was a panelist, speaking specifically to the situation and context in Tanzania. The goal of the webinar is to collate evidence of all types and create a report that will assist Uganda, and hopefully other governments, in creating better policy, funding, and environment for menstrual health in the country. PASS-MHW was brought up as an example of the multiple levels of government and other stakeholder engagement, as well as its strategies for (funding) sustainability and scaleability. |
Year(s) Of Engagement Activity | 2022 |
Description | University visit |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Undergraduate students |
Results and Impact | We talked to all the 2nd year medical students (~220) about adolescent health and menstrual health. We had very animated discussions about various myths and misconceptions, specifically around the menstrual cup. By the end there was considerably more interest in the menstrual cup. |
Year(s) Of Engagement Activity | 2021 |
Description | Webinar: New Frontiers in Reproductive Health |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Postgraduate students |
Results and Impact | In partnership with the University College London, LUNA, Students for Global Health Society and Women Lead Now Society, Jen Rubli from Femme presented about menstrual health and specifically the PASS research project and what its objectives and expected outcomes would be. The overall outcomes was to continue to advocate for menstrual health to be considered in reproductive health programming. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.studentsforglobalhealthucl.org/new-frontiers |