Supporting Menstrual Health and Hygiene to Improve Women and Girls’ Wellbeing

Community health workers supported by APHRC (African Population and Health Research Center) displaying a menstrual cup used by women in Korogocho slum, one of Nairobi's most populated informal settlements. Young mothers that visit the clinic also receive family planning services and sexual reproductive health options.

By guest author Isha Padhye with contributions from Traci L. Baird, President and CEO; Meskerem Setegne, Associate Project Director, A Rights-Based Approach for Enhancing SRHR in Ethiopia; and Blandine Yeo, Program Associate, Communications

Half of the world’s population will spend half of their lives menstruating (or, having periods), yet 500 million women and girls1 around the world lack access to menstrual hygiene materials and safe, clean facilities. This “period poverty” is detrimental to their physical, mental, and emotional health. On this World Menstrual Hygiene Day, we highlight the importance of including menstrual health and rights within the broader portfolio of sexual and reproductive health and rights (SRHR), and we call for increased action, policies, and resources to support menstrual health.

Menstrual health includes having information about menstruation and self-care; access to menstrual hygiene materials; diagnosis and treatment for menstrual cycle disorders; and the ability to be free from stigma and discrimination related to menstruation.  

Menstrual health is increasingly conceptualized as part of the SRHR field and is also often included in programs that address water and sanitation and humanitarian assistance. The Guttmacher-Lancet Commission on Sexual Health and Reproductive Health and Rights defined reproductive health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes” and affirms that people should be able to “manage menstruation in a hygienic way, in privacy, and with dignity.” This inclusion is vital as menstrual health is inextricably linked to many other aspects of SRHR and needs to be supported to ensure the right to health is a reality for all.

Women and girls around the world may sacrifice other aspects of their health and lives to protect their menstrual health. For example, some adolescent girls may engage in transactional sex to purchase period products, which can endanger their lives and health by increasing their risk of pregnancy, infection, and violence. A lack of menstrual hygiene management (MHM)—including clean water and safe washroom facilities—in schools coupled with the stigma surrounding menstruation leads to girls staying at home and missing school. When they have to choose between managing their menstrual health or facing shame and humiliation at school, girls miss out on their education. Additionally, when women and girls have their periods they may be prevented from attending large events, bathing, or cooking because they are thought to be unclean. Isolated from others and stripped of basic human dignity, women and girls are often shunned from society in more ways than one. Addressing menstrual health and rights is not just an SRHR issue, but also a human rights issue.

Menstrual health must be addressed holistically; policymakers, healthcare providers, educators, community leaders, and individuals can take steps to protect menstrual health. At a policy/governmental level, there are a few countries that offer menstrual leave where governments provide time off of work for dysmenorrhea (painful periods). Other countries have stopped taxing menstrual management products, recognizing that such taxes discriminate against women and girls.

Institutions, including the healthcare system, schools, and correctional facilities, can support women’s and girls’ MHM and other aspects of menstrual health. In healthcare facilities, healthcare providers should be prepared to give advice on managing period pain and offering or referring for screening for causes of severe pain or irregularities.

Schools play an especially important role in informing girls about their periods and ensuring that all young people understand menstruation as a normal and healthy process. Destigmatizing menstruation and menstrual products and ensuring that institutions including schools and healthcare settings have facilities and products available for those who need them will increase access to healthcare and to education. For instance, in 2022 through EngenderHealth’s A Rights-Based Approach for Enhancing SRHR in Ethiopia program, we trained school communities on menstrual hygiene management. The training enhanced participants’ capacity to equip and support adolescent girls with basic information about menstruation and its hygienic management, including how to prepare reusable menstrual pads. The participants shared their new knowledge and skills by training others on MHM and educating 294 girls in eight schools on how to make their own menstrual products using cotton fabrics.

Correctional facilities, such as jails and prisons, are another important institution where menstrual health is often ignored, to great detriment. Ivorian partner organizations Soutien Aux Mères et aux Enfants en Détressse de Cote d’Ivoire (SMED-CI) and Actuelles believe that every woman has the right to dignity during her menstrual period, including and especially those who are incarcerated. They work in correctional facilities as well as in schools to reach women and girls where they are, with the information and supplies they need.

A man stands next to the back of an open truck. Boxes of menstrual pads are piled in the truck.

At the community level, organizations can provide support to their community members. For example, through the Rights-Based Approach project mentioned above, EngenderHealth purchased menstrual pads and distributed them in COVID-19 quarantine and isolation centers, supporting the menstrual needs of more than 36,000 women and girls. Since 2018, Actuelles has reached more than 20,000 women and girls with menstrual pads, including creating “towel banks” in high schools and colleges. Another Ivorian partner organization, Arc en Ciel du Bonheur, works to destigmatize menstruation and in 2022 provided 50,000 free menstrual pads to women and girls. In an EngenderHealth project in Bihar, India, community health workers identified and trained adolescent peer educators on a range of priority health topics, including menstrual hygiene.

At an interpersonal level, we can encourage family members, friends, teachers, athletic coaches, and other members of the community to speak about menstruation as a normal process and help all people understand how to manage periods. Above all, we need to support women and girls in feeling empowered, informed, and unashamed of this very normal bodily function. The more they are informed and prepared, and the more we destigmatize menstruation, the more people can advocate for themselves and protect their health.

We advocate for a multi-level approach that creates systemic strongholds to ensure the right to menstrual health for all. We call on individuals, community organizations, institutions, and policymakers to join the effort to promote menstrual health and SRHR by:

Recognizing the challenges that people face with menstruation and building menstrual health content into education, supply programs, services, and advocacy interventions are critical to ensuring health and rights for all. We are proud to partner with organizations addressing this important health and rights issue and honor them as we collectively acknowledge World Menstrual Hygiene Day.

Community organizations in Côte d’Ivoire address menstrual health

EngenderHealth is proud to partner with several community organizations in Côte d’Ivoire supporting menstrual health in a number of important ways.

With special thanks to and appreciation for our partners in Abidjan, Côte d’Ivoire:

Header photo courtesy of Jonathan Torgovnik/Getty Images/Images of Empowerment. Some rights reserved.

  1. We recognize that not all people who menstruate are girls or women. Non-binary people and trans men may menstruate, too.