Non-communicable disease (NCD) risk factors such as excessive alcohol intake, tobacco consumption, drug intake, unhealthy diets and physical inactivity have an effect on sexual and reproductive health. With her interest in health promotion of the intersection between sexual and reproductive health and rights (SRHR) and NCDs, and to her personal experiences of struggling with her menstrual cycle, Young Leader Louise Johansson created a simple and educational trivia game called ‘BUMM – body, uterus, mind and mixed‘ as part of her NCD Child Young Leaders Program year two project.
Underlying problems of SRHR and NCDs
The unmet needs for SRHR that women usually face are coupled with the rising burden of NCDs. The menstrual cycle, which punctuates most women’s lives, may be linked with various physical, psychological, and behavioural shifts. Multiple health issues should and can, be addressed simultaneously.
Menstrual disorders are highly neglected in many health areas and are not recognized at all on the NCD agenda. However, they are interconnected, contributing to many mental health problems and suffering for young girls and women. Apart from more comprehensive health systems, with better locally available awareness for adolescents, there will be an understanding of what is “normal” and when to seek help for irregularities. There needs to be knowledge free from shame attached to bodies and their functions. Awareness building of menstrual disorders is essential, but unfortunately, education about menstrual health and how it connects to related health issues are out of reach for many.
With the growing NCD burden on increasingly younger populations, the demand for health systems to manage NCD-SRH co-morbidities will rise. NCDs’ risk factors need to be addressed at all life course stages. Similarly, improving health outcomes calls for a comprehensive understanding of women’s health, from menarche to menopause. Menstrual disorders should not only be seen as a “women’s and girl’s issue”. There is a need for targeted efforts, and agenda-setting should go from “one-condition” only campaigns to focus on integrated solutions to women’s health challenges across the life cycle.
Project objectives and partners
- Increase awareness of menstrual disorders and its intersection with NCDs
- Educate young people about SRHR and NCDs
- Develop an accessible, informative and culturally relevant learning tool about SRHR and NCDs
Collaborating partners include: My Period is Awesome, NCD Child, The Wellbeing Experience in Uganda, and Dukataze in Rwanda.
What is the BUMM game?
The BUMM game is an easily accessible and understandable trivia card game used to learn about critical and complex issues of SRHR. The game has been rolled out in ‘Menstruation Stations’, which are a platform for people to access a safe space for menstrual hygiene and participate in sexual and reproductive health and rights sessions, in Kigali, Rwanda and Kampala, Uganda. Trivia cards are available in English, Luganda and Kinyarwanda and is played by adolescents weekly.
The game has four themes: body, uterus, mind and mixed, and trivia questions are mixed with talking cards stating questions like: “What can someone do to relieve period pain?” or “Where can someone seek help and support for mental health issues?”. The trivia cards are also mixed with deep dives into relevant topics to learn more about SRHR-related conditions such as endometriosis, obesity, menopause, the menstrual cycle and hormonal fluctuations, stress, and diabetes.
Example of game questions include:
- Do mental health disorders affect young people?
- What is a menstrual cycle?
- What causes period pain?
- What is a menstrual disorder?
- Why is adolescence the most significant period in the life course regarding NCDs?
- Can obesity be linked to hormonal disorders?
- True or false. Every person who has a menstrual cycle has the same symptoms.
- Is it a woman’s right to decide when or whether to consider having children?
- What does PMS stand for?
- True or false. Menstrual migraine can significantly affect someone’s quality of life and cause functional disability.
- True or false. High levels of anxiety, depression, and other pathological mood symptoms that characterise psychiatric disorders are reported by women diagnosed with endometriosis.
The game is still to be evaluated by participants and collaborating organizations.
Acknowledgements
Louise would like to thank everyone who has been a part of creating this project with her, especially to Gilbert Odong in Uganda, Amina Umuhoza and Sharon Mbabazi in Rwanda, Hanna Hellström and Terese Lann Welin in Sweden. Last but not least, the team and NCD Child for believing in her project.
