Secrets, shame and discipline: School girls' experiences of sanitation and menstrual hygiene management in a peri-urban community in Ghana

ABSTRACT

Women and girls need proper sanitation and hygiene facilities to maintain health and dignity. In this study we show how schoolgirls from a peri-urban community of Ghana, experience severe multidimensional ‘hygiene poverty’ when attending schools. Hygiene poverty was characterized by poor water and sanitation infrastructures and serious social and emotional challenges, including shaming and disciplining of their sanitation and menstrual practices, which forces girls to apply secretive coping strategies. We discuss the importance of changing the negative MHM discourses at schools and fostering supportive teaching methods in adolescent female health.

Acknowledgments

Thank you to Dodowa Health Research Centre for providing professional fieldwork logistics and research support and community sanitation data. Special thanks to Elizabeth Odai and Irene Siaw for interviewer assistance and to Gifty Adwoa Bondzie and Sefiamor Baah for supporting initial steps of data analysis. Thanks to Adriana Opong and the SUSA research project for research administration.

Notes

1. Sustainable Sanitation Ghana: http://publichealth.ku.dk/sections/global/research/projects/susa_ghana/

2. The Ghanaian Government has instituted several ‘Menstrual Pad programs’ which supplies school girls with subsidized menstrual pads, as a strategy to minimize school girls absenteeism. The study area was previously included in such a program.

Additional information

Funding

The project was supported financially by the Sustainable Sanitation Ghana Project (SUSA), with a grant from The Danish Ministry of Foreign Affairs, Danida (grant number: 10-050KU).

Notes on contributors

Thilde Rheinländer

TR conceptualized the study together with FK, DA and MG. DA organized and conducted the fieldwork assisted by several research assistants, supervised by MG and TR. DA, TR and MG together developed a plan for analysis, coded and categorized the data. TR analyzed the data further and drafted the paper. FK provided comments to the first full draft of the paper. All other co-authors commented on the draft and gave their full consent before publishing.

Margaret Gyapong

TR conceptualized the study together with FK, DA and MG. DA organized and conducted the fieldwork assisted by several research assistants, supervised by MG and TR. DA, TR and MG together developed a plan for analysis, coded and categorized the data. TR analyzed the data further and drafted the paper. FK provided comments to the first full draft of the paper. All other co-authors commented on the draft and gave their full consent before publishing.

David Etsey Akpakli

TR conceptualized the study together with FK, DA and MG. DA organized and conducted the fieldwork assisted by several research assistants, supervised by MG and TR. DA, TR and MG together developed a plan for analysis, coded and categorized the data. TR analyzed the data further and drafted the paper. FK provided comments to the first full draft of the paper. All other co-authors commented on the draft and gave their full consent before publishing.

Flemming Konradsen

TR conceptualized the study together with FK, DA and MG. DA organized and conducted the fieldwork assisted by several research assistants, supervised by MG and TR. DA, TR and MG together developed a plan for analysis, coded and categorized the data. TR analyzed the data further and drafted the paper. FK provided comments to the first full draft of the paper. All other co-authors commented on the draft and gave their full consent before publishing.