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 test this approach. It aims to improve access to menstrual products, reduce stigma, and eventually create jobs through a scaled up pad production program. The project will be guided by a community advisory board and evaluations will assess changes in attitudes, behaviors, and school attendance from the interventions. Limitations around long term sustainability and potential stigma are also discussed.

1. FEMALE HYGIENE IN
RUKUNGIRI DISTRICT
OF UGANDA
Tiffany Colburn, Mugdha Mokashi, Samuel Moss,
Priyanka Parajuli, Aaron Stuber

2. Rukungiri District
• 176 government-aided primary
schools + 76 private girl-only schools
• Total population: Approx. 300,000
• Unemployment rate: 59% 3.8%
• 200 complete for 45 highly qualified
jobs
• 1,524 square kilometers
Higher Local Government Statistical Abstract. Rukungiri District: REPUBLIC OF UGANDA, 2009.

3. Population Pyramid
http://www.indexmundi.com/uganda/age_structure.html

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

8. Web of Causation

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/

10. Community Based
Participatory
Research
Guiding Principle
“Researchers and
community participate as
equal members and
share control over all
phases of the research
process”

11. Socioecological Model
Public policy
Community
Schools
Interpersonal
Individual

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)

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
• 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/

21. Phase 2: Polycaprolactone (PCL) Covering
• Biodegradable polyester
• Inert (No irritation to skin)
• Low-cost
• Flexibility
• Biocompatabile
https://www.engineeringforchange.org/round-two-banana-fiber-sanitary-pads-need-curves-and-wings/

22. Pilot StudyTimeline
continuous
continuous

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