4Background information on Bangladesh Population of almost 150 million people (2011)The most densely populated country in the world (1015 people per square kilometre)Vulnerable to natural disasters, including cyclones, droughts, flooding and earthquakesRanked 146th out of 187 in the HDI ranking43% of the population living on less than US$ 1.25 per dayBangladesh is a predominantly Muslim country, conservativePredominantly rural (Urban: 23.3%)Recent trends: rapid urbanisation, working women and Middle income Status (2021)Positive examples of community mobilisation: BRAC, Micro-credit (Grameen bank), CATS and ORS
5Menstrual Hygiene - why is it important? In some communities girls are removed from school to reduce the risk of girls being attacked on the way to or from school which would bring shame upon the family, if the girl becomes pregnant.There is a sense of shame bestowed upon the girl and her participation in various practices (Ramadan, consummation and preparation of particular food types) is restricted.Reduced attendance and attention rates in schools due to a lack of adequate and appropriate facilities.Reproductive tract infections due to unsafe menstrual hygiene management owing to a lack of information on what menstruation is, and how to manage it safely.The need to hide menstruation necessitates that girls and women must travel before dawn to waterbodies to wash, raising protection concerns.
6The issues?Menstruation seen as being ‘unclean’ (Koran) - Shame associated with anything related to menstruationShame is manifested through a silence on the topic – it is rarely discussed between mothers and daughters, or in school and the needs are ignoredLack of dataRestricted movement of women and activities (excluded from society/communities/Ramadan –eating/preparing certain foods)Quite a variety of restrictions across the countrySuperstitions relating to genies and misfortune happening to men who come into contact with the bloodGirls use old saris as - often not cleaned or dried properly leading to Reproductive / Urinary Tract Infections
7Even more issues …Inadequate facilities in school for washing and drying properly and so girls miss out up to one week a month (quarter of their school time), contributes to increased drop out of girls from school (hard to catch up)Generally, poor access to adequate WASH facilities in schools – in secondary schools, mixed schools, high student ratios, facilities often not maintained or functioningOften girls sit all day with one padTense that there might be staining (reduced concentration)Most Secondary School Teachers are male – not discussed in class
8To be a Social Norm or Not to be? Why is it a Social Norm and not a custom or Descriptive Norm? – Empirical Expectations: there is a belief that most people do not speak about the subject – Normative Expectations: there is a belief that you should not to speak about the subject, and to do so would incur shame (negative sanction) Extent of Pluralistic Ignorance?
9Schema and Scripts?Good Mother: maintains the family’s honor, upholds the concept that menstruation is unclean, prioritizes the needs of her family above her daughter/s, expects her daughter to find out about menstruation through her own network, hides her own menstruation, continues on the tradition as her mother and grandmother didGood Daughter: does not seek advice on how to manage menstruation from her mother or seniors, manages her problems herself, hides her menstruation to not contaminate her father/brother/neighbor, does not bring attention to herself, does not taint the family honor, will get married and to have children and carry on the shame and the silenceGood Teacher: does not pollute the class or the students with talk of unclean topics, directs the students to the relevant chapters in the books and maintains the sense of order in the communityMenstruation: is ‘Unclean’, and should be hidden and managed independently, will be endured without complaint or attention.
10Interventions to date?Historical interventions have predominantly concentrated upon one manifestation of the problem ….… Build build, build, build latrines and more latrines and even more latrines …. And even more latrines, some had water, others didn’tSome orientation on Menstrual HygieneLittle money or thought on how to maintain the faciliites
11Possible future interventions using a Social Norms approach? National level discussion on whether it is even deemed to be an issueFive pilots where School led Total Sanitation is underway (in communities where it is successful)Surveys … to assess the Empirical and Normative Expectations, from this, the Pluralistic IgnoranceDetermine the Core Groups and conduct Values Deliberation sessionsDevelopment of a Community Action PlanShare the findings at a national levelPiloting of the new menstrual hygiene management facilities and monitoring their effectivenessConducting a review of the new WASH in School standards to assess the adequacy of the coverage of menstruationCooperation with private sector to scale-up production of hygienic sanitary materials, as an income generation activityInvestigation of more hygienic alternatives to rags and pads
12Communication Strategy Develop a message to transition from the ‘Unclean’ association to one of ‘Celebration of Fertility’. Koran – sensitivity – reinterpretation. In addition, there is honor in cleanliness and taking care of your body, as outlined in the Koran and this could be endorsed by Imams and communicated during prayers.Adopt a Ready for the Change Champion symbol (visible by wearing a white bracelet or hat with the symbol, and the symbol would be from Bangla tradition) - to make change more evident. Power within girls and womenCarry out additional training to the School Brigade to make them Champions in schoolAdvocate for Positive Role Models to be identified and to become Mentors for young girls, (these mentors could also be entry points for other campaigns)Community Declaration through a Ready for the Change CelebrationRadio shows for girls, together with medical and teaching representativesVillage level discussions including at mosques and temples, with Ready for the Change Champions (Natural Leaders)Village theatre (paut shows)
13Organized diffusion, not confusion At a national levelCreation of an adolescent sister for MeenaInclusion of the issue in popular soap operasDistrict competitions to reward the most ‘Ready for the Change’ village through agreed ways of classificationDesignation of high profile Ready for the Change Champions (successful females, as well as males and respected senior figures)Declaring a National Ready for the Change Day
14New Schema and Scripts?Discussions … at different levels … revision of the scripts for the Girls and Mothers, wherein ….. Power within …. …. Proactivity and the demand for information and facilities – needs supported and expected For the Menstruation script, this could be transformed into something empowering, which makes girls special and something which needs to be supported for the benefit of the whole community. An alteration of the Bangladeshi citizen script: citizens of Bangladesh have strong communities, these communities support girls and boys to have access to adequate facilities and information to be able to maintain their hygiene and to be, and produce, healthy Bangladeshi citizens
15Solved?The likely time-frame is significantly in excess of any standard donor-funded intervention ==>So, it is essential that ….The government of Bangladesh + key multi-sectoral actors (including UNICEF) + high level commitment + long term funding = sustainabilityCoordinate with other interventions e.g. child marriage and reproductive health
16The likely time-frame is significantly in excess of any standard donor-funded intervention ==> So, it is essential that ….The government of Bangladesh + key multi-sectoral actors (including UNICEF) + high level commitment + long term funding = sustainabilityCoordinate with other interventions e.g. child marriage and reproductive health
17Laws without morals Norms, and Legal Obedience are useless