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According to UNICEF, every month 1.8 billion persons menstruate. Millions of these have no resources to manage their menstruation in a dignified manner. The issue cuts across child, non-gender conforming persons, and women’s rights. The issue is surrounded by a complex mix of gender inequality, discriminatory social norms, cultural taboos, poverty, and a lack of basic services like safe toilet facilities and sanitary products. This mix of circumstances, which may differ across countries, but has the same negative effects, can all cause menstrual health and hygiene management (MHM) needs to go unmet and have a further impact on school-age girls and young women that diminish their educational opportunities and social participation. The impact on the environment can also be sizeable.
UNESCO, since 2011, cited studies that estimated that as many as 10 to 20 percent of school days were lost worldwide due to menstruation. A more recent study in India found that up to a quarter of adolescent girls reported missing school during menstruation. Other studies point to more than half of adolescent girls remaining at home during menstruation (South Sudan), or missing from one to three school days with a very high negative impact on their grades and falling behind at school (Kenya). This is even worse due to the fact that only a very small percentage of schools offer meaningful education on health and hygiene and only a very small percentage of girls knows about menstruation before their first period (Bangladesh).
According to the WHO/UNICEF menstrual hygiene management is defined as:
“Women and adolescent girls are using a clean menstrual management material to absorb or collect menstrual blood, that can be changed in privacy as often as necessary, using soap and water for washing the body as required, and having access to safe and convenient facilities to dispose of used menstrual management materials. They understand the basic facts linked to the menstrual cycle and how to manage it with dignity and without discomfort or fear.”
As stated by the Special Rapporteur on Human Rights to Water and Sanitation in his report on Gender Equality, “Poor menstruation management has far-reaching consequences for society as a whole and lack of knowledge by both men and women reinforces the taboos on this topic”. Furthermore, “Girls all over the world grow up with the idea that menstruation is something they should hide and not speak about, as an embarrassing event associated with shame. This powerful stigma and taboo surrounding menstruation translates into fear of leaking or staining clothes”.
Thus, a holistic approach beyond only WASH and related SDG 6 objectives is needed to cover all of the elements that surround Menstrual Health and Hygiene (MHH) management. Taking the five priority areas to holistically address the issue as proposed by the Global Water Security & Sanitation Partnership (GWSP) of the World Bank into account (education, health, gender equality, economy, and the environment), LIDE Infinite Skills Africa (LIDEISA)-a not-for-profit Development and Education social enterprise was established in 2021 with a purpose of offering holistic hands-on skills education and leadership mentorship to all people with focus on youth without discrimination including in the area of MHM.
LIDEISA works to bridge the education gap between the poor and rich, and mentors a new breed of leaders for communities’ transformation, aiming to skill job creators as opposed to job seekers.
Targeting acceleration of efforts to push attainment of SDGs by 2030, through skilling, LIDEISA prioritises girls’ formal education because it is an enabler for sustainable development and the fact that the right to education plays a multiplier role. The focus is on girls’ education because they face barriers to their education every day, including growing poverty levels within Uganda and other African countries.
MHM enables girls to make decisions about their own lives and eventual contribution to their communities. It is true, as research by the Abdul Latif Jameel Poverty Action Lab (J-PAL) in Nepal points out, that access to education about menstruation and access to safe menstruation management and hygiene products are not the only reason why girls in particular may have disadvantages in education and later in life in the labour market and active participation in society. However, working with all stakeholders together with other initiatives in Uganda and the East African region that address the issue, a virtuous circle has commenced. Coverage by diverse news channels and LIDEISA’s own communication strategy through social media has also been key to spreading the word about the campaign and opening collaboration with education, health and environmental actors in Uganda and beyond.
Here are some of the testimonials by girls and boys reached by the campaign in Kitagobwa UMEA Primary School in Ngando sub-county, Butambala district.
“I have learnt how to perfectly use pads without blood outflow,” Nalwanga Sunaje, a Primary (7th grade) pupil said. “I am now more confident and proud about menstruation than before when I had to stay at home waiting for the end of my periods to come back to school.”
Nandawula Masitulah joined her schoolmate saying, “I had never received a very serious talk about menstruation since I started it. It has been delivered in a way that makes it fun for all of us to understand and I was pleased to see boys and male teachers taught about what we go through and taught ways to support us especially at school instead of bullying us.” She also learnt how to fix LIDEISA reusable sanitary pads in underpants to “menstruate safely without blood leakages".
Therefore, ensuring that the rights of persons who menstruate are understood to go beyond access to safe, suitable and reasonably priced sanitation, and hygiene, to also include the promotion of girls’ and women's empowerment is key.
It aligns with their enjoyment of the right to have and make choices, to have access to opportunities and resources, and to have control of their own lives in the private and public arenas-it needs all our support to be achieved.