The Giving Capsules: Menstrual Health and Hygiene (MHH) Matters

The Giving Capsules: Africa needs to do a lot more to combat gender discrimination and violence
Baptista S. H.Gebu (Mrs.)

…Consider needs for safe and dignified menstruation to achieve the world vision for sanitation and hygiene

World Menstrual Hygiene Day is observed on May 28. The reason for marking this day is to create awareness and change the social stigma associated with menstruation. Without considering needs for safe and dignified menstruation, the world cannot achieve the vision for sanitation and hygiene.

Menstruation or menses is the normal biological process of discharging blood and associated matter from the uterus through the vagina as part of the menstrual cycle. Menarche is the onset of menstruation, the time when a girl has her first menstrual period. Menstrual hygiene management (MHM) refers to management of hygiene associated with the menstrual process and it includes both MHM and the broader systemic factors that link menstruation with health, well-being, gender equality, education, equity, empowerment, and rights. A menstruator is a person (women and girls for instance) that menstruates. These menstruators have needs including health and hygiene needs which affects girls, women, trans-gender and non-binary persons. We usually use the term ‘girls and women’ to refers to all menstruators regardless of gender identity.

Menstrual hygiene materials are the products these women and girls use to catch menstrual flow, such as pads, cloths, tampons or cups. Menstrual supplies are other supportive items needed for MHH, such as body and laundry soap, lime and lemon for natural cleansing, underwear and pain relief items. Menstrual facilities are those facilities most associated with a safe and dignified menstruation, such as toilets and water infrastructure. Gender refers to the roles, behaviours, activities, and attributes that a given society at a given time considers appropriate for men and women.

Let’s discuss the summary of menstrual materials. Menstrual cloth, re-usable pad, disposable pads, menstrual cups and tampons are all examples of menstrual materials. Some are re-usable whiles other are very convenient and affordable. Some relies on good disposal systems whiles others are hindered by cultural taboos.

  • Menstrual cloth is reusable, affordable, already used in many contexts. Relies on privacy, clean water and soap, and time to wash and dry. Not having access to a good and clean drying line and space can generate health issues with its use. This is because, these cloths must be well washed first with soap and clean water and allowed to dry preferably under sunny conditions. Adopting a practice of adding lime and lemon juice as a natural washing conditioner prior to drying helps to take away germs and bad odour.
  • Reusable pad is reusable, can be home-made or produced locally, when the good quality is good, its use is comfortable. It also relies on privacy, water soap and time to wash and dry. The quality of material used in its production is always the big issue. Poor material usage in its pad’s design will propose adverse reaction for the menstruator when used.
  • Disposable pads are convenient, widely available, preferred by many women and girls and comfortable. It relies on disposal systems and access to markets. It can be expensive as compared to other materials.
  • Menstrual cups are reusable, available in some countries. Relies on privacy, water and soap to clean, but hindered by cultural taboos on inserting and virginity. It can be considered affordable due to the duration of use and the cost associated with it initial purchase. It is not known by many and due to cultural taboos, seen by many not as a viable alternative.
  • Tampons are also convenient, available in some countries. Relies on disposal systems and hindered by cultural taboos surrounding insertion and virginity.

Menstruation is not a problem, poor menstrual hygiene is. This is because for the over 1. 8 billion girls and women of reproductive age, menstruation is a normal fact of life and a monthly occurrence. Menstrual health and hygiene is a neglected health and development issue, seen as a taboo in many cultures. . It is often assumed that girls with disabilities do not menstruate, so education is needed to dispel menstruation and disability myths. Menstruating girls and women with different disabilities may have different needs. As a result, women and girls are denied the right to manage their monthly menstrual cycle in a dignified and healthy way.

It is interesting to note that, on any given day more than 800 million women and girls are menstruating. Hence the stigma, taboos, and ignorance around periods harm women and girls every day. In many parts of the world, women and girls are considered dirty or impure during menstruation. They are restricted from daily activities such as eating certain foods, touching animals, going to school, or socializing with boys and men. In some cultures, burning a used pad symbolizes burning a baby. In extreme cases, women and girls are isolated to places like cow sheds during their period. Welcome to the 21st century, we can do something about this. The world is now a global village, be encouraged on May 28, 2021 this year to create awareness about the subject matter across all social media outlets at minimal if you can. You can be an advocate to support change the social stigma associated with the subject matter.

But menstrual health and hygiene is not just an issue in developing countries.  While the concrete challenges might be different, menstruation is still met with silence, neglect, and stigma in countries like the United States, Germany, and Japan. It is high time that we step up our efforts to ensure that women and girls are no longer limited because of their periods.

According to the publication, “A Time for Global Action: Addressing Girls’ Menstrual Hygiene Management Needs in Schools” Gender inequality, discriminatory social norms, cultural taboos, poverty and lack of basic services often cause girls’ and women’s menstrual health and hygiene needs to go unmet. Adolescent girls may face stigma, harassment and social exclusion during menstruation. Transgender men and non-binary persons who menstruate often face discrimination due to their gender identity that prevents them from accessing the materials and facilities that they need. All of this has far-reaching negative impacts on the lives of those who menstruate: restricting their mobility, freedom and choices; affecting attendance and participation in school and community life; compromising their safety; and causing stress and anxiety.

The challenges are particularly acute for girls and women in humanitarian crises. The onset of menstruation coincides with new opportunities – and vulnerabilities – that arise during adolescence. Menstrual health and hygiene interventions can be an entry point for other gender-transformative programmes during this period, like sexual and reproductive health education and life skills development. By strengthening self-efficacy and negotiating ability, MHH programmes can help girls build the skills to overcome obstacles to their health, freedom and development, such as gender-based violence, child marriage and school dropout. Investments in adolescent girls’ well-being yield triple dividends: for those girls, for the women they will become, and for the next generation.

MHH is important for the fulfillment of girls’ and women’s rights, a key objective of the Sustainable Development Goals (SDGs). Women and girls’ access to MHH is a component of gender-responsive WASH services; SDG 6.2 acknowledges the right to menstrual health and hygiene, with the explicit aim to, “By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations”. Without considering needs for safe and dignified menstruation, the world cannot achieve the vision for sanitation and hygiene under Goal 6. Women and girls’ access to MHH is also central to achieving other SDGs.

The lack of basic knowledge about puberty and menstruation may contribute to early and unwanted pregnancy; the stress and shame associated with menstruation can negatively affect mental health; and unhygienic sanitation products may make girls susceptible to reproductive tract infections – all affecting SDG health outcomes (Goal 3).

Girls may be absent or less attentive in school during menstruation due to a lack of WASH facilities or support from the school community, affecting education (Goal 4), or at work, affecting economic opportunities (Goal 8). Gender equality (Goal 5) cannot be achieved when taboos and myths prevent menstruating women and girls from full participation in society. Failure to develop markets for quality menstrual materials can impact on sustainable consumption and production patterns (Goal 12) as put forward by Menstrual Health and Hygiene; a global opportunity publication by UNICEF.

Specifically, achieving these goals requires addressing four interrelated determinants; social support, knowledge and skills, facilities and services, and materials and supplies – along with improvements in the enabling environment through appropriate policies, coordination, financing, capacity building, and monitoring in the education, health, and WASH sectors.

Weak enabling environment, including a lack of political will, lack of policy framework, and lack of resource allocation, insufficient knowledge, guidance and skills coupled with inadequate access to basic WASH services and MHH-supportive systems (e.g. waste disposal) in schools, households and health facilities are a challenge.  Inadequate access to affordable and appropriate menstrual materials, unsupportive attitudes and social norms around menstruation leading to stigma, myths and taboos must be addressed.

World Health Organization and World Bank (2011) World Report on Disability and UNICEF’s publication on promoting the rights of children with disabilities has it that, “More than 1 billion people worldwide are estimated to have a disability. This includes up to 10 per cent of children. Children with disabilities were 30 per cent less likely than their peers without disabilities to be in primary and secondary school; the same study found that only slightly more than 50 per cent of children with disabilities were attending school.

Inaccessible WASH facilities in communities, schools, health care facilities and public places add to the long list of barriers that prevent girls and women with disabilities from participating fully in social and economic life. Lack of accessible facilities can be another barrier to girls’ with disabilities school attendance. MHH education and support is critical in both in- and out-of-school programming to reach girls with disabilities. It is often assumed that girls with disabilities do not menstruate, so education is needed to dispel menstruation and disability myths. Menstruating girls and women with different disabilities may have different needs. Those with mobility limitations with their upper body and arms may have difficulties placing their sanitary protection materials in the correct position, and washing themselves, their clothes, and the material. Those with vision impairments (blind or low vision) may face challenges knowing if they have fully cleaned themselves, and those with intellectual and developmental impairments may need tailored support to learn about MHH. Partnering with women and girls with disabilities and Organisations of Persons with Disabilities (DPOs)  or MHH programming will help ensure those programmes are responsive to the needs of women and girls with disabilities.

Becoming a healthiest you is always necessary and important, never consider it too late or too early a time when you get to that realisation. Start today” – Baptista S. Gebu

Baptista is a Hybrid Professional and the Executive Director of ProHumane Afrique International.  ProHumane is a charitable, development & think thank organization working with communities & individuals to create sustainable solutions to transform communities through diverse pro-poor initiatives. Pro-poor initiatives are initiatives that help to alleviate poverty. Baptista is a realist, affable, simple and humane. You can reach her via e-mail on [email protected]  and follow this conversation on all our social media sites: Linked-In/ Twitter/ Facebook/ Instagram: ProHumane Afrique International.  Call or WhatsApp: +233(0)262213313. Hashtag: #behumane #thegivingcapsules #prohumaneafriqueint  #fowc

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