Apologies about my lack of posts! The last months have been busy with all kinds of things: finishing up my RUMPS program at my site, planning for Camp GLOW, getting sick on and off, celebrating Halloween, etc. Below is a summary and final report about my RUMPS project that took a whole
year to complete (from grant writing to evaluation). I thought some of you might be interested in what we accomplished and our evaluation results. The final report will be sent to all government schools in my center. (It's in British English)!
RUMPS Final Report
Chelsea Roberts, CCT/PCV Butaleja Coordinating Centre
Peace Corps Uganda
2012
Introduction
In Uganda, primary
school girl children are given equal opportunities to pursue their education,
but they face more challenges than their male peers. Upon reaching puberty, many are not adequately informed
about the bodily changes to expect and possible ways of managing their
menstrual periods. The lack of
resources causes many girls to stay at home during their menstrual period. Absences lead to poor academic
performance, which ultimately resulting in dropouts.
Reusable Menstrual Pads
(RUMPS) is a sustainable program that helps a girl appropriately manage her menstruation
periods. RUMPS is a program that
has been established and used throughout Uganda since 2008. RUMPS are made from local materials:
the pad is sewed from cotton material, and the liners are layers of cotton
towels. A RUMPS kit is not thrown
away after just one use. It is
washed daily during a menstrual cycle and should last for one year before it
needs to be replaced. In the
future, she will be able to make these pads on her own using cheap locally
available materials.
Project Implementation: RUMPS Teacher
Training
In Butaleja CC, we have
successfully executed a RUMPS program for our 15 government schools. Our program first trained the Senior
Women Teachers and Head Teachers of each school.
The workshop took place
on 11 April, 2012 at the Butaleja Coordinating Centre. The workshop was facilitated by Chelsea
Roberts, and visiting Peace Corps Volunteers, Audrey Denton and Bethany
Miota. At the workshop, all
participants received a manual about reproductive health and HIV/AIDS, as well
as a RUMPS kit. Each school worked
in pairs to create long lasting instructional materials. During the workshop, the following
topics were covered:
- Importance of RUMPS
- Female Reproductive System
- Menstrual Cycle
- Family Planning
- HIV/AIDS
- RUMPS kit construction
- Instructional Material construction
- Roll out for Term II 2012
Of the 29 participants,
the following government schools were represented in the workshop: Butaleja
Integrated, Butaleja P/S, Namulemu P/S, Leresi P/S, Nakwasi P/S, Mulandu P/S,
Mabale P/S, Namutima P/S, Namulo P/S, Bugosa P/S, Butesa P/S, Hisega P/S,
Lunghule P/S and Bunghaji P/S.
BUPA Nursery & P/S was the only private school to attend the
workshop.
Project Implementation: RUMPS Roll Out
In Term II
2012, the RUMPS program was rolled out to the P5-P7 girls of all 15 government
schools. The Peace Corps Volunteer
travelled to the schools to provide the RUMPS kits and supervise the Senior
Women Teachers’ presentations.
At most
schools, Senior Women Teacher gave a presentation to the girls concerning the
female reproductive system, the menstrual cycle, HIV/AIDS and RUMPS. At few schools, the Senior Women
Teacher was not prepared, absent or had been transferred, so Chelsea gave the
presentation with assistance of a female teacher.
RUMPS Roll Out
Attendance
P5 Girls
|
582
|
P6 Girls
|
396
|
P7 Girls
|
217
|
Total Girls Attendance of Presentations
|
1195
|
RUMPS Roll Out Kit
Distribution
Total Girls with
RUMPS Kits
|
1008
|
Total RUMPS Kits Distributed (including extras and kits for teachers)
|
1105
|
Our program
reached at least 1,200 girls and beyond because many of the schools included
mature girls from P4 at the RUMPS presentation. Additionally, we have empowered at least 1,000 girls with
RUMPS kits; a tool to help improved their self-esteem, their school attendance
and hygiene.
Project Implementation: Family Planning
and HIV/AIDS with Primary Teachers
As the
Peace Corps Volunteer visited the primary schools for the roll out, she met
with the teachers at lunch for a short survey about family planning and
HIV/AIDS. Each teacher filled the
survey individually, which had 17 questions. The best performers were rewarded with soda or airtime.
Primary Teachers
Participation
in Family Planning and HIV/AIDS Activity
Male Teachers
|
72
|
Female Teachers
|
42
|
Total Teachers
|
114
|
Project Evaluation: Senior Woman Teachers
and Head Teachers
In Term
III, we evaluated the program on several levels. First, the Senior Women Teachers and Head Teachers were
asked to fill surveys to assess the retention of knowledge from the workshop
and an evaluation of the program.
These results have been compared to the pre-survey from the RUMPS
Workshop.
|
Question
|
Pre-survey
Percentage
|
Post-survey
Percentage
|
Percent
Increase
|
|
Identify
the five reproductive organs of the female reproductive system:
|
|
|
|
|
Uterus
|
83%
|
96%
|
15%
|
|
Fallopian
Tubes
|
83%
|
100%
|
20%
|
|
Ovary
|
75%
|
92%
|
22%
|
|
Cervix
|
58%
|
83%
|
43%
|
|
Vagina
|
75%
|
100%
|
33%
|
|
Where
does a woman’s body store her eggs?
In
her ovaries
|
83%
|
100%
|
20%
|
|
Where
does fertilization of the take place?
In
the fallopian tubes
|
50%
|
58%
|
17%
|
|
What
do the letters HIV stand for?
Human
Immunodeficiency Virus
|
25%
|
25%
|
0%
|
|
Name
the four bodily fluids that transmit HIV:
|
|
|
|
|
Blood
|
96%
|
100%
|
4%
|
|
Vaginal
fluids
|
63%
|
96%
|
53%
|
|
Semen/sperm
|
83%
|
96%
|
15%
|
|
Breast
milk
|
13%
|
58%
|
367%
|
|
What
are the ABCs of HIV prevention?
|
|
|
|
|
Abstain
|
88%
|
100%
|
14%
|
|
Be
Faithful
|
92%
|
92%
|
0%
|
|
Condom
Use
|
92%
|
100%
|
9%
|
From these results, we can determine that teachers have learned something significant about to these topics. The most phenomenal result is the 367% percent increase regarding breast milk as a bodily fluid that can transmit HIV. However, it is obvious that some things remain troublesome, such as HIV in full. For further questions about these issues, refer to the manual.
In the post
evaluation process, the teachers were also asked to answer free response
questions regarding their advice to young girls. All teachers answered correctly about how to properly wash
RUMPS pads.
Only 61% of
teachers correctly answered the question regarding young girls’ safe days for
sex. Young girls do not have safe days. Her cycle is still unpredictable and is
prone all kinds of changes. Her
body is still practicing the menstrual cycle; therefore her MP can jump months
at a time or come twice in one month.
All teachers need to understand this very clearly: Young girls do not
have safe days, and this method will not work for them! The best method for young girls is to
abstain; however, some girls will have sex even if they are advised to
abstain. If girls are asking about
their family planning options, it is important to advise them to use condoms
because it is the only method besides abstinence that protects them from
pregnancy, HIV/AIDS and STDs.
Additionally,
only 78% of teachers correctly answered the question regarding young girls’ MPs
skipping or jumping months. It is
very normal for girls to miss their MP for months at a time for several
reasons. Their bodies are just
starting this process and their hormones are unpredictable, which can cause
them to miss their MP or even have their MP twice in one month. A women’s menstrual cycle can also
change if her diet changes or is not balance, if she is not getting enough
sleep, if she starts or stops exercising and if she is stressed. If a young girl has not had sex, she
does not need to worry if she has missed her MP; however, if she has had sex,
she should get a pregnancy test at the health clinic.
In the
evaluation, most teachers have expressed satisfaction with the RUMPS program,
as well as plan to continue the program with the help of their School
Management Committee. Many schools
have noticed a positive change in their girls’ attitudes, as well as their
attendance.
Project Evaluation: P7 Girls
In order to
evaluate the effectiveness of the RUMPS roll out, the first schools were given
written surveys for the girls to fill.
Unfortunately, the girls did not understand the surveys well enough to
fill them out properly. Therefore,
the final evaluation of the girls was more of a discussion with the P7
girls. From 15 schools, 190 girls
were interviewed in groups. P7
girls were chosen because they were able to understand the Peace Corps
Volunteer. At some schools, the P7 girls were very eager to participate and ask
questions. However, at other
schools, the girls were shy and unwilling to answer questions, which made the
evaluation process very difficult.
In the oral
evaluation, the girls were asked to identify the parts of the reproductive
system and its functions. Then,
they were asked questions regarding the topics covered in the RUMPS
presentation. The girls performed
well regarding the following topics:
- Identifying the organs of the female reproductive system
- Site of fertilization
- Site of implantation of the egg and development of a baby
- The ABCs of HIV prevention
- The bodily fluids that transmit HIV
- Local materials used to make RUMPS
- Washing and drying of RUMPS
The
following topics were difficult for at least 60% of the schools:
- The cause of menstruation periods: the egg was not fertilized, the woman is not pregnant
- The purpose of the menstrual cycle: to prepare a women’s body for pregnancy
- The cause of skipping or jumping MPs: see above
- The purpose of vaginal fluid: to clean the vagina
- The signs or symptoms of Candida: white, thick vaginal discharge; itching; irritation
These
topics are important for girls so they can understand their bodies and make
important health decisions. Senior
Woman Teachers should continue with further sensitization so these matters are
clear to the girls.
Of the P7
girls, 92% purchased RUMPS, and over half claimed to use their RUMPS kits. After the RUMPS presentation, at least
90% of the girls shared their new RUMPS knowledge with someone at home (mother,
father, sister, aunt, friend, etc).
Finally,
the girls were given a chance to ask questions. The most frequent questions are below with answers:
Why do we have menstrual pains?
The uterus is a muscular organ. Before and during menstruation, the
uterus is working very hard to push out the uterine lining- tissue and blood
that would become the placenta if the woman became pregnant. When the uterus is contracting and
working, it is going to get tired and cause us pains. The pains are very normal. To help relieve them, she should drink plenty of water. She can also take Panadol, place
something warm over her stomach (such as bottle of hot water) and go for light
exercise.
What is fertilization?
Fertilization is when the man’s
sperm meets the woman’s egg, and it can now develop into a baby.
What days am I safe to go with a boy?
Young girls do not have safe days. Further explanation above.
What is sex?
Sex is when the man’s penis enters
the woman’s vagina. We talk a lot
about avoiding sex at school, but some of our pupils may not know exactly what
they are avoiding.
If I go for sex, will my breasts grow?
No. A woman’s hormones determine the size of her breasts. Every girl and woman is different. Her breasts will grow to the right size
for her. Boys try to deceive girls
by telling them this.
If I have feelings for boys, how do I avoid
having sex?
As an adolescent, having feelings
for boys is very normal. It comes
from the increase in hormones.
However, having feelings does not mean you need to act on them. One of the best ways to avoid having
sex is to avoid being alone with a boy.
If you want to spend time with your friends, stay in groups. Also, be friends with other girls or
boys who want to abstain from sex too.
How is Candida spread?
Candida is generally not spread from
one person to another. Candida is
caused by a warm and moist environment or a change in vaginal bacteria. Therefore, a girl or woman may develop
Candida if she wears wet knickers or wears knickers that do not dry quickly
(cotton is the best). She may also
get Candida from lack of bathing or washing her knickers. It is possible to get Candida from
sharing towels that are not dry.
Finally, taking antibiotics (treatment for various illness, including
Malaria) will kill the bacteria in her body and may lead to growth of
Candida. Treatment for Candida is
very simple: a tablet or cream.
If I throw my pads down the latrine, does it
mean I can’t produce?
No. Throwing pads down the latrine will not affect her ovaries,
fallopian tubes or uterus, all things that affect her ability to produce.
If I have sex with a man that is 50, can I get
pregnant?
Yes. Men continue to produce sperm until late in life. This question is very troublesome. Girls need to know that sex with adults
is considered rape. Adult men
should not be asking or having sex with minors (children under 18 years
old). If this happens, the man
should be taken to the police.
Why do I get pimples before my MP?
Girls and women get pimples before
their MP because their hormones have changed. Before their MP, their hormones increase the oil production
in their skin, which cause pimples.
The best way to avoid pimples is to wash your face every day with
soap. Additionally, avoid smearing
Samona on the oily parts of your face (or where you get pimples).
Why are some women barren?
Women can be barren for many
reasons. It may be biological: her
ovaries are not releasing eggs, her uterus is not producing good tissue to
support a baby, the structure of her fallopian tubes make it difficult for the
egg to reach the uterus. For these
reasons, it is not the woman’s fault, and they are completely unavoidable. Some women may have suffered from an
infection or STD that has caused damage to her uterus or fallopian tubes. Some women may not be eating well
enough, therefore her body is not producing tissue in her uterus to support a
baby. It is important to stress:
if a couple cannot get pregnant, 30% of the time, there is a problem with the
man’s sperm, not the woman.
If I use withdraw methods, can I get pregnant?
Yes. This method is only 70% effective because men release
pre-ejaculate fluid. Pre-ejaculate
fluid are small droplets of semen that are released when a man is sexually
aroused, but prior to ejaculation.
These droplets can also contain HIV/AIDS. Some experts believe that the effectiveness is further
decreased because men may fail to withdraw in time or may release semen on the
vulva. As a young girl, you have
no control over the proper usage of this method because you cannot control if
the boy or man removes his penis in time.
Is it good for me to pull my privates parts?
When a girl or woman pulls on her
private parts, she pulls her labia.
This is a cultural practice, and it is her decision whether she wants to
pull her labia. The labia’s major
function is to protect the woman’s urethra and vagina from infection. The labia is designed to stretch during
childbirth. Pulling the labia does
not help a woman produce because it does not affect her eggs, ovaries,
fallopian tubes or uterus. It also
does not help her push the baby because the labia will stretch.
Summary
The RUMPS
program has directly affected over 1,300 girls and teachers in the Butaleja
community through the sensitization about reproductive health and
HIV/AIDS. It has indirectly
impacted many parents, siblings and relatives. Hopefully, our community is now more aware of the issues
that affect our girl children.
Through the use of RUMPS, girls will be able to afford a method of
menstruation management, which will improve her school attendance, sanitation
and confidence. Schools should
continue the RUMPS program by mobilizing the SMC to budget for materials or
asking girls to contribute materials from home.
Chelsea
Roberts still has RUMPS kits available for 300 UGX at her home. If girls or teachers can organize
funds, they can arrange to pick RUMPS kits.
AFRIPads
are pre-made reusable menstrual pads kits that are produced by Ugandan women in
Masindi. They are sold at Biyizika
Drug shop at Hirya House in Butaleja directly across from the police
station. Agness sells them at
5,000 UGX. These pads will last
for about one year.
Although
Chelsea is a Peace Corps Volunteer for the Butaleja Coordinating Centre, she
has had the opportunity to bring RUMPS to many more teachers and girls. Following the success in the RUMPS
program in Butaleja, Chelsea has co-facilitated RUMPS workshops for Busaba CC,
Butebo CC, Busabi CC, Hasahya CC, Mukuju Core PTC, Save the Children of Fort
Portal, A little bit of HOPE Charity of Busolwe, Camp GLOW East in Iganga, National
Camp GLOW in Kisubi and Peace Corps Uganda.
