On the 55th anniversary of Ghana’s Republic Day on July 1, 2015, Women’s Health to Wealth used this public holiday to hold the first in its series of Adolescent Reproductive Health Fora (ARHF) for female students of the Simms Senior High School in the Kwabre East district of the Ashanti Region. The theme for the forum was “Be a Strong Girl – Know the Facts!”
The high and unacceptable rates of teenage pregnancy of 99 in 1000 live births in the region coupled with high rates of complications of unsafe abortions among girls in secondary institutions, and the low completion rates of girls in second-cycle institutions in the region prompted WHW to include the ARHF as one of its strategies to address this menace.
WHW used this opportunity to inform and educate the girls on adolescent reproductive health issues, provide a platform for girls to share problems related to their sexuality, and also identify girls who would be used as peer educators in the school.
Funding for the program was through the kind support of Women Strong International. WHW partner AmeriCares supported the Forum by providing each girl with a pack of sanitary towels, panty liners and 2 toothbrushes, to improve their personal hygiene. Marie Stopes International also supported the forum, with the donation of 100 branded exercise books, 30 note pads, 100 key holders as souvenirs and 200 handbills on useful reproductive health information for the girls.
Participants
334 female students and 10 tutors from the school, nine facilitators from the WHW Girls Clubs in the Afigya Kwabre and Kwabre East districts, two resource persons each attended the forum from the Ghana Health Service and Marie Stopes International, as well as five staff members of WHW.
What Happened
The Assistant Headmistress, Cassandra Antobre in her address after an opening prayer by Mary Boakye, the Senior House Mistress of Simms, stressed the timeliness and appropriate nature of the forum and urged the students to take advantage of the presence of the resource persons to seek answers to their health and sexuality issues.
The WHW Executive Director, Nana Abenaa Akuamoa-Boateng, gave an overview of WHW’s objectives with regards to female literacy, and she introduced the rest of the invited guests. She shared the statistics based on Demographic and Health Surveys on adolescent reproductive health issues from the global to the local setting, such as teenage pregnancy, contraception, unsafe abortion, anaemia, education, mental health and injuries.
Ms Memuna Yankasa Mahama, a Senior Nutrition Officer of the Ghana Health Service provided education on nutrition during adolescence. She stressed on the need to eat balanced meals, with emphasis on adequate intake of fruits and vegetables and reduction in fatty and sugary foods.
She stressed on need for routine exercise and talked about good and inexpensive ways, like dancing, walking briskly and jogging where possible.
Mr Peter Titiati, the Regional Coordinator for the Youth Project at Marie Stopes International,addressed the issue of having a positive self-image. He talked about the need for girls to be confident, to have a lot of knowledge and skills, to take pride in who they are, to identify and know what to do in order to boost their confidence, and to always place their education first. It is only then that they can actually control their sexuality.
The girls were given the opportunity to pose questions to the panel. The questions covered a variety of topics from menstruation, sex and sexually transmitted infections (STI), through contraceptives to the issue of sexual abuse by some guardians.
Mr Simeon Acheampong, Regional Manager for Marie Stopes International, also proved to be an invaluable resource during the discussion period, and together with the panel provided concrete and practical responses to questions asked. Several students also interacted with members of the panel on a one-on-one basis after the forum to seek guidance on highly personal issues. Girls with STIs were referred to the Marie Stopes centre for management.
Observations and Findings
- The school does not have an infirmary where girls can go when they are ill
- The majority of the girls had been given some amount of adolescent reproductive health knowledge from their female teachers, and they had no problems talking about condom use
- 60% of the questions posed to the panel were related to sexual and contraception issues, 30% were related to menstruation and menstrual issues, 9% were related to candidiasis and the remaining 1% talked about anaemia and its effect on the individual’s studies
- The panel gave very brief but concrete responses to questions asked by girls
- A large number of the girls had specific problems they wanted to discuss with the panelists after the program
- The program was very interesting for the gathering, as the majority of them seemed excited -21 girls voluntarily registered with WHW to train as peer educators for the school. The training will be organized during the upcoming vacation period. The trained team will form the nucleus of the WHW Girls Club in the school.
Recommendations
After a brief meeting after the forum between the WHW team and the GHS team, the following suggestions were made for subsequent fora:
- More time should be allotted to issues regarding Sexually Transmitted Infections, as most of the questions were focused on sexual issues.
- The time for the program was short, and an additional hour should be added.
Next Steps
- WHW to liaise with GHS for training program for peer educators.
- The Assistant Headmistress to coordinate with WHW on possible ARHF at Antoa Senior High School before end of July 2015.
Interested in continuing the conversation about Health and Wellness?
Girls’ Clubs: Why We’re Here
Mary Dufie, 14, is a Grade 7 pupil at Worakose Junior High School and a member of the WHW Girls’ Club in the Ashanti region’s Bosomtwe district. Mary (not her real name) is the only girl in her family, born between her two male siblings.
Mary’s parents operate a drinking bar where the top-selling drink is the locally brewed drink known as “Akpeteshie.” Unfortunately for Mary and her brothers, their parents have a great affinity for their product and are almost always busy and drunk, therefore paying little or no attention to their children’s daily needs. This has resulted in hunger and neglect and has led to Mary’s brothers’ abandoning school and idling about in the neighborhood.
Mary caught the attention of the WHW facilitator, who has reached out to others and is working to help the child continue with her education and not succumb to the pressure from her parents to stop schooling and assist them in their trade.
Mary and six other girls with similarly heartbreaking stories of parental neglect are currently being helped by WHW to put body and soul back together and to stay in school.
Getting Teenage Mothers Back To School
Every year a girl stays in school can increase in her future income by 10 percent, and when women earn more, they are more likely than men to spend the money on food, health, family and education. But there are many obstacles to overcome in keeping girls in school.
In the Kwabre East District of the Ashanti region, teenage pregnancy is a leading cause of girls dropping out. But Nancy Boakyewaa, a determined 16-year-old mother, is defying the trend, proving that even the most vulnerable adolescent girl can, with the right support, begin to feel safe again, recover her appetite for learning and unite her community behind her.
Born on June 14, 1999, Nancy is the seventh of 10 children of Comfort Boakye, a farmer, and Joseph Boakye, the Roman Catholic catechist in the community.
In August, after dating a young man in her community, Nancy gave birth to a baby girl, whom she named Josephine Maame Abena Boakye. We first met Nancy in July at the Krobo District Assembly Junior High School Girls’ Club, where, under a program supported by WomenStrong International, we were counselling teenage and expectant mothers about their future. After intense counselling sessions with Nancy and her mother, Nancy agreed to go back to school after giving birth, if her mother would look after baby Josephine.
Now in Grade 7, Nancy is excited to be back in school. “It feels as though I never left because everyone makes me feel good about being back,” she says.
Support comes from everyone. Her mother brings the baby to school, and her teachers give her time in between classes to breastfeed. Women’s Health to Wealth provides some financial support to Nancy and her mother for the baby and for school supplies, and her classmates have also been very supportive.
Nancy sees herself becoming a nurse in the future. Of staying in school, she says,
“I am doing this first for myself, for my little girl and for your organisation that gives hope to people like me. I want to further my education to improve upon my life and secure my baby’s future. I also want to support my family in the future.”
Thanks to the timely, far-sighted intervention by WHW, Nancy’s dream has a better shot at actually becoming her reality, thereby improving her and her family’s chances of leading fruitful, more fulfilling lives freed of extreme hardship.
Regular exercise by adolescents is known to promote physical fitness, reduce stress and improve classroom performance. Team sports in particular enhance adolescents’ social and psychological development, including confidence, goal-setting and leadership: all critical to developing strong, healthy, empowered young women, a primary goal of Women’s Health to Wealth and its partner organization WomenStrong International.
To this end, on Friday, November 20, girls in the Afigya Kwabre district of Ashanti competed in a football match, or, in American parlance, a soccer game. The smaller girls from Swedru Junior High School were intimidated by the tall, athletic stature of the girls at Wawase Junior High School, but played valiantly for 70 minutes. At the end of the match, Wawase came out victorious, 2-0.
After the game WHW Girls’ Clubs Coordinator Sheila Effah-Kyei led a discussion about confidence, one of the seven key strengths emphasized in the Girls’ Clubs’ curriculum. The girls learned how confidence can help them overcome obstacles in their lives by focusing on achieving their goals, rather than on their perceived limitations.
The football game was a welcome new activity for the Girls’ Club, getting everyone out of the classroom and interacting with girls from different schools. After this success, WHW will continue to explore innovative ways to collaborate with the girls on their roads to self-discovery.
Dehydration in children younger than five years of age as a result of diarrhea and vomiting, malarial fever and other infections, is a major contributory cause of mortality in under-5s in Ghana. The ominous nature of dehydration in children warrants an immediate and effective restoration of body water balance, to forestall death. Reducing child mortality has been a key goal of the international community for decades; improving child and family health, perhaps the most essential goal for women worldwide, is a critical objective of Women’s Health to Wealth and WomenStrong International.
The Komfo Anokye Teaching Hospital (KATH) Pediatric Emergency Unit, or PEU, is where children with such acute febrile conditions as severe malaria, diarrhea, vomiting, bacterial and viral infections and other acute medical conditions are initially admitted and stabilized before being transferred to wards for further treatment or discharged.
Severe diarrhea and vomiting, either as an additional symptom to an underlying disease or as a diagnosis itself, is the third most frequent cause of admission to the PEU. In July 2015, Women’s Health to Wealth donated 30 cases of DripDrop® Hydration Powder to the PEU, containing 5760 units of 10g packs, to assist the unit in the effective management of dehydration of children with indicative conditions.
The most widely used cure for rehydration, for these diseases as for severe malnutrition, is oral rehydration solution, or ORS, which combine sugars, salts and other ingredients and which is credited with saving some three million children annually. Most of the solutions on the market don’t taste very good, however, meaning that children well enough to balk at the unappetizing or medicinal taste simply won’t drink the stuff. The formula for DripDrop®, developed by a San Francisco-based family physician, Dr. Eduardo Dolhun, combines medical-standard hydration with child-friendly flavors, making it easier and more appealing for children to get the solution down and to finish the course of treatment. Dr. Dolhun’s ORS product has gained wide acceptance in hospitals and is now marketed through his own firm, DripDrop Inc.
In September, two months after the DripDrop donation was made, WHW paid a follow-up visit to KATH’s PEU to discuss with the staff the usefulness or otherwise of the medication and the relative effectiveness of DripDrop® as compared with other oral rehydration salts in preventing or reversing dehydration. As attested to by some key PEU staff, illustrated below, the results are clear, and striking:
Mrs Felicia Boakye-Agyeman, Matron-in-Charge of the Pediatric Emergency Unit at Komfo Anokye Teaching Hospital:
“Since DripDrop® Hydration Powder was received till now (a period of two months after the donation), the ward admitted 51 cases of diarrhea and vomiting. These children were given DripDrop® oral rehydration solution prepared at the unit. All 51 cases tolerated the drug very well, and over 90 percent of the cases had the diarrhea stopping completely within 24hrs. Unlike the other oral rehydration solutions, the DripDrop® solution has a very pleasant taste, and the children willingly consume adequate amounts with little no coaxing, thereby ensuring complete rehydration within a significantly shorter period.”
Dr. Maame Serwaa Asafo Agyei, a PEU pediatrician:
I observed that the DripDrop® oral solution causes the dehydration in the children to reduce and stop more promptly. I have also noted that because of the fruity taste of DripDrop® oral solution, the children are able to take in more, as compared with the other types of solutions, and this has helped to minimize the number of children eventually requiring intravenous fluids to correct their dehydration. The inclusion of zinc in the DripDrop® Hydration powder eliminates the additional zinc tablet that has to be added to the other oral rehydration solutions that have no zinc. This product is superb.
Now there has been a reduction in number of admissions of cases of diarrhea and vomiting, because when they such cases come to the PEU and the solution is prepared and given to them, their condition improves so quickly that they are discharged home with some of the drug. DripDrop® is a good drug that has come to support our interventions for diarrhea control. We thank Women’s Health to Wealth for the donation of the drug to the unit.
The usefulness of the DripDrop® Hydration Powder in addressing the rehydration of children with diarrhea and vomiting at the KATH PEU is worthy of note, as it not only reduces the workload of the already overworked staff, hospital costs and health bills for families but ultimately saves lives! Women’s Health to Wealth would like to acknowledge the support of our partner, AmeriCares, who made the supplies possible, and to WomenStrong International, which supports all the activities of WHW.
Bantama SoCCs Participants Clean Up Their Community
In mid-November a clean-up exercise was organized by the women of the Bantama community who are members of the Social Capital Credits (SoCCs) groups created by Women’s Health to Wealth (WHW) in partnership with WomenStrong International (WSI). The clean-up was an example of the WHW’s and WSI’s activities focused on two of women’s 6 essential needs: economic empowerment and creating a functioning urban environment.
All of the SoCCs group women are market traders eager for their area to be more orderly, less dusty or garbage-ridden, and more attractive to shoppers, to improve their daily sales. Eighty women from Bantama’s three SoCCs groups participated in this exercise, which ran from 11:00am -1:30pm. Participants gathered at the Bantama Ebenezer Methodist Church, where their SoCCs meetings are usually held, and proceeded into the surrounding streets and pavements, where business activities were ongoing.
The clean-up focused on the vegetables and plantain section of the market, where a lot of rotten organic waste had heaped up. Surrounding areas where the women swept and tidied up the grounds included the church premises. The women earned between 10 and 20 SoCCs points for their efforts, depending on the extent of their participation as determined by their groups’ SoCCs managers, who determined that those who swept the church premises and other external surroundings without helping to remove the rotten waste heap would earn 10 points, while those who did both would earn 20. Each SoCCs group has its own menu for how these earned points can be spent; items range from making incremental improvements to their own market stalls (an extra table, or expanding the array of wares for sale) to paying the cost of a child’s school fees, and include other desired goods and services, all selected by the group members themselves.
Because the activity was organized on a very busy Wednesday morning, when market activity was at its peak, traders camped along the sidewalks were reluctant to let the energetic Bantama women sweep the pavement where they were conducting their business transactions. Nevertheless, the SoCCs women, sporting their WHW T-shirts, went about their business, without interfering with ongoing sales. Designed to help the program gain exposure, the WHW T-shirts came in handy, as many women were curious to know who these WHW cleaner-uppers were and what we were about.
The “social currency” of earning SoCCs enabled these conversations, which hopefully will attract more market women to come to WHW’s clinics to be screened, so that they can then be prequalified to enroll in WHW’s savings and SoCCs groups: “women’s health to wealth,” indeed!
Challenges in Getting Girls’ Club Underway
Following our training of our new Girls’ Club facilitators Girls’ Club meetings in all 10 junior high schools began in earnest in the second week of June 2015, once they had been supplied with writing supplies and other materials by Women’s Health to Wealth.
As of end-June, the 10 Clubs had a total membership of 209 girls between 12-16 years old. Club membership ranged from 14, at Worakose Junior High School, to 30, at Piase D/A Junior High.
Each Club has developed a special song and a message for welcoming members to meetings and for ending their sessions.
The Clubs agreed to have three sessions in June, with an expected 100% attendance. However, only 481 girls actually attended, representing roughly three-quarters of the possible 627, due to reported ill health. In the future, with the cooperation of teachers, parents and girls, Women’s Health to Wealth is planning to conduct medical screenings for all Club members and to provide appropriate treatment for those found to have health-related problems. The screenings will take place in September, as soon as schools reopen for the first term of the 2015/2016 academic year.
Meanwhile, each Club has been presented with a First Aid Box that contains medicines for headaches and pains, diarrhoea and dressings for scrapes and cuts, among other things.
WHW has been made aware of seven at-risk girls for whom financial constraints and other domestic problems, such as parental neglect and drunkenness, have made it difficult to attend school regularly. WHW has started the process of speaking with these girls and their parents, to try to find amicable solutions to their various issues and to help keep the girls in school.
Other feedback from both the facilitators and the girls has been heartwarming, as the Clubs are helping to foster bonds of friendship and trust among the girls, and between the girls and their facilitators. Both groups are enjoying the freedom to be themselves during the weekly Club sessions, and in four schools, the Clubs have already been shown to make a positive difference in members’ school attendance, even in these early days.
Nearly 50 per cent of all newborns develop a yellowing of skin and eyes known as jaundice. Newborn jaundice can occur when babies have a high level of a yellow pigment bilirubin produced during the normal breakdown of red blood cells. The high levels of bilirubin are due to the inability of the still- developing liver of the newborn to remove bilirubin.
In most cases the jaundice goes away on its own however the high levels of bilirubin can put a baby at risk for deafness, cerebral palsy or other forms of brain damage and ultimately death. The irreparable damage that can be caused by jaundice in the newborn therefore makes it important that all cases of jaundice are immediately detected and addressed by health providers. The levels of bilirubin can be detected through the skin or blood sample.
In Kumasi, jaundice in the newborn is responsible for the admission of up to one in every five babies at the two low-resource neonatal units and the Komfo Anokye Teaching Hospital (KATH) Mother-Baby-Unit Kumasi.
In KATH, the absence of the means of testing for levels of bilirubin in the unit, babies who show up with jaundice have to be admitted for tests. Mothers of babies admitted with jaundice have to pay between $6 and $8 USD to have the test performed in a laboratory to help doctors determine and confirm the treatment for the jaundiced baby. Laboratory tests typically have a turnaround time of 36 hours with the earliest being 24 hours for mothers who are able to afford it. Delay in early assessment of bilirubin levels due to mothers ability to pay for the test can result in situations where babies who could have been sent home are kept on the already overcrowded unit .
Women’s Health to Wealth (WHW) has been working with KATH to improve neonatal health outcomes. After a careful consideration of the costs of the existing situation in the current diagnosis of jaundice in the MBU decided to acquire some Transcutaneous Bilimeters (TCB)to facilitate the detection and treatment of neonatal jaundice.
With funding support from Women Strong International, a consortium of which WHW is a member, four pieces of TCB were purchased to facilitate the detection and assist in the timely management of neonatal jaundice.
Two pieces of the TCB were donated by WHW to the KATH MBU in June 2015. The equipment was received by the head of the unit, Dr. Gyikua Plange–Rhule in the company of her colleague and administrators. In her acceptance speech, she stressed on the speed of diagnosis and ultimately the efficiency that the equipment would bring to the treatment of sick babies and the unit. She also emphasized the budget relief that the equipment would bring to both mothers and the unit as the TCB can diagnose 500 patients at virtually the cost of 2 AA batteries. Her major concern was with the fragile nature of the black tip cover and the need for users to handle the equipment with care.
On her part, Nana Abenaa Akuamoa-Boateng the executive director of WHW thanked them for the opportunity to make a difference in the care of newborns with the provision of the diagnostic equipment. She however implored them to ensure that the usefulness of the tool is not hampered by the inability to replace the batteries that will cost the department less than $2 a month.
The two low resource MBU at the Kumasi South and Suntreso Hospitals in Kumasi have also been given one TCB each.
WHW wishes to appeal to well meaning individuals interested in donating TCBs to the remaining 35 district facility level hospitals in Ashanti to contact us.
Introduction
Sexual expression is an essential component of healthy human development (Freud, Maslow et al as cited by Zimbardo 1992). However when this expression happens in an unguided manner in young adolescents, the result is the high rates of pregnant teens and teen moms.
The high and unacceptable rates of teenage pregnancy of 99 in 1000 live births in the region coupled with high rates of complications of unsafe abortions among girls in secondary institutions and the low completion rates of girls in second cycle institutions in the region prompted WHW to include the ARHF as one of its strategies to address this menace.
Objectives / purpose of the forum
WHW used this opportunity to
- provide the adolescents with medically accurate sex education and information in school in an age appropriate manner,
- enhance adolescents access to family planning services in confidential manner to promote safer-sex practices in communities.
- identify girls who would be trained as peer educators for their schools to develop communication, negotiation and refusal skills
Participants
Between July and October 31, 2015, WHW organised three separate platforms for sexual reproductive health for girls aged between 15 and 19 years in three Senior High Schools in the Kwabre East district of the Ashanti region. The district is a focus district for WHW programs and also noted to be a district with a high prevalence of teenage pregnancies and high school drop out rates for girls in both Junior and Senior high schools.
Facilitators and Collaborators
The nurses and nutritionists from the Ghana Health Service, the adolescent programme officer from Marie Stopes International and the district officer in-charge of girl child education in the district assisted WHW.
Find below the schedule and numbers of girls who attended each session.
| SNo. | Name of School | Date | No. of participarticipants | No. of Teachers |
| 1 | Simms Senior High School | July 1,2015 | 334 | 6 |
| 2. | Adventists Girls Senior High School | October 2, 2015 | 661 | 10 |
| 3. | Antoa Senior High School | October 30, 2015 | 402 | 8 |
| Total | 1397 | 24 |
Source: Field data, 2015
A total of 1397 students and 24 teachers in three schools attended the three sessions that covered a total of 11 hours. The highest attendance was recorded at the Adventist Girls Senior High School and the least at Simms Senior High School. However the observations and findings were similar in all the schools visited.
The forum provided medically accurate and appropriate information on adolescent reproductive issues such as menstruation, teenage pregnancy, contraception, unsafe abortion, anaemia, nutrition and mental health the global to the local setting.
The girls were given the opportunity to pose questions to the panel. The questions covered a variety of topics from menstruation, sex and sexually transmitted infections (STI), through contraceptives to the issue of sexual abuse by some guardians.
Several students also interacted with members of the panel on a one-on-one basis after the forum to seek guidance on highly personal issues. Girls with STIs in Simms and Adventist Girls Senior High School were referred to the Marie Stopes centre for management. In Antoa Senior High School , WHW organised a medical outreach session a week later to attend to 57 girls who had STI.
Observations and Findings
- All the three schools which are boarding institutions had no infirmary or school nurses on their compound to attend to girls when they have a health problem or handle medical emergencies
- Majority of the girls had been given some amount of adolescent reproductive health knowledge from their female teachers and they had no problems talking about condoms
- Majority of the questions posed to the panel were related to sex and sexually transmitted infections, family planning andcontraception issues, and less than 10 per cent each related to menstrual and nutrition issues
- The panel gave very brief but concrete responses to questions asked by girls
- A large number of the girls had reproductive infections for which they required medical treatment they wanted to discuss with the panel after the programme.
- In two schools, the female teachers expressed a lot of concern about how some of the male teachers were having sexual intercourse with the girls and requested assistance to deal with the problem.
- The medical outreach conducted in one school a week later revealed that, of the 54 girls who turned up with complaints,
- Only 3 had never had sexual intercourse as the vaginal examination and verbal interview confirmed the finding
- 2 had positive pregnancy tests
- 2 already had a child at home
- 3 had symptoms suggestive of pelvic inflammatory disease
- 5 had cervicitis
- 47 had mixed vaginal infections with main organisms being Trichomonas, candidiasis and bacteria vaginosis.
- 28 had already had at least one termination of an unwanted pregnancy.
- Two had normal vaginal pH with no infections
- None of them used a contraceptive during the last sex encounter they had.
All cases of infection were given treatment by the medical team that day. The findings conveyed the urgency of having a school nurse on the compound and also starting a Girls Club to assist address the issues of inadequate knowledge on responsible sex behaviour.
Girls and their “Red Days”
The health of women of all ages is an essential need for sustainable urban development. Research among adolescent girls has shown the importance of education and emotional support in girls’ understanding that the onset of menstruation is a healthy and hopeful part of growing up.
In Akan society, the transition of a girl into womanhood, marked by menarche, is an occasion that is celebrated and held in high esteem by the community. In the days of old, girls who had attained their menarche were ushered into womanhood by a celebration known as “Bragoro.”
Euphemisms such as “w’akum sono” – literally, “she has killed an elephant” – and others, such as “w’ako afikyire” (“she has gone to the backyard”) or “w’abu ne nsa” (“she has broken her hand”), are used to describe the monthly flow of blood, which is linked to fertility and the sanctity of new life.
In the traditional communities of yesteryear, the young girl who had just passed into womanhood would be given an additional piece of cloth to cover her breast down to her knees and would put a loin cloth in between her legs through her circle of gorgeous waist beads, both to catch her monthly flow of blood during her menses and to guard her womanhood from unwanted “visitors.”
In those days, the majority of the girls had their menarche in the latter part of the teens – usually between 16 and 18 years of age. Once the “Bragoro” was performed, the young woman was declared ready for marriage, and no girl worth her salt stayed unmarried more than a year after her “Bragoro.” Those were the days when the lot of a woman was to support her husband and bring forth children, to increase the labour force for their agricultural enterprise.
With improved nutrition, girls today start their menses quite early in life, and it is on record that girls as young as 9 have had their menses, with the average age of onset for the majority of girls being 13. With modernization and the hopeful change in society’s view of female education, early marriages and child brides are not as common as before, and girls are now marrying in their 20s. This positive trend nevertheless poses a major challenge for teenage girls of today, most of whom are in school and have no source of income, yet they need to acquire suitable sanitary pads to deal with their menses.
The days of the loincloth in between the waist beads ended with the invention of disposable sanitary towels. However, these towels come at a cost and not all girls are able to buy them every month. Thus for some school-going girls, absenteeism becomes the norm during the week of their menses. This absenteeism can lead to poor school performance and heighten many girls’ desire to be done with school as soon as possible.
In a bid to encourage girls to go to school and stay in school even during their menses, an organization known as Days for Girls International has introduced the reusable sanitary kit that makes it possible for a girl to purchase a one-time kit that will last over 36 menstrual cycles. By the kind courtesy of Mrs. Patti Law, a Presbyterian Minister from Stratford, Connecticut in the United States, thirty-six kits were donated to the Women’s Health to Wealth to undertake a pilot study with members of the WHW Girls Clubs.
WHW undertook focus group discussions with students of Junior High Schools in in 3 districts Afigya Kwabre, Atwima Kwanwoma, and Kwabre East districts to understand the current knowledge, attitude and practices of teenage girls in the peri-urban communities with regards to the sanitary materials used during their menstrual flow and to explore the acceptability of the reusable kits.
Participants
A total of 99 girls aged between 12 and 18 years participated in 7 focus group discussions. Ninety of the girls had started menstruation while 9 had not attained menarche. See Appendix 1 for more detail.
Objectives
The following outlines the objectives of the focus group discussions:
- To introduce the use of the Days for Girls International reusable sanitary kits.
- To get the views of girls on how they would feel about using the reusable sanitary kit.
- To identify girls who have difficulty purchasing regular sanitary pads as beneficiaries to pilot the free reusable kits.
Overview of Discussions
The discussions that were moderated by WHW team members centered on menstruation, the cost of materials used to staunch flow and how the girls would feel about using a reusable sanitary kit.
The girls were taken through the use of the Days for Girls International sanitary kit which includes a monthly menstrual record chart from WHW, 8 pieces of flannel (reusable pad), 2 shields that holds the flannel in place, a small bar of soap, an empty Ziploc bag and a face towel.
Observations and Findings
- A small number of girls were able to define menstruation and discuss the changes that characterises adolescence.
- A majority of the girls had heard about menstruation before they attained menarche. Over half of them heard about it from their female teachers, while of the remaining half, equal numbers had heard of menstruation from their mothers and from friends. A small minority gave their source of information on menses as female relatives, such as older sisters and grandmothers. Girls confirmed that their mothers hardly interact with them because they disrespect them sometimes.
- Most of the girls said their mothers/guardians warned them after attaining menarche that sexual intercourse with the opposite sex will result in pregnancy.
“My grandmother told me to desist from engaging in unnecessary acts of play with the opposite sex, if not, they will swallow me up!” – a 15-year old club member.
- About half of the participants use sanitary pads in staunching the blood flow during their menses. YAZZ, Proper, Beauty Lady, Soft care, Forever Easy, Yovi, Cute, Always and Sandy are some of the brands used. These pads cost between GHC 3.50-6. The rest of the girls use other toilet paper, baby diapers and pieces of old cloth when they are menstruating.
- About two-thirds of the girls reported that their parents/guardian provide money for their monthly purchase of sanitary pads, while the remainder have to save from their meager daily allowances of GHs1 towards this purchase.
- Girls were very happy when they finally saw the kit of reusable sanitary pads, which they agreed is very attractive.
“This is beautiful! It looks like a handkerchief, and I wouldn’t mind hanging it outside. No one would notice that I use it to manage my menses.” – a 14-year-old girl at Piase.
- Girls indicated their readiness and willingness to buy and use the reusable sanitary pads if the cost of the Days for Girls International sanitary kit is priced between GHC 5-15. Girls claim that the current price quote of GHs 35 will be prohibitive and will incur the wrath of their parents. As aptly said by one 14-year-old girl at Twedie,
“My father will say, quote, “I cannot even afford what I need to buy rat poison to kill myself and be free from the crippling poverty, how can I afford something this expensive!?”
- Apart from a few girls who claim they feel uncomfortable washing their blood-stained panties, the majority of the girls did not seem to have a problem with doing so.
“ I do not have a problem with washing my panties when they are stained with blood because it is from my own private part” – a 15-year-old girl from Esereso.
Based on the interactions with the girls, 25 girls in the four districts were each given a Days for Girls International Sanitary kit.
Next Steps
The 25 beneficiaries in the various districts are to give WHW feedback on the use of the sanitary kits in December 2015. This feedback will be extremely useful in determining whether to promote and get more kits for use by girls in school who have difficulty purchasing regular sanitary pads.
Conclusion
While WHW awaits the feedback from our beneficiaries, we would want to acknowledge with thanks for the gift of 30 kits from Ms. Patti Law, which set us on this path. We also will discuss the cost of the kit with the Days for Girls International office in Accra, as the asking price of GHs 35 is out of reach for the girls we are hoping to serve.
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