Request for Proposals (RFP): Menstrual Health

A Request for Proposals (RFP): Assessing the impact of a social ecosystem approach to addressing menstrual health for girls in Addis Ababa, Ethiopia.

Issuance Date: February 16, 2023

Response Due Date: March 16^th, 2023

THIS IS A REQUEST FOR PROPOSALS ONLY. Responses to this RFP are strictly voluntary and Splash will not pay respondents for the information provided in response to this RFP. The purpose of the activity as envisioned under this RFP is to support in the research of the content domains identified below, and to provide high-quality and sector-specific analytical, technical and evaluation services to Splash. This will allow Splash to address critical knowledge and learning gaps related to the impact of our menstrual health programming on the experience of girls throughout puberty. These research findings will help to improve Splash’s Menstrual Health program which aims for every girl to be educated and empowered to manage her menstruation with dignity and without fear so that she is able to achieve her full potential.

SUBMISSION INSTRUCTIONS RESPONSE REQUIREMENTS

Splash invites menstrual health sector thought-partners to submit comments, suggestions, and other information for consideration regarding its approach to the research initiative as described in the Scope of Work. Research and learning institutions and other potential research partners based within countries or regions where research is likely to take place are particularly encouraged to respond to this RFP. Applicants are encouraged to submit their own proposed activities based on their interpretation of the research needs as well as their own unique skill set.

Responses to the Scope of Work should include the following:

1. Cover page, not to exceed one (1) page, that includes:

• Point of contact name and contact information.
• Bios and resume of proposed research collaborator(s)

2. Splash is interested in receiving proposals including the following:

• Your capacity and qualifications to support the completion of the three research activity components and specific research focus areas are highlighted below.
• Your proposed methods for analyzing the data collected in relation to the research initiatives are highlighted under each focal area.
• Proposed approach to ensure uptake of learnings resulting from research (within and beyond Splash) in decision-making, policy and programs.
• A proposed personnel budget for your work, which includes the number of days for each member of the team and the cost per day. The budget ceiling for this Scope of Work is 20,000USD. Please do not include data collection costs in your budget, as these will be covered by Splash.

Please provide one (1) electronic copy of your response in Microsoft Word format as a single email attachment to Mrs. Emily Cruz (emily@splash.org) and Mr. Chris Nicoletti (Chris@splash.org). Please submit your response via our website only by March 16^th, 2023.

THE CHALLENGE

Women and girls across the globe continue to face a broad set of challenges that negatively influence their health, empowerment, and well-being, including the lack of access to menstrual health solutions. Countless girls do not have access to education on puberty and menstrual health before the start of their menses. Compounding this, many do not have access to adequate sanitation facilities, sanitary products, or pain management methods to manage their menstruation at school.

Poor sanitation and toilet insecurity in schools disproportionately affect girls and may contribute to their absence from school. Additionally, hygienic, and discrete disposal solutions for sanitary materials are critical; yet are rarely considered in sanitation programs and designs. Girls in school often undergo the discomfort of not being able to change their pad throughout the school day due to poor toilet conditions.

Lastly, pervasive stigma around menstruation and a lack of social support from peers, parents, and teachers directly impacts girls’ confidence, empowerment, and body literacy. These harmful social norms can result in girls dropping out of school earlier than their male peers, early marriage, early first birth, lack of decision-making power within their households, lack of financial independence, and so on.

Unsurprisingly, all these barriers to menstrual health management solutions at school greatly interfere with girls’ abilities to concentrate in the classroom and feel confident in their bodies, potentially leading to lifelong consequences.

SPLASH MENSTRUAL HEALTH INTERVENTION COMPREHENSIVE INTERVENTION

Training and Curriculum

We work to increase knowledge, change behaviors, and shift social norms through puberty and menstrual health education. Splash delivers age-appropriate education to children in primary and secondary schools to normalize periods, reduce stigma, and address common misconceptions. We offer additional support to girls through trainings on the practicalities of managing menstruation and maintaining personal hygiene. We aim to build knowledge, foster self-efficacy, and increase confidence and body literacy.

Supportive Social Ecosystem

By delivering complementary programs that leverage peers, older students, teachers, parents, and other critical stakeholders, we hope to drive normative change in the social ecosystem so menstruation can be seen as it truly is: a normal biological process that signifies health and well-being. The Social Ecosystems programs were designed to complement the content and delivery method of the WASH United-design Menstrual Health curriculum, Abeba’s World (Rosie’s World)- which serves as the core curriculum. These programs aim to increase knowledge, shift social and gender norms, and target the internal motivations of the social stakeholders within girls’ lives. The Social Ecosystems programs were designed through a participatory process including human centered design sessions and live prototyping with girls, parents, older/younger female peers, boys, and teachers over the course of a year.

Facilities with Dignity

Splash's menstrual health approach includes both infrastructure and behavior change. Our infrastructure approach focuses on ensuring access to girl-friendly sanitation facilities that are gender-segregated, clean, well-lit, ventilated, and equipped with water for personal hygiene, waste bins for product disposal, doors that lock to ensure privacy, and in-stall components such as stall hooks and shelves. We factor in broader considerations like the sanitation block location, the location and positioning of the external door, and provision of in-block features such as full-length mirrors to ensure accessibility, functionality, and safety.

SOCIAL ECOSYSTEM OVERVIEW

Parent Program

Parents’ Discussion Group: A parent discussion group focused on different Menstrual Health related topics will be organized for Parents during Parents’ Day by a trained focal teacher. The topics will include “Understanding menstruation and menstrual hygiene management,” “how to talk to children about puberty,” and “how to support girls during menstruation.” The discussion will be moderated by teachers with support from a Splash project officer. Parents will be given menstrual health reference materials to take home to share with other co-caregivers within their households.

Parents will also be engaged on Menstrual Hygiene Day and International Women’s Day celebrations in Schools. Parents will be invited to participate in the celebration events through the School PTSA. Parents will celebrate the events with their children to show their support to the girls.

Parent Program Objectives

• To build parent self-efficacy to discuss sensitive topics related to puberty and menstruation with children.
• Increase levels of knowledge in parents around puberty and menstruation.
• Provide parents with guidance on how to support children during puberty and menstruation.

BOYS PUBERTY WORKSHOP

Engaging male students in Splash’s menstrual health program to decrease instances of teasing and transform them into allies for their female peers. As menstrual health is a taboo topic, it will form a part of the Behavior Change package on gender equality, rather than being addressed as a standalone topic. The communications package will be delivered through a workshop co-facilitated by a male teacher and Splash project officer. The format will be discussion based, utilizing a reference booklet, movie screening/role playing, and activity sheet.

The Boys Puberty Workshop will be hosted at least once a year, ideally after the summer holidays or at the start of a new academic session. To reach the most boys possible, the workshop can be hosted twice a year with a different group of enrollees.

Boys Puberty Workshop Objectives

• To build empathy and inspire male students to be allies of their female peers
• To create a supportive environment for menstruating girls in schools by shifting norms and decreasing instances of teasing and shaming around menstruation by male students
• To increase levels of knowledge in boys around topics related to menstruation, puberty, and gender norms

PEER MENTORING PROGRAM + ABEBA'S WORLD

Peer Mentoring support will serve as an opportunity for girls to learn from each other and to get real-life advice and emotional support about puberty and menstruation from their peers. The peer mentoring program will be led by trained peer mentors from older grade levels to provide peer support to younger students for primary level schools, and from the same grade levels to provide same-age peer support to secondary level schools. Peer mentors will work together to provide emotional support and build a community of trust among girls.

The Peer Mentoring program is comprised of four 1-hour peer mentoring sessions (or the three 1-hour peer mentoring sessions for secondary students) and can span over the course of a month, with weekly sessions; or be spread throughout the academic year.

Peer Mentoring Program Objectives

• To increase levels of knowledge in menstruating girls around topics related to menstruation, puberty, and gender norms
  • For younger girls - objective is to have this knowledge PRIOR to menarche
• To create a peer support network for younger girls through providing real life emotional support and advice about puberty and menstruation
• To build the leadership skills among girls
• Self-efficacy to management menstruation with dignity

SCOPE OF WORK

The overall objective of this research is to assess the social normative changes in girls, boys, and parents after exposure to menstrual health interventions in Addis Ababa, Ethiopia. The research will focus in two primary domains: independent program component investigation and an investigation of a systems approach to normative change:

• Independent program component investigation: Splash will assess each program component independently to 1) identify the program-specific core drivers for normative change related to menstruation, puberty, and gender norms and 2) to find areas for future iteration and improvement of the program content and delivery.
• Systems approach to normative change: Splash will also take a high-level look at how the comprehensive menstrual health intervention and external factors (such as product availability/market constraints) interact to create a system of normative change related to menstruation, gender equity, and the role of girls within her social network.

Research Questions:

1. What is the impact of a boy-facing puberty workshop on increasing rates of empathy and allyship for menstruating female peers?
2. What is the impact of a parent support and education group on increasing parent knowledge, addressing stigma and misinformation, and increasing self-efficacy to support their children during puberty and menstruation?
3. What is the impact of a peer mentoring program in building leadership skills for girls, addressing social taboos related to puberty and menstruation, and creating a supportive peer network among girls?

Current Status of Research

At this point in time, the research tools have been finalized, ethics approval has been obtained, and the baseline data collection has been completed. Where Splash needs support is in the analysis of the existing baseline data and all future data collected, in the development of plans for the collection of the mid and endline data, the management of data collection and data quality review, in the drafting of journal articles, white papers, and other learning resources, and in the selection of academic journals and publications where the subsequent journal articles can be submitted.

SPLASH RESEARCH TEAM

The research team will consist of Emily Cruz, MSPH, Bellen Moges, MPH, Chris Nicoletti, MS, and Fiker Abebe, MS, MA. Splash may seek support from sector thought partners to create a steering committee to support in the design and execution of the research study. Splash is seeking additional research team members who will bring complimentary skills and knowledge to this research initiative.