Jackline Rwegasira, A360 Youth Officer, PSI Tanzania
“You’re a grown up now, so you should stay away from boys,” said my sister when I arrived home from school. It had happened without any warning. I had a red spot on my skirt and was worried that I was in danger.
But the first words my sister told me were to be more concerned about boys and not the real issue: I was having my first ever period.
Across Tanzania, some parents and family members perceive menstruation as something to be ashamed of, a factor that holds them back from teaching their daughters about their periods and what their menses means for them. Menstrual literacy is strongly affected by disabling cultural taboos and community perspectives, which can impact access to accurate knowledge about menstruation and menstrual health and hygiene for young people.
Through Adolescent 360’s Kuwa Mjanja (Be Smart)—PSI’s flagship youth-powered sexual and reproductive health (SRH) program in Tanzania—we’re identifying new ways to integrate menstrual health into our existing youth-responsive contraceptive programming.
Kuwa Mjanja is a program in Tanzania that delivers life skills and contraceptive counseling sessions for girls aged 15-19. We create solutions with and for young people to help girls identify their dreams and understand how they can voluntarily choose (and stay with) contraception as a tool to achieving their goals.
MENSTRUAL HEALTH AS AN ENTRY POINT
With fears that contraception could lead to side effects— like infertility – and with misconceptions around how contraceptive use could change menstruation, including changes to bleeding patterns, girls told us they did not trust that contraceptives were safe to use or believe that they were relevant to them. We found that a lack of understanding about their own bodies (including limited knowledge about their menstruation) were among the barriers to them using contraceptives.
To address these concerns, we developed “Know Your Body” sessions during Kuwa Mjanja events for girls to learn about their menses and body changes. The team, in partnership with young designers like myself, also developed an interactive tablet-based app called Mjanja Connect for girls to use pre- and post- counseling. The app includes testimonial videos from “girls like me” with girls’ addressing side effects experienced per method chosen. The app’s “Buzzfeed-like” interactive quiz tests girls on their knowledge of side effects they may experience, like changes to menstruation, when using different contraceptives.
Not only do girls receive the information about menstruation, they also gain entrepreneurial skills training to support themselves and their communities, for example, by learning how to make their own menstrual pads with affordable and accessible materials.
By listening to and centering on what matters to girls, we adapted how we could reach girls with adolescent and youth SRH services and information that would give them the knowledge and tools to achieve their goals. In knowing more about their menstrual cycle—and wholly understanding that bleeding changes due to contraceptive use do not lead to infertility – girls gain more insights about their ability to choose to use contraception to pursue their life plans, including motherhood – whenever they are ready.
CLOSE THE LOOP
Engaging girls to learn about their body changes, particularly around their menstrual health, is the right thing to do. When girls gain knowledge about their bodies, including their menstrual health, they are better equipped to make decisions about their SRH.
Girls who can imagine their future are willing to make better choices and strive for them. The role of Kuwa Mjanja is to help these girls realize their goals, identify challenges and provide them with the tools and knowledge to tackle them. We are eager to continue incorporating menstrual health into our adolescent and youth SRH programming to #closetheloop and to provide young people with the holistic range of SRH services they need, now more than ever.