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FEMALE HYGIENE IN
RUKUNGIRI DISTRICT
OF UGANDA
Tiffany Colburn, Mugdha Mokashi, Samuel Moss,
Priyanka Parajuli, Aaron Stuber
Rukungiri District
โ€ข 176 government-aided primary
schools + 76 private girl-only schools
โ€ข Total population: Approx. 300,000
โ€ข Unemployment rate: 59% 3.8%
โ€ข 200 complete for 45 highly qualified
jobs
โ€ข 1,524 square kilometers
Higher Local Government Statistical Abstract. Rukungiri District: REPUBLIC OF UGANDA, 2009.
Population Pyramid
http://www.indexmundi.com/uganda/age_structure.html
Table 4.12 Latrine coverage
Overall water coverage of the district
โ€ข 79% at household level while in towns it goes to 90%
โ€ข Rwerere, Kebisoni, Buyanja, Nyakagyeme, Buhunga, Bikurungu, Rweshama, Kisiizi
towns are all served with piped water.
Higher Local Government Statistical Abstract. Rukungiri District: REPUBLIC OF UGANDA, 2009.
Table 5.1 Distribution of schools and teachers
house by sub counties
Higher Local Government Statistical Abstract. Rukungiri District: REPUBLICOF UGANDA, 2009.
Table 8.1 Non-Governmental Organizations
in Rukungiri District
No. of Community groups
โ€ข 460 No. ofWomen
groups
โ€ข 69 No. of NGOs
Higher Local Government Statistical Abstract. Rukungiri District: REPUBLICOF UGANDA, 2009.
Table 1. School status at follow-up according to
condition (n=1008)
Menstruation and the Cycle of Poverty: A Cluster Quasi-Randomised Control Trial of Sanitary Pad and Puberty Education Provision in Uganda
Paul Montgomery Julie Hennegan Catherine Dolan Maryalice Wu Laurel Steinfield Linda Scott
Web of Causation
Existing Solutions
AFRIpads
โ€ข Locally manufactures high-quality
reusable sanitary pads
โ€ข Reached more than 750,000
females worldwide
โ€ข Employs over 150 Ugandans
Sustainable Health Enterprises
โ€ข Assists in building social
businesses to produce and
distribute sanitary pads to
women in Rwanda
โ€ข 4,500 girls with increased
access to pads at school and
in the community
http://afripads.com/
http://sheinnovates.com/
Community Based
Participatory
Research
Guiding Principle
โ€œResearchers and
community participate as
equal members and
share control over all
phases of the research
processโ€
Socioecological Model
Public policy
Community
Schools
Interpersonal
Individual
Strategy
CAB
Education
Training of
school staff
Health and
stigma
education
sessions in
school
Dissemination
of health
literature
Signage for
washroom
Resources
Production of
sanitary pads
through local
enterprise
Sustainable
market
development
Employment of
women
Pilot Study
Will be developed in two districts:
โ€ข Rural Bugangari sub-county (pop. 26,362)
โ€ข Urban RukungiriTown Council (pop.
14,400)
Proposal
Strategy
Community
Advisory Board
Pilot Study
Curriculum
Development
Analysis of
Formative
Research
Implementation of
Health Program
Biodegradable
Banana Fiber
Napkin
Outcomes
Evaluation
PHASES
Phase 1: Formative
Assessment
Preparation
โ€ข Assessment and
Training
โ€ข Town Council &
Bugangari
Assessment
โ€ข Relationship
formation
Phase 2: Pilot
โ€ข Implementation of
Pilot Education
Curriculum
โ€ข Production and
Dissemination of
hygiene products
Phase 3
โ€ข Post-pilot
assessment
โ€ข Scaling up for
future
developments (if
pilot is successful)
Phase 1: Community Advisory Board
โ€ข Wives or sisters of influential church leaders (or female church leaders)
โ€ข NGO Staff
โ€ข Rukungiri Women Development Company (RUWODEC)
โ€ข Rukungiri Gender and Women Development Association (RUGADA)
โ€ข Female and male teachers
โ€ข Local healthcare professionals
โ€ข Local education administrators
โ€ข Other key influential figures in community
Phase 1: Improving Latrines
Computer Aided Design (CAD)
by Stuber.
โ€ข Current latrines are currently in
poor condition
โ€ข Would propose a
completely aluminum
stand
โ€ข Would modify latrines to have
gravity-assisted water sources
in them
โ€ข Come from recycled
barrels
โ€ข Can repurpose other drums
in the area as well
โ€ข Will be filled by rain and by
person
โ€ข Addresses need for wash
areas
Poor condition latrine
Current latrine design
RepurposedWaterTank
design (by Green
Permaculture)
Phase 2:
Education
Curriculum
Session 5
(co-ed) respect for other genders and supporting
each other
Perceived norms
Session 4
Q&A for understanding development of other sex,
interpersonal relationships
Perceived norms
Session 3
Managing development-related stigma
Attitude, perceived behavioral
control
Session 2
Hygiene management Self-efficacy
Session 1
Changing bodies and minds during puberty
(introduction to menstruation for girls)
Self-efficacy, information
Phase 2 Production
โ€ข Collect banana fibers from local farmers
โ€ข Cost of collect already included in our final market analysis
โ€ข Processing Sanitary Pads
โ€ข Banana fibers will be stamped between two polycaprolactone sheets
โ€ข Process produces biodegradable and non-toxic alternative
โ€ข Current design using polyethylene produces CO2
โ€ข Our design does not
Phase 2: Characteristics of Banana Fibers
โ€ข Chemical composition of banana fiber is cellulose, hemicellulose, and lignin.
โ€ข Highly strong fiber, light weight, strong moisture absorption quality
โ€ข It is bio- degradable and has no negative effect on environment and thus can be
categorized as eco-friendly fiber.
https://www.engineeringforchange.org/round-two-banana-fiber-sanitary-pads-need-curves-and-wings/
Phase 2: Polycaprolactone (PCL) Covering
โ€ข Biodegradable polyester
โ€ข Inert (No irritation to skin)
โ€ข Low-cost
โ€ข Flexibility
โ€ข Biocompatabile
https://www.engineeringforchange.org/round-two-banana-fiber-sanitary-pads-need-curves-and-wings/
Pilot StudyTimeline
continuous
continuous
MarketCost Analysis:Trial Region
โ€ข Female Population of Bugangari: (Trial Region): 22,491 Females
โ€ข Based on age distribution, approximately 29% of women of menstration age
โ€ข This implies 6,523 women in need of sanitary pads
โ€ข In general, women use approximately 22 pads per month
โ€ข Need to produce 143,493 sanitary pads per month
โ€ข To produce 143,493 pads per month, a total of 8 jobs will be created
โ€ข 30 hour work week jobs for 8 women
โ€ข Will bring $261.30 annually into the home for 8 women
MarketCost Analysis: Bugangari to
Rukungiri
Evaluation Criteria Bugangari (Trial Region) Rukungiri (Full Scale Operation)
Female Population 22,491 Females 153,000 Females
% of Reproductive Females 29% 29%
Total Reproductive Females 6,523 Females 44,370 Females
Assumed Sanitary Pad Use 22 Sanitary Pads/Month 22 Sanitary Pads/Month
Total Pads to Produce 143,492 Sanitary Pads 976,140 Sanitary Pads
Yearly Salary per Job Created $261.30 $261.30
Jobs Created forWomen 8 Newly Immediate Jobs 53 Newly Immediate Jobs
Mid-Pilot and Final Outcome+ Process
Evaluation
โ€ข Quantitative
โ€ข Number of pads distributed
โ€ข Number of girls with access to pads
โ€ข Number of teachers successfully trained on education topics
โ€ข Total of funds allocated
โ€ข School attendance rates in comparison to pre-implementation
โ€ข Qualitative
โ€ข Attitude, self-efficacy, perceived behavioral control, and perceived norm changes in girls,
boys, and women
โ€ข Internal content validity of educational training
Limitations and Possible Risk
โ€ข Long term sustainability and community adoption
โ€ข Encountering stigma or internalized stigma that disrupts effectiveness of
education
โ€ข Pushback from religious organizations (may be mitigated by CAB participation)
โ€ข Resistance in introducing banana fiber pads as compared to traditionally used
alternatives
Sustainability
โ€ข Utilization of pre-existing NGO infrastructure
โ€ข Production facility will be self-sustaining through generation of revenue
โ€ข Continued demand for product and need for renewal
โ€ข Education passed through generations

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2017 UAB Case Competition (1st place Team): Team 11

  • 1. FEMALE HYGIENE IN RUKUNGIRI DISTRICT OF UGANDA Tiffany Colburn, Mugdha Mokashi, Samuel Moss, Priyanka Parajuli, Aaron Stuber
  • 2. Rukungiri District โ€ข 176 government-aided primary schools + 76 private girl-only schools โ€ข Total population: Approx. 300,000 โ€ข Unemployment rate: 59% 3.8% โ€ข 200 complete for 45 highly qualified jobs โ€ข 1,524 square kilometers Higher Local Government Statistical Abstract. Rukungiri District: REPUBLIC OF UGANDA, 2009.
  • 4. Table 4.12 Latrine coverage Overall water coverage of the district โ€ข 79% at household level while in towns it goes to 90% โ€ข Rwerere, Kebisoni, Buyanja, Nyakagyeme, Buhunga, Bikurungu, Rweshama, Kisiizi towns are all served with piped water. Higher Local Government Statistical Abstract. Rukungiri District: REPUBLIC OF UGANDA, 2009.
  • 5. Table 5.1 Distribution of schools and teachers house by sub counties Higher Local Government Statistical Abstract. Rukungiri District: REPUBLICOF UGANDA, 2009.
  • 6. Table 8.1 Non-Governmental Organizations in Rukungiri District No. of Community groups โ€ข 460 No. ofWomen groups โ€ข 69 No. of NGOs Higher Local Government Statistical Abstract. Rukungiri District: REPUBLICOF UGANDA, 2009.
  • 7. Table 1. School status at follow-up according to condition (n=1008) Menstruation and the Cycle of Poverty: A Cluster Quasi-Randomised Control Trial of Sanitary Pad and Puberty Education Provision in Uganda Paul Montgomery Julie Hennegan Catherine Dolan Maryalice Wu Laurel Steinfield Linda Scott
  • 9. Existing Solutions AFRIpads โ€ข Locally manufactures high-quality reusable sanitary pads โ€ข Reached more than 750,000 females worldwide โ€ข Employs over 150 Ugandans Sustainable Health Enterprises โ€ข Assists in building social businesses to produce and distribute sanitary pads to women in Rwanda โ€ข 4,500 girls with increased access to pads at school and in the community http://afripads.com/ http://sheinnovates.com/
  • 10. Community Based Participatory Research Guiding Principle โ€œResearchers and community participate as equal members and share control over all phases of the research processโ€
  • 12. Strategy CAB Education Training of school staff Health and stigma education sessions in school Dissemination of health literature Signage for washroom Resources Production of sanitary pads through local enterprise Sustainable market development Employment of women
  • 13. Pilot Study Will be developed in two districts: โ€ข Rural Bugangari sub-county (pop. 26,362) โ€ข Urban RukungiriTown Council (pop. 14,400)
  • 14. Proposal Strategy Community Advisory Board Pilot Study Curriculum Development Analysis of Formative Research Implementation of Health Program Biodegradable Banana Fiber Napkin Outcomes Evaluation
  • 15. PHASES Phase 1: Formative Assessment Preparation โ€ข Assessment and Training โ€ข Town Council & Bugangari Assessment โ€ข Relationship formation Phase 2: Pilot โ€ข Implementation of Pilot Education Curriculum โ€ข Production and Dissemination of hygiene products Phase 3 โ€ข Post-pilot assessment โ€ข Scaling up for future developments (if pilot is successful)
  • 16. Phase 1: Community Advisory Board โ€ข Wives or sisters of influential church leaders (or female church leaders) โ€ข NGO Staff โ€ข Rukungiri Women Development Company (RUWODEC) โ€ข Rukungiri Gender and Women Development Association (RUGADA) โ€ข Female and male teachers โ€ข Local healthcare professionals โ€ข Local education administrators โ€ข Other key influential figures in community
  • 17. Phase 1: Improving Latrines Computer Aided Design (CAD) by Stuber. โ€ข Current latrines are currently in poor condition โ€ข Would propose a completely aluminum stand โ€ข Would modify latrines to have gravity-assisted water sources in them โ€ข Come from recycled barrels โ€ข Can repurpose other drums in the area as well โ€ข Will be filled by rain and by person โ€ข Addresses need for wash areas Poor condition latrine Current latrine design RepurposedWaterTank design (by Green Permaculture)
  • 18. Phase 2: Education Curriculum Session 5 (co-ed) respect for other genders and supporting each other Perceived norms Session 4 Q&A for understanding development of other sex, interpersonal relationships Perceived norms Session 3 Managing development-related stigma Attitude, perceived behavioral control Session 2 Hygiene management Self-efficacy Session 1 Changing bodies and minds during puberty (introduction to menstruation for girls) Self-efficacy, information
  • 19. Phase 2 Production โ€ข Collect banana fibers from local farmers โ€ข Cost of collect already included in our final market analysis โ€ข Processing Sanitary Pads โ€ข Banana fibers will be stamped between two polycaprolactone sheets โ€ข Process produces biodegradable and non-toxic alternative โ€ข Current design using polyethylene produces CO2 โ€ข Our design does not
  • 20. Phase 2: Characteristics of Banana Fibers โ€ข Chemical composition of banana fiber is cellulose, hemicellulose, and lignin. โ€ข Highly strong fiber, light weight, strong moisture absorption quality โ€ข It is bio- degradable and has no negative effect on environment and thus can be categorized as eco-friendly fiber. https://www.engineeringforchange.org/round-two-banana-fiber-sanitary-pads-need-curves-and-wings/
  • 21. Phase 2: Polycaprolactone (PCL) Covering โ€ข Biodegradable polyester โ€ข Inert (No irritation to skin) โ€ข Low-cost โ€ข Flexibility โ€ข Biocompatabile https://www.engineeringforchange.org/round-two-banana-fiber-sanitary-pads-need-curves-and-wings/
  • 23. MarketCost Analysis:Trial Region โ€ข Female Population of Bugangari: (Trial Region): 22,491 Females โ€ข Based on age distribution, approximately 29% of women of menstration age โ€ข This implies 6,523 women in need of sanitary pads โ€ข In general, women use approximately 22 pads per month โ€ข Need to produce 143,493 sanitary pads per month โ€ข To produce 143,493 pads per month, a total of 8 jobs will be created โ€ข 30 hour work week jobs for 8 women โ€ข Will bring $261.30 annually into the home for 8 women
  • 24. MarketCost Analysis: Bugangari to Rukungiri Evaluation Criteria Bugangari (Trial Region) Rukungiri (Full Scale Operation) Female Population 22,491 Females 153,000 Females % of Reproductive Females 29% 29% Total Reproductive Females 6,523 Females 44,370 Females Assumed Sanitary Pad Use 22 Sanitary Pads/Month 22 Sanitary Pads/Month Total Pads to Produce 143,492 Sanitary Pads 976,140 Sanitary Pads Yearly Salary per Job Created $261.30 $261.30 Jobs Created forWomen 8 Newly Immediate Jobs 53 Newly Immediate Jobs
  • 25. Mid-Pilot and Final Outcome+ Process Evaluation โ€ข Quantitative โ€ข Number of pads distributed โ€ข Number of girls with access to pads โ€ข Number of teachers successfully trained on education topics โ€ข Total of funds allocated โ€ข School attendance rates in comparison to pre-implementation โ€ข Qualitative โ€ข Attitude, self-efficacy, perceived behavioral control, and perceived norm changes in girls, boys, and women โ€ข Internal content validity of educational training
  • 26. Limitations and Possible Risk โ€ข Long term sustainability and community adoption โ€ข Encountering stigma or internalized stigma that disrupts effectiveness of education โ€ข Pushback from religious organizations (may be mitigated by CAB participation) โ€ข Resistance in introducing banana fiber pads as compared to traditionally used alternatives
  • 27. Sustainability โ€ข Utilization of pre-existing NGO infrastructure โ€ข Production facility will be self-sustaining through generation of revenue โ€ข Continued demand for product and need for renewal โ€ข Education passed through generations