An inclusive COVID-19 response: addressing the menstrual health of girls and women with disabilities

Above: woman with disability is counselled on the use and disposal of a sanitary pad during MH Day (SNV/Pankaj Singh)

In Nepal, Water for Women partner, SNV Netherlands Development Organisation is on the frontline of COVID-19 response and ensuring responses leave no one behind.

With support from the Australian Government and in response to large numbers of workers returning to Nepal, SNV initially installed handwashing facilities in 130 key locations across Nepal, a strategic response to ensure their facilities were accessible to more people by placing them at quarantine stations and Health Care Facilities (HCF). SNV collaborated with the Government of Nepal who declared a nationwide lockdown as part of an effort to manage the spread of the coronavirus and identified these strategic locations.

SNV are a well established and trusted partner in Nepal, whose work under their Water for Women project, Beyond the Finish Line is delivering inclusive and sustainable rural water supply services in Nepal. 

A COVID-19 response is a WASH response

Hygiene promotion (the H in WASH - water, sanitation and hygiene) is a critical response measure to the COVID-19 pandemic. However, it is clear that for potentially disadvantaged groups such as people with disabilities, the spread of coronavirus has evolved into yet another factor that compounds the hygiene-related challenges they face.

People with disabilities are at greater risk of practising poor hygiene and contracting health-related infections and diseases. These risks are heightened for women with disabilities, especially when they are menstruating.

In some rural areas, there has been a long tradition of viewing menstruation as impure. Although there has been some improvements in disrupting this belief system, change has been slow. Menstruation continues to be a taboo subject and as a result, menstrual health and hygiene (MHH) planning for girls and women within WASH programmes has been inadequately prioritised, moreover for girls and women with disabilities.

Ensuring inclusive approaches is a core focus of Water for Women and of SNV's WASH project. To further ensure that the government’s COVID-19 response and mitigation measures also considered the MHH needs of women and women with disabilities, SNV – along with its local partner and Rural Municipality-level Disabled Peoples’ Organisation self-help groups – engaged in an MHH awareness raising programme during Menstrual Hygiene Day (28 May), because periods don't stop in pandemics.

Using loudspeakers in rural communities, the programme broadcast messages on the importance of MHH and organised individual counselling for women with disabilities and their caregivers. Sanitary pads and soaps were distributed to over 150 women with severe disabilities, and to 12 women in quarantine centres. SNV also met with rural municipality chairpersons, presenting MHH-related gaps in their plans, and the need to strengthen their MHH response within these plans as part of the municipality’s commitment to Nepal’s ‘Total Sanitation’ programme.

As a result, several Rural Municipality chairpersons expressed their commitment to allocate budgets for MHH in their municipality’s annual plans. This shows the importance of approaching these challenges at multiple levels, not just with the community, but also strengthening the systems that are set up to support these people and communities - an area SNV is also making headway on.

"While making our annual plan, we generally prioritise budget for people with disability. But we never understood the MHH-related problems of women with (severe) disabilities. Working with the SNV team taught us the importance of MHH and we will consider this a priority in our rural municipality."

Elected RM Chairperson in Ramnagar

The expressed budget commitment of Rural Municipality chairpersons is an encouraging development, not just for women, but also for women with disabilities. If this commitment is followed through, it has potential to help advance tailor-made sanitation and hygiene programming to ensure that no one is left behind.

Thanks to SNV for sharing your work. This story was originally written by Ratan Budhathoki and has been edited by Water for Women.