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By Theresa Nyava-Machadu
In 2020 there was a landmark development in the menstrual health management space, following the signing of the Education Amendment Act into law by President Mnangagwa. We celebrated Section 4(1a) of the Act which requires the State to “ensure the provision of sanitary wear and other menstrual health facilities to girls in all schools to promote menstrual health.” This legislation makes it a legal obligation for the government to provide free sanitary wear to all school girls.
The background of this legislation is that many school girls were and are still suffering from period poverty, with many of them missing school due to a lack of proper menstrual products and pain management, which affects their right to education. For those girls that may choose to attend school wearing makeshift materials for pads, they risk being mocked in the event of staining their uniforms with blood, especially noting how period stigma and taboos are still prevalent countrywide.
They also find it difficult to concentrate in class or participate in co-curricular activities, fearing that they might stain. In the absence of proper sanitary wear, some school girls are desperately forced to resort to using medieval means such as cow dung, pieces of rags, newspapers and other unsafe and unhealthy means, which expose them to health risks such as urinary and reproductive tract infections, toxic shock syndrome, cervical cancer, or even infertility.
In light of the above, some of us who had been lobbying for the Education Act to address the issue of sanitary wear for school girls were quite elated that girls were now guaranteed to get sanitary wear, to address the challenges above. Treasury allocated Z$200 million (US$12.5 million) in the 2020 National Budget, Z$600 million (US$7.34 million) in the 2021 National Budget, and Z$1.23 billion (US $11.64 million) in the 2023 National Budget for the provision of sanitary wear to school girls. While I acknowledge these steps in the right direction, I however started to observe some issues of concern in the implementation of this school girls’ sanitary wear programme. I will discuss some of the key issues below.
The first issue of particular concern is late allocation by Treasury. While it is ideal that the funds be allocated before the commencement of the first term of the year, to allow for the acquisition of sanitary wear, I have observed that it has not been the case since 2020 as funds will be disbursed late into the year. If disbursed late, the money will not effectively serve its fundamental purpose as the intended beneficiaries will still miss school during the early months of the year. In the case of the year 2023, the first term opens on 9 January 2023 and I strongly urge Treasury to therefore allocate the funds in November 2022 so that tender processes can immediately commence allowing for the logistics of having to acquire and distribute the consignments to the respective beneficiary schools across the country in time.
I have also observed that the programme is only targeting a fraction of the total number of school girls who menstruate. The 2022 budget allocation for example was targeting 300 000 learners, which is a small number considering the total population of girls between Grade 4 to Form 6 girls who menstruate. The total number of school girls between Grade 4 and Form 6 is 1 336 693, and the majority of them are already menstruating. From my estimates, the 2023 allocation for schools’ sanitary products should be at least Z$15 billion.
From my observation of some of the tenders which were flighted by the Ministry of Primary and Secondary Education, only sanitary wear was purchased. It should be noted that some girls may actually not have underwear, to begin with, especially in rural areas. Therefore, giving them pads only, without underwear to hold the pads, will not be effective as the recipients will continue suffering from period poverty. Authorities should therefore seriously consider including at least 3 pairs of knickers per student in the sanitary wear distribution exercise.
I also strongly believe that the taxes for imported sanitary wear should be scrapped. This will help suppliers of underwear to supply at competitive prices, which will also make the programme cost-effective. It is of concern that imported underwear is currently attracting 40 percent customs duty, 14.5 percent value-added tax and US$1 per kilogram, which also makes it unaffordable to the generality of the population. Underwear and sanitary wear are twin complements that are both used when managing periods. The government removed duty and VAT on imported sanitary wear a couple of years ago and should do the same on imported underwear that is new.
The schools’ sanitary wear programme is also being implemented without much regard for menstrual health and hygiene education. You will realise that girls who are receiving sanitary wear in schools are not being properly taught about how to use them correctly as they are just given the pads and there is no education that follows. According to a study by SNV Zimbabwe, about 70% of school girls in rural areas do not know any commercial sanitary wear brand, which means that they have probably not used any before. They, therefore, require to be educated about how to use those products to avoid problems associated with incorrect use. The common mistake many school girls make is to wear the same pad for the whole day, as long as it’s not full, which is very unhealthy and can cause toxic shock syndrome and other infections.
It is therefore important to also include education components as part of the distribution of free sanitary wear. According to a study by Unicef Zimbabwe, over 76% of schools in the country don’t have learning materials on Menstrual Hygiene Management to support the learning of the subject. This makes it difficult for teachers to teach about periods. It is therefore crucial for the budget to also allocate resources to have learning materials for menstrual health in all schools. Government should also consider engaging stakeholders from the non-profit sector who have already been offering menstrual health training, to be also part of this education programme.
The issue of quality should also be paid attention to. Speaking in Parliament on 27 July 2022, Hon Johnson Madhuku, the Member of the National Assembly for Bikita East said: “We have seen that in certain instances, the quality of the sanitary wear was very poor to such an extent that some of the girl children refused to get that sanitary wear because of its poor quality.”
The Parliamentary Portfolio Committee on Primary and Secondary Education, also conducted an outreach where they also discovered that the quality of the pads was poor and that in some instances girls in some schools were given panty liners instead of actual pads. Quality is a very important factor to ensure that girls receive products that are fit for purpose and that will not harm them. I understand that the sanitary wear was acquired through tender, and it is everyone’s expectation that this competitive process should result in products that are fit for purpose being procured. I therefore recommend that only sanitary wear that is certified by the Standards Association of Zimbabwe be considered. Zimbabwe has a standard for disposable sanitary pads (ZWS 730:2015) and reusable cloth sanitary pads (ZWS 1023:2017).
The type of sanitary wear to distribute to girls should also be looked at. I have also observed that in some instances, girls were given disposable sanitary wear and others also got panty liners. Given the scarce resources, which are not even enough to cater for all school girls in line with the dictates of the Education Act, I am concerned about the decision to provide disposable pads which can be used once only and disposed of, with more needed in the subsequent months. In my view, sustainable sanitary wear that can be reused over a longer period of time should be considered, especially reusable cloth pads from reputable and certified suppliers.
There is also a misconception that needs to be dispelled, that reusable pads are not ideal in areas facing water challenges. From my practical experience working with girls even in areas facing water challenges, they still get water to drink, cook, bathe and wash. Women and girls there still wash their knickers on a daily basis, and they can also have water to wash their reusable pads for a few days each month when they are on their menstrual cycles. I therefore recommend that reusable pads be used instead of disposable pads. Reusable pads also contribute to a cleaner environment as they reduce waste significantly and also reduce pollution in landfills.
Government has been taking a decentralized approach in the procurement of the sanitaryry wear, with provincial administrations of the Ministry of Primary and Secondary Education flighting their different tenders. From the tenders, I observed that they were flighted at different time intervals and had different specifications in terms of the type of sanitary wear and other specifications. This also resulted in differentials in terms of the time of delivery as well as products received. In my view, this decentralised approach is not efficient. Authorities should consider a centralised approach that standardizes the specifications so that girls receive products that are uniform, and also pay attention to quality, delivery time and conformance to standards. If the process is to remain decentralised, I propose that the dates, specifications and delivery all be the same and also target to ensure that the sanitary products are distributed before the start of the school term.
Government should also take into account the issue of disposal facilities. Having noted that some schools were given disposable sanitary pads, it is of concern that some of them do not have proper disposal facilities. In the absence of such, for schools in rural areas using Blair toilets – it is likely that girls might end up just throwing the used pads in the toilets. Even for schools in urban areas, if they do not have proper disposal facilities, the used pads can be flashed in the toilets. In both instances, it creates an environmental menace, as most disposable pads contain 70% plastic which can take up to 500 years to decompose. The budget should therefore have an allocation for disposal facilities such as incinerators for schools receiving disposable sanitary wear. Again, that is why I recommend distributing reusable sanitary pads as they are sustainable and reusable over a longer period of time.
Budgetary allocations for sanitary wear for school girls are in their third year now. However the impact of the budgetary support is not being felt as many schools in areas that are in most desperate need are still not getting it, amongst many other concerns from stakeholders. In light of the above, I urge all government departments that are responsible for this programme to issue out a comprehensive joint statement explaining how the funds were utilised over the past three years, the criteria used to identify beneficiaries, who the suppliers of the pads are, whether their products are certified, the unit price of each product, the type of sanitary product procured and the justification of such, which schools benefitted and the number of beneficiaries per year, as well as the challenges and lessons they learnt in implementing this programme. The majority of this information is not publicly available.
Lastly, in light of the issues explained above, among others, it is apparent that the sanitary wear programme for school girls lacks proper coordination to ensure efficient and effective delivery to the intended beneficiaries. The lack of effective communication, transparency and accountability in the implementation of the school girls sanitary wear funds is also causing confusion in the menstrual health management spaces. The fact that stakeholders don’t know which schools are being targeted and in which areas makes it difficult for them to plan their work as they do not know which areas to go to that are not going to benefit from the government programme.
Secondly, it also causes duplication of activities as other organisations might unwittingly go to those areas that will later be targeted by government. It also throws away the chances for building synergies and collaborations that create bigger impact. For example, if information is made publicly available about which schools are being targeted and when exactly they will receive the products, other organisations that offer other complementing menstrual health and hygiene services might also tag along to offer those services such as menstrual hygiene education, demonstrations of product use, amongst other services. That is why I believe that this information should be publicly availed prior to going to the schools for distributions.
It is also important to create a working committee that is composed of different stakeholders from the menstrual health management sector to monitor and evaluate the implementation of this sanitary wear budget. We don’t want our girls to continue missing school because of period poverty, even though the money has been allocated, simply because of inefficient and ineffective implementation of the programme.
Theresa is the founder and executive director of Sanitary Aid Zimbabwe Trust