| Reporting Organization: | WaterAid Canada |
|---|---|
| Total Budget ($CAD): | $ 6,603,841 |
| Timeframe: | May 1, 2019 - March 31, 2024 |
| Status: | Completion |
| Contact Information: |
Nicole Dagher [email protected] |
| Burkina Faso - $ 1,849,075.48 (28.00%) | |
| Pakistan - $ 1,849,075.48 (28.00%) | |
| Liberia - $ 1,452,845.02 (22.00%) | |
| Sierra Leone - $ 1,452,845.02 (22.00%) | |
| Sexual Health & Rights (25 %) | |
| Health Promotion & Education (15 %) | |
| WASH (45 %) | |
| Other (15 %) | |
The HerWASH: Sexual and Reproductive Health and Rights (SRHR) project aimed to enhance the menstrual health (MH) of women and adolescent girls in Burkina Faso, Liberia, Sierra Leone, and Pakistan. This was achieved through two pillars: (1) increased government and civil society responsiveness to the menstrual health needs of women and adolescent girls; and (2) increased use of gender-sensitive menstrual health facilities and product supplies in schools, healthcare centers, and communities. HerWASH addressed menstrual health through policy, advocacy, and practical interventions using youth-centered and female-centered approaches.
Menstrual health was a largely overlooked aspect of development and a critical pathway for advancing gender equality and the empowerment of women and girls through integration with water, sanitation, and hygiene (WASH) interventions. By addressing menstrual health, HerWASH enabled women and adolescent girls to better understand menstruation and leverage this topic as a starting point for discussions around SRHR. Importantly, the project supported them to participate in daily life during menstruation without discrimination, through improved social attitudes and an increased sense of personal freedom.
| Gender and age: | Adolescent females Adult women |
|---|---|
| Descriptors: | Rural |
| Total Direct Population: | 127,541 |
| Total Indirect Population: | 69,500 |
| 1 | Adolescent boy and girl students sensitized |
| 1 | Advocacy carried out for WASH4Work campaigns |
| 1 | Community champions for menstrual health identified and trained |
| 1 | Existing local supply chains/gaps for menstrual hygiene products mapped |
| 1 | Local authorities and service providers trained |
| 1 | Local awareness raising campaigns implemented |
| 1 | Menstrual health gaps in target districts mapped and used |
| 1 | Relevant national ministries reached and supported |
| 1 | School and healthcare centre staff trained |
| 1 | Selected local businesses, women entrepreneurs, women-led and youth-led groups supported |
| 1 | WASH facilities improved |
| 1 | Women influencers at national government level championing menstrual health |
Ultimate Outcome Improved comprehensive sexual and reproductive health and rights (SRHR), with a focus on women and adolescent girls, through menstrual health interventions in Burkina Faso, Liberia, Sierra Leone, and Pakistan.
Intermediate Outcomes
1100 Increased government and civil society responsiveness to the menstrual health needs of women and adolescent girls.
1200 Increased utilization of gender-sensitive WASH facilities and menstrual hygiene product supplies in schools, healthcare centres and communities.
Immediate Outcomes
1110 Enhanced ability of national government officials to take menstrual health needs into account in national level policies and guidelines
1120 Enhanced ability of regional, district and local authorities to take menstrual health needs into account in district level plans and budgets
1210 Enhanced ability of targeted schools and health centers to meet menstrual health needs.
1220 Enhanced ability of local private sector actors to deliver sustainable supply of menstrual hygiene products.
1230 Improved awareness of community members on menstrual health as a foundation of SRHR and gender equality.
HerWASH achieved meaningful progress toward improving comprehensive sexual and reproductive health and rights for women and adolescent girls by positioning menstrual health as a practical and socially acceptable entry point. Despite significant contextual challenges including political instability, flooding, and the COVID 19 pandemic, measurable improvements were observed across ultimate, intermediate, and immediate outcomes.
At the ultimate outcome level, 70 percent of women and girls reported positive menstrual health, representing a substantial increase from baseline. Improvements were observed across all age groups, with better knowledge, practices, attitudes, and access to menstrual products and appropriate facilities. In Liberia, 78 percent of in school girls reported that school sanitation facilities were acceptable for their needs, compared to universal dissatisfaction at baseline. Across countries, women and girls demonstrated stronger understanding of menstruation and greater confidence in challenging harmful taboos.
At the systems and governance level, the project strengthened government and civil society responsiveness to menstrual health. Ninety three percent of national government and civil society stakeholders demonstrated positive knowledge of menstrual health, and 74 percent of local government and civil society actors showed improved knowledge. Advocacy efforts resulted in tangible budgetary shifts. In Sierra Leone, district allocations for menstrual health and hygiene increased from 0.3 percent to 0.5 percent. In Burkina Faso, municipal WASH and menstrual health budgets increased significantly, reaching an average of 7.95 percent. In addition, 56 percent of targeted schools and 48 percent of targeted healthcare facilities incorporated gender sensitive sanitation for menstrual health into their plans, reflecting major institutional uptake.
Utilization of gender sensitive facilities and menstrual products increased across schools and healthcare facilities. Forty nine percent of in school girls reported that school sanitation facilities were acceptable for their menstrual needs, reflecting a major improvement. Seventy one percent reported availability of handwashing facilities in schools and 57 percent reported menstrual products were available either free or for purchase. In healthcare facilities, 77 percent reported functional latrines and 73 percent reported availability of handwashing facilities. Fifty percent reported availability of single use sanitary pads in healthcare facilities, marking strong improvement.
Knowledge and capacity building were significant achievements. Eighty eight percent of healthcare facility workers and 79 percent of teachers demonstrated positive knowledge of menstrual health. In Pakistan, knowledge among male healthcare staff improved dramatically. At community level, 60 percent of respondents demonstrated positive menstrual health knowledge, with substantial gains among both women and men. The project also expanded private sector engagement by training 118 community members in entrepreneurship to produce and sell affordable menstrual hygiene products, contributing to both product access and women’s economic empowerment.
Infrastructure investments supported these behavioural and institutional changes. Across the four countries, the project worked in 267 communities, 83 schools, and 20 healthcare facilities. Gender sensitive sanitation blocks, water access points, handwashing stations, and menstrual hygiene facilities were constructed or rehabilitated. Sustainability mechanisms were embedded through operation and maintenance committees, community financing mechanisms, government budget allocations, and integration into national monitoring systems. Independent evaluators found the infrastructure appropriate to context and with high potential for long term sustainability.
Beyond planned indicators, several unintended positive outcomes emerged. Women trained in reusable pad production reported improved income and economic confidence. Increased menstrual health awareness contributed to reductions in absenteeism and dropout among girls. Men became more engaged in discussions and support around menstrual health. Communities initiated their own WASH development activities beyond project sites, demonstrating ownership and replication.
Overall, HerWASH successfully advanced menstrual health as a catalyst for broader sexual and reproductive health and rights. It strengthened policy environments, improved service delivery, expanded product access, shifted social norms, and empowered women and adolescent girls to participate more fully in daily life without stigma or discrimination.
