ACROSS Menstrual Hygiene Educator conducting a follow up survey with a Ruby Cup user in Mahad IDP Camp

Supporting Offline Communities During the Pandemic: Ruby Cup and ACROSS Find Ways to Mentor Menstrual Cup Users in South Sudan

Photo: ACROSS Menstrual Hygiene Educator conducting a follow up survey with a Ruby Cup user in Mahad IDP CampĀ 
(Photo credit: Anna Abel / In Partnership with ACROSS)


Ruby Cupā€™s regular donation programmes have been put on hold during the Covid-19 pandemic. Instead, weā€™ve been focusing our efforts on distributing menstrual cups toĀ frontline health workers. But our donation programmes are about more than simply giving out Ruby Cups. Every donated cup we give out is provided as part of a wider education and mentorship programme, ensuring that every person who receives a cup is supported during their first few months of use. As well as new donations, our follow up mentorship and support programmes, which usually happen in groups, have also been put on hold. The vast majority of our recipients donā€™t have internet access, so online sessions are not an option. Instead, Ruby Cup and our partners have had to look for creative solutions to ensure that every person we are working with is still being supported.Ā 

Donating Menstrual Cups in South SudanĀ 

In South Sudan, we partner with ACROSS, a locally based organization that works with residents of the Mahad Internally Displaced Persons (IDP) Camp in the capital city of Juba. In 2020, we worked together to distribute 300 Ruby Cups to women at the settlement. Mahad IDP is home to around 7,000 people, most of who were forcefully displaced from their homes due to the ongoing fighting that began in 2013. Mahad IDP is located on the grounds of a University in the centre of the city. The land was not built to house large numbers of people and as a result, it can be hard for residents to access clean, private bathroom facilities.Ā ā€œManaging periods can be a challenge anywhere, but one of the toughest environments of all would be a crowded refugee camp or informal settlement such as Mahad IDP Camp in South Sudan."In Mahad, there are only two blocks of latrines for over 8000 people. People living in Mahad IDP Camp have been forcibly displaced from their homes by war, and many are unemployed and extremely poor, so even purchasing soap can be a challengeā€ explains Kimika Oddie the programme manager at ACROSS.Ā 

Menstrual products can be particularly difficult to find or are unaffordable in the settlement, with the result that many people are forced to use scraps of cloth or rags to manage their periods. During their work at Mahad IDP Camp, ACROSS found that many of the women fear embarrassing leaks during their period and choose to stay at home during menstruation. Those who are able to access disposable pads have no choice but to dispose of them in the overcrowded communal latrines, which contributes to problems with waste management on the site. ā€œUnlike the cloth and disposable pads, you donā€™t have to think of where to dispose of your menstrual cup,ā€ says Teresa James, a programme participant.Ā 

Working With Local PartnersĀ 

At Ruby Cup, weā€™ve offered a Buy One, Give One scheme on every cup sold since we were founded in 2012. To date, weā€™ve donated around 96,000 cups in 12 countries. To distribute our cups responsibly, we work with locally based partner organisations who have a strong understanding of the local cultures and context. Our partners adapt our workshop and education programmes to fit the needs of the communities where they work.Ā 

ACROSS led an initial trial of a menstrual cup scheme in Mahad IDP Camp in 2019. They found that menstrual cups provided a popular solution to menstrual management in the settlement.Ā 96% of pilot participants stated that they were recommending a menstrual cup to other women as their preferred method of period management.ā€œIā€™m very comfortable with the menstrual cup,ā€ says 17 year old Akwany Ajit, ā€œand it doesnā€™t leak on my skirt.ā€Ā 

Mentoring and Educational SupportĀ 

Key to the success of the project was the ongoing menstrual health and hygiene mentoring model , which continued over 5 months to support and troubleshoot any issues with using the cups. Following the distribution of cups, ACROSS worked with a group of women representatives from each of the ethnic groups in the community to becomeĀ  ā€˜Cup Championsā€™ who acted as mentors and role models within their community. These women were given training and support to lead workshops and information sessions in their local languages. ACROSSā€™ trainers also spent time working with elders, mothers and fathers within the community to educate them about the benefits of menstrual hygiene and menstrual cups. This helped to create the groundwork for acceptance of the menstrual cups with support from the wider community.

Following the trial, demand for menstrual cups grew. ACROSS reached out to Ruby Cup, and we were happy to donate a further 300 cups, which were distributed in Mahad IDP Camp in January 2020. The cups were offered to women as part of a ā€˜dignity kitā€™, allowing women to manage their periods with dignity.

Adapting to The Global PandemicĀ 

In March 2020, ACROSS were due to conduct a follow up evaluation and mentorship programme with the cup recipients, but the spreading pandemic meant that group programmes and workshops had to be put on hold. To Ruby Cup and our partners, education and mentorship are essential to ensuring that women can live dignified periods, so we decided to get creative and to look at safe, alternative ways to connect with cup recipients to ensure they got the support they needed during the first few cycles of using the cup.

Instead of group discussions, ACROSS trainers carried out door to door follow-ups, providing in depth and direct support to each person who needed it, and gathering vital feedback and data about the use of the cup.Ā ā€œIndividual doorstep follow ups allow for more personal feedback and sharing, and give space for quieter people to ask questions, who might be too shy to speak up in a group context."Individual surveys and conversations can also allow people to share honest feedback rather than leaning to the group consensus.ā€ explains Kimika Oddie from ACROSS. ā€œFrom a data collecting perspective, individual surveys provide more accurate quantitative data than focus group discussions, which is helpful for measuring statistics. However, group workshops can be very powerful if facilitated well, and allow for more peer to peer sharing and learning and confidence building than individual follow upsā€ she continues.Ā 

The support programme worked well. The trainers recorded a 97% adoption rate with 91% of the new users reporting that the Ruby Cup was now their preferred method of menstrual management.100% said they would recommend Ruby Cup to other people with periods. When asked why the women would recommend a menstrual cup to other women, 44% said that it was comfortable. An evaluation report from ACROSS found that ā€œwomen and girls in Mahad IDP camp have wholeheartedly accepted menstrual cups as an appropriate and valuable product to manage menstruation.ā€1 Thanks to the menstrual health workshops that were offered alongside the donated Ruby Cups, the survey also recorded an increase in menstrual hygiene in women living in the settlement.

ACROSS Post Distribution Evaluation Report, March 2020

ACROSS Post Distribution Evaluation Report, March 2020

Feedback from menstrual cup recipients in Mahad IDP also provided an extra insight into why they have proved so popular. In South Sudan, traditional dances form an important part of cultural celebrations. During ACROSSā€™ work within the settlement, they found that unlike other period management solutions, menstrual cups allowed women to participate in these social dances and celebrations rather than sitting them out. ā€œThe ordinary pad made me feel uncomfortable. When I sat down in public, I kept checking behind. Since I got my menstrual cup, I donā€™t feel that Iā€™m on my period. If I want to run, to dance, to do anything, I just do it normally,ā€ says Kawaja Peter.Ā 

Thanks to ACROSSā€™ pioneering and dedicated approach to supporting their community, we are now able to recommend this technique as best practice to our other partner organisations who are operating in areas where social distancing is in place.Ā 

1ACROSS Post Distribution Evaluation Report, March 2020
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