What Women Want: Menstrual Hygiene
By Leslie Telleria
“My one request for quality reproductive and maternal healthcare service is [to] teach young girls on how to keep themselves clean during their menstrual periods,” Fatuma (32, Uganda).
On March 22nd, the world celebrated World Water Day to highlight the importance of access to freshwater. Beyond the obviously vital role which water plays in sustaining life, the ability for all people to access clean water — regardless of income, geography, or gender– is a matter of human rights.
Water, sanitation, and hygiene (WASH) are key factors to determining equity for women and girls. WASH is also essential to determining wellness and equal access to success for women and girls; without access to clean water or safe sanitation practices, people who menstruate face an increased risk for infections and health complications such as UTIs, hepatitis B, and cervical cancer. The lack of provision of free and affordable menstrual products such as pads and tampons also poses greater risk for infection – forcing women and girls to turn to socks, newspaper, and other unsanitary materials to absorb their menstrual blood.
When women and girls lack safe access to clean water and proper sanitation, they often have to miss or drop out of school or work. This disproportionately affects young children living in poor and rural communities, as well as communities where extreme inequity based on gender and ethnicity already exists. In Sub-Saharan Africa, it is estimated that one in ten girls misses school during their period, which is roughly 20% of a given school year.
When girls miss school, their chances of child marriage and teenage pregnancy increase significantly. Not only does this erase opportunities for young girls, but it also poses complications during pregnancy and childbirth given that teenage pregnancy is the leading cause of death for 15-19-year-old girls globally. Along with a pregnant adolescent’s greater risk for maternal mortality, there is an increased chance of their babies being stillborn or dying in the first few weeks of life.
Barriers to menstrual hygiene severely affect the health and opportunities of women and girls, while also perpetuating period stigma and creating insecurities about normal bodily functions. When women and girls can’t even access products to manage their period — let alone have conversations about menstrual health — this perpetuates shame. Menstrual shaming prohibits those who menstruate from participating in a normal life.
The lack of access to free menstrual products is a serious human rights issue, and it is an issue which extends beyond these countries. In India, many women are tackling the stigma and lack of access to menstrual products by forming their own businesses and producing menstrual products themselves. In the United States, 33 states continue to tax menstrual products as “luxury items” because they aren’t deemed to be a necessity; this is known as the tampon tax. Organizations like PERIOD. and Period Equity are working to ensure accessible menstrual products and the removal of the tampon tax. These cases of menstrual activism demonstrate how important it is to uplift the work of grassroots movements and to leverage political systems to better address women’s issues.
Barriers to menstrual hygiene were also reflected in the responses from the global What Women Want campaign. Beginning on 11 April 2018, International Maternal Health and Rights Day, and continuing for one year, 359 partners asked women and adolescent girls in 114 countries: what is your top request for your maternal and reproductive healthcare? The What Women Want campaign is unique in that it asked women and girls to set the agenda, as opposed to beginning with a premise of what is important or asking them to decide among a set of options.
Over 1.2 million women and girls around the world spoke up and identified their specific demands for reproductive and maternal services, including access to menstrual products and education on menstrual hygiene. In Kenya and Uganda, the demand for improved menstrual health rose to the top of their demands.
In both Kenya and Uganda, roughly a third of respondents requested that menstrual products be free.
In Kenya, 118,545 women and girls participated in the campaign. WASH was the top demand (9.7% of respondents), closely followed by respectful and dignified care (9.4%) and menstrual health (6.9%). Of the nearly 7% of total respondents demanding improved menstrual health, 68% of those specifically asked for the provision of quality sanitary towels and pads.
In Uganda, 90,771 women and girls participated in the campaign. The percentage of respondents who demanded menstrual health was the third highest demand (8% of respondents), with provision of basic medical supplies (9%) and labor and delivery services (9.4%) as the top two demands. Of the 8% of total respondents demanding improved menstrual health, 61.23% of those highlighted the need for sanitary pads. “Provide free menstrual pads to teenage girls,” Rose (37, Uganda).
This is why organizations like the White Ribbon Alliance are asking those in power such as politicians and health leaders to incorporate women’s voices in their healthcare decision-making. With the demands that have emerged from the What Women Want campaign, the White Ribbon Alliance is building an advocacy agenda for national and global change and encouraging other activist groups to do the same.
True advocacy is about uplifting the demands of those who know what they want. When we highlight the need for access to basic human rights like clean water and dignity through menstrual hygiene, we agree that girls and women deserve to fully participate in their lives.
In this way, when we listen to the demands of women and girls, we foster a more gender equal world.