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TERMS OF REFERENCE FOR A LOCAL CONSULTANT TO DEVELOP MENSRUAL HEALTH MANAGEMENT GUIDELINES FOR THE MINISTRY OF HEALTH

Background

Global Context

Menstruation marks the onset of puberty for girls. This natural, normal and healthy physical change is the most vivid sign of girls’ puberty. Menstruation, however, is usually a taboo, and has many negative cultural attitudes and beliefs associated with it, including the notion that menstruating women and girls are ‘contaminated’, ‘dirty’ and ‘impure. These myths negatively affect girls’ social life. Anecdotal evidence shows that 1 in 10 school-age African girls skip school during menstruation or drop out entirely because they lack access to necessary sanitary products. In addition, limited support for menstrual hygiene management among schoolgirls may results in four to five days of absence from school per month. This could mean adolescent girls lose 10- 20% of their school calender time. This statistic alone could profoundly affect the academic potential of millions of schoolgirls. It is estimated that almost 70% of the world’s 130 million out-of-school youth are girls. In light of these unnecessary challenges for adolescent girls, the United Nations in 2014, declared May 28 of every year as Menstrual Hygiene Day.

A move that is described as a reaffirmation of the world’s commitment to create more befitting living conditions for girls and women. 2 Menstrual Health Management in Eswatini Following the UN declaration on menstrual health management (MHM) in 2014, there has been limited investment and programs on MHM in Eswatini in various fronts and levels. This invisibility of MHM in policies, strategies and guidelines has negative impacts on the health, wellbeing and rights of girls and women in their reproductive years. Proper MHM does not happen in a vacuum, but various factors influence and or promote its occurrence and practice. Safe and decent MHM is severely compromised or threatened by a combination of issues that are of social, infrastructural and economic nature.

In many cultures, including Eswatini’s culture, menstruation is not openly discussed which leads to passing on of myths and misinformation about menstruation from generation to generation. These misconceptions are deep-seated in the cultural beliefs and kind-of form part of the knowledge that is passed on to both boys and girls as they grow up in a typical family locally. Such knowledge and understanding facilitate and promote stigmatization of girls and women having their menses. The use of derogatory statements especially for school going girls by each other or their male schoolmates. Such statements directly send messages that; menstruation is not an open subject; it is not a normal time/function and that it is kind of dirty. Whilst menstruation is a natural and physiological period marking the onset of puberty for girls. Sanitation infrastructure at all levels including households, schools, work places and public places does not accommodate safe and decent MHM. School going girls are mostly affected by this shortage as their resilience level to cope with this absence is a bit low compared to their female counterparts.

Some school girls opt to miss school when they have their menstruation because their schools do not have either water, decent toilet and they cannot afford sanitary materials. Disabled females of reproductive years almost suffer double as the basic toilets at school just doesn’t accommodate people with disability generally. The country’s Schools Inqaba guidelines and sanitation and hygiene policy need to be more specific and detailed to describe how safe and decent MHM should be ensured at household, schools, workplaces and public places. This includes the disposal of used sanitary materials and accessibility to people with disability. The cost for sanitary. Purpose and Objectives 3 The purpose of the consultancy is to develop Comprehensive National Menstrual Health Management Guidelines with the aim of providing programmatic guidance and compliance with national, regional and global MHM standards/guidelines.

The objectives of the consultancy are:

 To document concisely but comprehensive and accurate MHM priorities and guidance

 To elaborate on the National MHM priorities/guidance and development guidelines for programming, implementation and compliance including coordination and Monitoring and evaluation.  To facilitate the validation of draft National MHM Guidelines

Methodology and Technical Approach

The Consultant is expected to:

 Provide a detailed inception report note on how she/he will undertake the assignment

 Develop National MHM guidelines for programming, implementation and compliance including coordination and Monitoring and evaluation.

 Facilitate during the validation of the draft National MHM Guidelines All necessary guidance and documentation will be provided by MOH and UNFPA

Deliverables and Timeframe

The consultant will be engaged on a full-time basis starting from May to 30 June 2021, for 45 working days.

Deliverables are:

1. Inception report

2. Final National MHM guidelines: