Indonesian schools are still lagging behind on sanitation and hygiene condition, affecting female students and contributing to poor menstrual hygiene management (MHM) practice.
A study done by SMERU research institute and Plan International in March 2018 finds that sanitation and hygiene practices that are still not properly implemented at schools are some of the factors limiting access to information and poor MHM practices. The study was conducted at three sub-districts in Jakarta, East Nusa Tenggara and West Nusa Tenggara provinces. It found that lack of knowledge; limited sanitation facilities such as clean water, toilet and sanitary pads; and cultural norms contribute to poor MHM practices among female students.
“Female students are more prone to skipping classes due to sanitation and hygiene problems,” said Rezanti Putri Pramana, a Junior Researcher for SMERU. She referred to a 2014 study by UNESCO that found the quality of sanitation facilities in schools is directly related to the number of absent days of female students.
“Once they menstruate and faced with inadequate sanitation facility, they would rather not go to school, or, in some extreme cases found by UNESCO, they drop out of school. Poor sanitation and hygiene condition in schools can potentially cause various sickness or health issues such as reproductive tract infections, cervical cancer, low birth weight, or premature birth.”
In addition, the culture of taboo surrounding the discussion on menstruation as well as stigmas attached to it deny girls the knowledge to menstrual health management practices.
“Thirty-nine percent of primary and secondary female students have been teased by their friends when they were menstruating,” said Silvia Devina, an advisor of water, sanitation, hygiene & early childhood development for PLAN International. “Sixty-three percent of their parents feel they do not have to explain menstruation to their daughters; 45 percent think they do not have to explain it to their sons because it is inappropriate, or because they are still too young and they will find out on their own as they get older.”
“The topic of menstruation is still very much a taboo in our society and schools. But people have to understand it in order to implement proper policies and facilities regarding health and sanitation,” she added.
In 2016, UNICEF Indonesia worked with the government to develop a book that aims to educate boys and girls on menstruation and menstrual hygiene management. Other organizations such as PLAN International Indonesia also holds seminars and education regarding sexuality and MHM.
Though improving school’s toilet is one of the focuses of the government’s school operational subsidy, the Badan Operasional Sekolah (BOS) fund, since 2016, according to the Primary Education Data taken in 2016 and 2017, only 34.1 percent elementary schools have clean and adequate gender-separated bathrooms and 64.8 percent have access to wash their hands. The same survey shows 30.5 percent of the schools have very poor to no access to water, 12.1 percent have very poor to no access to bathrooms, and 35.2 percent have no access to running water to wash their hands.
“There are about 200 thousands schools in Indonesia with 148 thousands of them being elementary schools, both public and private. We have to work hard in improving hygiene and sanitation conditions in schools considering the numbers, but we have to work together,” said Khamim, Director General for Primary and Secondary Education in the Education Ministry, in a School Sanitation and Gender conference held by SMERU on October 17.
He explained the existing zoning system in which a school is selected as a model school in a zone to set example for other schools in the area to follow suit.
There are 353 model elementary schools that meet international standards in the 2,578 zones in total receiving the funds to improve their water, hygiene and sanitation facilities. These schools have started to implement several programs including providing health education and health services, including improving their school’s infirmary, and maintaining a clean and healthy learning environment in schools. Some participated in the in International Handwashing Day on October 15, working with Unilever Indonesia.
“Washing hands regularly with soap is essential to health especially in children. We found that many students skip schools or even drop out due to illnesses that could have been prevented just by washing their hands with clean water. But even access to clean water is still unavailable at some schools, let alone access to an adequate place to wash hands,” said Khamim.
Unfortunately, the zoning program has not accomplished the goal to improve sanitation and hygiene in most schools that are not model schools, with lack of funding being the main issue.
According to the Ministry of Education and Culture, about 15 percent elementary schools still do not have enough access to clean water, 54 percent schools still have mixed gender bathrooms, and the majority of the toilets remain unusable in 2017.
“Schools have to aim to do better in improving their hygiene and sanitation facilities. This will affect the outcome for our future human capital,” he added.
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