Carley Truyens

Project title: Menstrual Hygiene Management in South African Communal Sanitation Facilities: Recommendations to the eThekwini Department of Water and Sanitation

Degree: MPH | Program: Environmental and Occupational Health (EOH) | Project type: Project
Completed in: 2012 | Faculty advisor: William E. Daniell


Nearly 40% of the world’s population lacks access to improved sanitation facilities, and there is a push within the water, sanitation, and hygiene (WASH) sector to find innovative ways to increase sanitation coverage worldwide to protect human health and the environment. South Africa considers water, sanitation, and housing to be human rights and has committed to providing them at no cost to those unable to afford them. eThekwini Municipality, in which Durban, South Africa, is located, has a housing backlog of 410,020 units, with nearly one quarter of its population living in informal settlements. This backlog results in a need for interim services for those waiting to shift from informal settlements to formal housing. To address the interim water and sanitation needs of those living in informal settlements, the eThekwini Municipality has constructed community ablution blocks (CABs) that consist of gender-separated toilets, showers, and washbasins, and each facility has a paid caretaker responsible for daily management and cleaning.

Menstrual management products (MMPs) are critical to gender equality, impacting women’s health, education, and economic involvement. In 2010, South African president Jacob Zuma promised that the government would provide free sanitary napkins to all indigent women and adolescent girls, and several manufacturers of MMPs have begun to market these products to women in low-resource settings. The interactions between women, unfamiliar sanitation systems, and MMPs are likely to impact women and the sanitation systems they utilize.

This project aims to characterize the relationship between CABs and menstrual hygiene management in Durban’s informal settlements. Through interviews, photo documentation, and observations, we gathered information on existing conditions in CABs with respect to solid waste management and disposal of MMPs, the supply chain for non-durable goods, facility maintenance, and caretakers’ perceptions of risk from bodily fluids and occupational safety. Based on the analysis of information gathered during the case study, we make the following recommendations to the eThekwini Water and Sanitation Department (EWS):

Coordinate with the Department of Solid Waste to provide garbage bags and bins and waste collection to communal sanitation facilities.Evaluate CAB-level supply chain, storage, and distribution of toilet paper as potential supply chain to distribute free MMPs to indigent women and girls.Seek additional guidance on proper collection and disposal of MMPs from research institutions in South Africa and internationally.Educate CAB caretakers on disease transmission from bodily fluids and proper protection.Educate community members, including caretakers and primary and secondary school students, on menstrual hygiene management and proper disposal MMPs.

We believe that these recommendations will improve women’s experiences at CABs, help protect caretakers from occupational hazards, and reduce negative impacts on the sanitation systems.

*Taken from “Executive Summary”