Menstrual Hygiene: Bridging the Gap in WASH Programming 

Dear Partners:

This month’s edition of the Technical eUpdate is dedicated to a topic within the WASH sector that although is often incorporated into WASH discussions, is rarely integrated with the level of detail or comprehension that it truly deserves: Menstrual Hygiene and Management. 

The impact of this issue on young women is profound. According to UNESCO, 50% of African girls report missing school due to their period because of a combination of inadequate sanitary materials, misinformation, or cultural taboos. The shame and stigma associated with menstruation also affects girls’ education indirectly through causing low self-esteem and confidence levels. 

Because of the challenges which exist around menstruation, many girls end up missing considerable amount of school, or at worst even dropping out, due to humiliation and stigma related to menstruation. In some cases, girls engage in transactional sex so that they can raise the money they need to buy sanitary towels, putting them at the risk of HIV and STI infection. Alternatively, young girls are forced to skip school during the time they experience monthly periods to avoid both the cost of pads or use of cloths. A girl absent from school due to menstruation for four days in a month loses 13 learning days, equivalent to two weeks of learning, in every school term. Without a safe, private space, with adequate facilities for washing the body, menstrual materials and clothing, women and girls face difficulties going about their daily lives having a negative impact on girls’ right to education. 

In 2012, UN Secretary General Ban Ki-moon said that “the greatest return [from development] comes from investing in girls and women. When they are educated, they drive development in their families, communities and nations.” Without access to toilets, sanitation facilities, menstrual pads and information, girls and women are unable to be the drivers of development they have the potential to be. We simply cannot afford to leave issues affecting female retention in schools unaddressed. 

Beyond academia, menstruation is too often taboo, and has many negative cultural attitudes associated with it, including the idea that menstruating women and girls are ‘contaminated’, ‘dirty’ and ‘impure’. In many cultures, women and girls are forced into seclusion, suffer reduced mobility and dietary restrictions, and can be stopped from participating in other routine daily activities in the home, as a result of the cultural norms around menstruation.

Unfortunately, the silence and stigma surrounding menstruation makes finding solutions for menstrual hygiene management a low priority. This is often reinforced by the fact that women and girls are not seen as priorities for specialized intervention in this area. However, continuing to neglect menstrual hygiene in WASH could also have a negative effect on WASH-sustainability. Failing to provide disposal facilities for used sanitary pads or cloths can result in a significant solid waste issue, with latrines becoming blocked and pits filling quickly.  Failure to provide appropriate menstrual hygiene facilities at home or school could also prevent WASH services being used by the intended users all of the time.

These are just a few of the issues which emerge on this topic. As feminine hygiene remains a taboo, menstrual hygiene has been routinely overlooked by professionals in the water sector, and in the health and education sectors too. It is often a sub-topic of discussion in broader WASH programs, with limited or no interventions to address comprehensively, while we know that the impact cuts across WASH, sexual and reproductive health, HIV-prevention, and economic development initiatives. 

The below resources are provided to help you and your teams review the latest discussions in menstrual hygiene as it intersects with WASH and broader community health programs, including HIV and sexual health. These tolls will provide you with the training materials, research, best practices and programatic learning to support modifying current WASH and life-skills programs to better mitigate the barriers around MHM in the communities you serve. 

1. Menstrual Hygiene Matters: A resource for improving menstrual hygiene around the world (ToolKit): 

In November 2010, WaterAid, with support from the research consortium SHARE (Sanitation and Hygiene Applied Research for Equity), brought together 16 practitioners and researchers with expertise in water, sanitation and hygiene (WASH), health, education and gender to share knowledge and experiences and develop a research programme on menstrual hygiene. 

 The main purpose of this resource is to provide a comprehensive resource on menstrual hygiene that supports the development of context-specific information for improving practices for women and girls in lower- and middle-income countries. It can be used as a toolkit for training different audiences on Menstrual issues and solutions to the different challenges that emerge for young women, in different institutional and community contexts. 

See attached PDF: Entitled Menstrual Hygiene Matters, for the complete toolkit. 

2. Menstrual Hygiene Day (Campaign and Website): 

Did you know that May 28^th is International Menstrual Hygiene Day? Menstrual Hygiene Day (MH Day) is a global platform that brings together non-profits, government agencies, the private sector, the media and individuals to promote Menstrual Hygiene Management (MHM). MH Day raises awareness of the challenges women and girls worldwide face due to their menstruation and highlights solutions that address these challenges, including through media work. It aims to catalyse a growing, global movement for MHM and supports partnerships at global, regional, national and local level. MH Day also creates opportunities for advocacy for the integration of MHM into global, national and local policies, programs and projects. 

Visit this website to access a clearinghouse of information, resources and multi-media documentation in support of the 2016 campaign. With material available in both English and French ready for download, should you wish to participate in celebrating this day within your programming this year.

Click Here for information. 

3. WASH in Schools Empowers Girls’ Education (Reference Document) 

Proceedings of the Menstrual Hygiene Management in Schools Virtual Conference 2012 This document consolidates the proceedings from this virtual conference hosted by UNICEF. The conference agenda included three sessions of presentations on overarching themes: (1) exploring the MHM barriers faced by girls; (2) approaches to addressing MHM for girls; and (3) MHM in humanitarian emergencies. Following the conclusion of each session, the presenters responded to questions from online participants about their activities, and two in-person experts summarized main points and posed key questions about the activities in the presentations and others that are in progress. This document serves as a valuable resource consolidating findings from multiple country contexts, program types around the three themes identified above. 

Click here to download the comprehensive report.

4. Puberty Education and Menstrual Hygiene Management (Policy Guidance):

Developed by UNESCO, this document is the product of an extensive literature review, key informant interviews and an international technical consultation consolidating learning to document best practices and programmatic learning in the area of MHM. Through this document, UNESCO reaffirms its position that comprehensive sexuality education is part of the skills-based health education that young people require through an age and developmentally appropriate skills-based health education curriculum framework that starts as early as age five and continues into young adulthood. This policy guidance aims to demonstrate that in every context, no matter how challenging, there are actions teachers and other education staff can take to improve learning and health outcomes. 

See Attached PDF: Entitled UNESCO Puberty Education, to access the guidance document.