Menstrual Health Management in East and Southern Africa: A Review Paper
Period shame, misinformation linked to serious human rights concerns
UNITED NATIONS, New York – Shame, stigma and misinformation surrounding menstruation are contributing to serious human rights concerns for women and girls, emphasizes a new report commissioned by UNFPA.
The report, a comprehensive review of available evidence on menstrual health management in East and Southern Africa, was undertaken by the non-governmental organization WoMena and released ahead of the Menstrual Health Management Symposium in Johannesburg, South Africa.
It powerfully underscores the ways period shame and misinformation undermine the well-being of women and girls, making them vulnerable to gender discrimination, child marriage, exclusion, violence, poverty and untreated healthproblems.
Stigma, taboos, misconceptions
The paper finds that menstruation taboos can keep women and girls from touching water or cooking, attending religious ceremonies, or engaging in community activities. These taboos reinforce gender-based discrimination, perpetuating the idea the menstruating women and girls are unclean.
But even without overt taboos, women and girls face stigma and ridicule that contribute to their exclusion from school and opportunities. “A report from Uganda brings out the fear of teasing by classmates as a reason for absenteeism,” the authors noted.
Global studies show a link between menstruation and lost wages. Women around the world experience limited access to sanitation facilities in the workplace.
And in many communities, menarche – the onset of menstruation – is associated with readiness for marriage. Child marriage increases the risk of adolescent pregnancyand other outcomes that undermine girls’ human rights.
Costs, economic and physical
The cost of menstrual products exacts a toll on the health and safety of vulnerable women and girls.
“Some studies from Kenya find that schoolgirls engage in transactional sex to pay for menstrual products, particularly for the younger, uneducated, economically dependent girls,” the report says. Transactional sex increases girls’ risk of experiencing violence, sexually transmitted infections and other threats.
The cost of menstrual products may also contribute to the perception that daughters are economically burdensome.
And the serious health consequences of menstruation – including menstrual disorders, known as dysmenorrhea – are too often neglected. The report finds that dysmenorrhea is a major complaint among adolescents, yet few seek medical care. This, too, affects school attendance, economic participation and quality of life.
Listening to those most vulnerable
Around the world, these human rights concerns are largely overlooked by policymakers – to the detriment of the most marginalized communities.
But much more must be done to address the menstrual health needs of women and girls – and to recognize how these unmet needs affect their human rights.
“In Africa, it is high time we throw aside the myths and misconceptions, and the negativity that, for too long, has surrounded the menstrual life cycle, from menarche to menopause,” said Dr. Julitta Onabanjo, UNFPA’s regional director in East and Southern Africa.
“We need to be transformational going forward,” she added.
This message was echoed throughout last week’s Menstrual Health Management Symposium, which offered a platform to people who had experienced these challenges firsthand.
Christina Changaira, of FEMPRIST, spoke of being refused medical care and menstrual products when she was detained for 30 days in a Zimbabwean prison. She said women in prison often resort to tearing up blankets and rags to use as pads. “Often there’s no water, or no running water. There are no sanitary bins. You have to find ways to dispose pads or rags, leading to increased health risks," she said.
Women in impoverished rural communities and those living in displacement camps also struggle with poor access to water and sanitation. “Where do women or girls dry a washable pad in privacy in refugee groups?” asked Yasmin Rajah, from Refugee Social Services.
“Those living with HIVface a double stigma when it comes to menstrual health management,” said Laura Thuo, from International Community of Women Living with HIV. “Lack of availability and affordability of menstrual products means that women and girls become more vulnerable to exploitation and HIV. When you’re living with HIV, you always think your blood is infectious, so you’re afraid of talking to anyone about menstruation.”
Members of the trans community also endure period shame and stigma.
“There are very few sanitary-ware options for the trans community,” shared Tinashe Sande, from Transgender Intersex Rising, Zimbabwe. “In Zimbabwe, you can’t find a gender-neutral toilet. You get told you’re in the wrong bathroom. And if you enter the male bathroom, there are no cubicles or sanitary bins.”
Time for change
UNFPA supports sexual and reproductive healthservices around the world, including by distributing dignity kits, which contain menstrual hygiene products, in communities affected by humanitarian emergencies. UNFPA also supports comprehensive sexuality educationprogrammes, which teach adolescents about their health, bodies and rights.