This document proposes a project to address female hygiene issues in Rukungiri District, Uganda. It involves developing an educational curriculum on puberty and menstruation, and producing sustainable banana fiber sanitary pads through a local enterprise. A pilot program will be implemented in two areas to train school staff, educate students, and make pads available. Outcome evaluations will assess changes in attitudes, behaviors, and school attendance. The goal is to scale up production to meet demand and create jobs, while limiting environmental impact and stigma through community engagement. Challenges may include ensuring long-term adoption and overcoming cultural barriers, but sustainability is supported through existing infrastructure and revenue generation.
SBI Youth for India Fellowship 2016-17 - Final ReportAnkur Chhabra
“Social behaviour change communication and community mobilisation to address the issue of maternal and child malnutrition in Palghar district, Maharashtra”
Learning to work as a farming family team: Farmer responses to a gender-inclu...CGIAR
This presentation was given by Gloria Nema (CARE), as part of the Annual Scientific Conference hosted by the University of Canberra and co-sponsored by the University of Canberra, the Australian Centre for International Agricultural Research (ACIAR) and CGIAR Collaborative Platform for Gender Research. The event took place on April 2-4, 2019 in Canberra, Australia.
Read more: https://www.canberra.edu.au/research/faculty-research-centres/aisc/seeds-of-change and https://gender.cgiar.org/annual-conference-2019/
SBI Youth for India Fellowship 2016-17 - Final ReportAnkur Chhabra
“Social behaviour change communication and community mobilisation to address the issue of maternal and child malnutrition in Palghar district, Maharashtra”
Learning to work as a farming family team: Farmer responses to a gender-inclu...CGIAR
This presentation was given by Gloria Nema (CARE), as part of the Annual Scientific Conference hosted by the University of Canberra and co-sponsored by the University of Canberra, the Australian Centre for International Agricultural Research (ACIAR) and CGIAR Collaborative Platform for Gender Research. The event took place on April 2-4, 2019 in Canberra, Australia.
Read more: https://www.canberra.edu.au/research/faculty-research-centres/aisc/seeds-of-change and https://gender.cgiar.org/annual-conference-2019/
A non-profit organization established in US, with major operations in India, WIN Foundation funds, supports and facilitates innovation in the areas of (i) Water and Sanitation (WatSan) and (ii) Maternal and Child Health (MCH), and apply it in empowering and improving the lives of underprivileged sections in a sustainable manner.
WASH in Schools Target Challenge in India OverviewRamesh Aggarwal
Presentation made by PDG Ramesh Aggarwal, Member Secretary, Rotary India WinS Committee at Rotary - UNICEF High level advocacy workshop on Oct 1, 2016 in New Delhi
Presentation about the Community and Regional Food Systems project given at the 2013 Wisconsin Local Food summit.
Included is an overview of the project, discussion of the food system framework we're creating, examples from our community engagement projects (carrots to schools, lead contamination, food policy council evaluation, healthy corner stores), and a review of our project's values and outcomes (just, healthy, place-based, prosperous, and sustainable).
WIN Foundation is a non-profit organization, established in US and with main operations in India. WIN Foundation funds, supports and facilitates innovation in the areas of (i) Water and Sanitation (WatSan) and (ii) Maternal and Child Health (MCH), primarily in India and apply it in empowering and improving the lives of underprivileged sections in a sustainable manner
2015 WASH e-Summit (Part 1): An Introduction to Water, Sanitation, and Hygien...Rotary International
View the recording: https://vimeo.com/142525709
Brought to you by Rotary and the Water and Sanitation Rotarian Action Group, this first of three webinars provides an overview of WASH (water, sanitation, and hygiene education) in Schools programs.
New to WASH in Schools? Join sector experts to learn about the importance of WASH in Schools efforts and the various hardware and software components that make these club and district-led projects impactful and sustainable.
Sustaining quality approaches for locally embedded community health services ...REACHOUTCONSORTIUMSLIDES
This presentation was given at the Bridging the Quality Gap - Strengthening Quality Improvement in Community Health Services Symposium which was held in September 2016
Integrated and sustainable through work centric Pre-vocational training in high school. The program integrates development of community and education. This makes education relevant to real life problems. Such Work based education in schools developed 'Capability to Act' in students along with 'Capability to think'.
The area is confronted with immense lack of awareness on the part of parents especially mothers, leading to problems like low quality education and health, poverty and unemployment which can be overcome through motivation and engagement.
A non-profit organization established in US, with major operations in India, WIN Foundation funds, supports and facilitates innovation in the areas of (i) Water and Sanitation (WatSan) and (ii) Maternal and Child Health (MCH), and apply it in empowering and improving the lives of underprivileged sections in a sustainable manner.
WASH in Schools Target Challenge in India OverviewRamesh Aggarwal
Presentation made by PDG Ramesh Aggarwal, Member Secretary, Rotary India WinS Committee at Rotary - UNICEF High level advocacy workshop on Oct 1, 2016 in New Delhi
Presentation about the Community and Regional Food Systems project given at the 2013 Wisconsin Local Food summit.
Included is an overview of the project, discussion of the food system framework we're creating, examples from our community engagement projects (carrots to schools, lead contamination, food policy council evaluation, healthy corner stores), and a review of our project's values and outcomes (just, healthy, place-based, prosperous, and sustainable).
WIN Foundation is a non-profit organization, established in US and with main operations in India. WIN Foundation funds, supports and facilitates innovation in the areas of (i) Water and Sanitation (WatSan) and (ii) Maternal and Child Health (MCH), primarily in India and apply it in empowering and improving the lives of underprivileged sections in a sustainable manner
2015 WASH e-Summit (Part 1): An Introduction to Water, Sanitation, and Hygien...Rotary International
View the recording: https://vimeo.com/142525709
Brought to you by Rotary and the Water and Sanitation Rotarian Action Group, this first of three webinars provides an overview of WASH (water, sanitation, and hygiene education) in Schools programs.
New to WASH in Schools? Join sector experts to learn about the importance of WASH in Schools efforts and the various hardware and software components that make these club and district-led projects impactful and sustainable.
Sustaining quality approaches for locally embedded community health services ...REACHOUTCONSORTIUMSLIDES
This presentation was given at the Bridging the Quality Gap - Strengthening Quality Improvement in Community Health Services Symposium which was held in September 2016
Integrated and sustainable through work centric Pre-vocational training in high school. The program integrates development of community and education. This makes education relevant to real life problems. Such Work based education in schools developed 'Capability to Act' in students along with 'Capability to think'.
The area is confronted with immense lack of awareness on the part of parents especially mothers, leading to problems like low quality education and health, poverty and unemployment which can be overcome through motivation and engagement.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
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comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
4. Table 4.12 Latrine coverage
Overall water coverage of the district
• 79% at household level while in towns it goes to 90%
• 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
• 460 No. ofWomen
groups
• 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
• Locally manufactures high-quality
reusable sanitary pads
• Reached more than 750,000
females worldwide
• Employs over 150 Ugandans
Sustainable Health Enterprises
• Assists in building social
businesses to produce and
distribute sanitary pads to
women in Rwanda
• 4,500 girls with increased
access to pads at school and
in the community
http://afripads.com/
http://sheinnovates.com/
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:
• Rural Bugangari sub-county (pop. 26,362)
• Urban RukungiriTown Council (pop.
14,400)
15. PHASES
Phase 1: Formative
Assessment
Preparation
• Assessment and
Training
• Town Council &
Bugangari
Assessment
• Relationship
formation
Phase 2: Pilot
• Implementation of
Pilot Education
Curriculum
• Production and
Dissemination of
hygiene products
Phase 3
• Post-pilot
assessment
• Scaling up for
future
developments (if
pilot is successful)
16. Phase 1: Community Advisory Board
• Wives or sisters of influential church leaders (or female church leaders)
• NGO Staff
• Rukungiri Women Development Company (RUWODEC)
• Rukungiri Gender and Women Development Association (RUGADA)
• Female and male teachers
• Local healthcare professionals
• Local education administrators
• Other key influential figures in community
17. Phase 1: Improving Latrines
Computer Aided Design (CAD)
by Stuber.
• Current latrines are currently in
poor condition
• Would propose a
completely aluminum
stand
• Would modify latrines to have
gravity-assisted water sources
in them
• Come from recycled
barrels
• Can repurpose other drums
in the area as well
• Will be filled by rain and by
person
• 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
• Collect banana fibers from local farmers
• Cost of collect already included in our final market analysis
• Processing Sanitary Pads
• Banana fibers will be stamped between two polycaprolactone sheets
• Process produces biodegradable and non-toxic alternative
• Current design using polyethylene produces CO2
• Our design does not
20. Phase 2: Characteristics of Banana Fibers
• Chemical composition of banana fiber is cellulose, hemicellulose, and lignin.
• Highly strong fiber, light weight, strong moisture absorption quality
• 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/
23. MarketCost Analysis:Trial Region
• Female Population of Bugangari: (Trial Region): 22,491 Females
• Based on age distribution, approximately 29% of women of menstration age
• This implies 6,523 women in need of sanitary pads
• In general, women use approximately 22 pads per month
• Need to produce 143,493 sanitary pads per month
• To produce 143,493 pads per month, a total of 8 jobs will be created
• 30 hour work week jobs for 8 women
• 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
• Quantitative
• Number of pads distributed
• Number of girls with access to pads
• Number of teachers successfully trained on education topics
• Total of funds allocated
• School attendance rates in comparison to pre-implementation
• Qualitative
• Attitude, self-efficacy, perceived behavioral control, and perceived norm changes in girls,
boys, and women
• Internal content validity of educational training
26. Limitations and Possible Risk
• Long term sustainability and community adoption
• Encountering stigma or internalized stigma that disrupts effectiveness of
education
• Pushback from religious organizations (may be mitigated by CAB participation)
• Resistance in introducing banana fiber pads as compared to traditionally used
alternatives
27. Sustainability
• Utilization of pre-existing NGO infrastructure
• Production facility will be self-sustaining through generation of revenue
• Continued demand for product and need for renewal
• Education passed through generations
