Menstrual hygiene and health – a call for dignity, rights and empowerment

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It is time to address the stigma, taboo and lack of knowledge around menstruation

By Rt Hon Helen Clark and Elhadj As Sy

We stand as advocates for addressing women’s issues. Because gender equity is so closely linked to health, we also see the achievement of universal health coverage - the need for which has only been heightened by the Covid-19 pandemic - as a global priority. We therefore take the opportunity of Menstrual Hygiene Day – 28 May – to highlight an unacceptable crisis: girls’ and women’s health issues with regards to stigma, taboo and lack of knowledge about menstruation, and unmet needs for essential health interventions and access to sanitation and hygiene systems.

On any given day, hundreds of millions of girls and women around the world are menstruating, yet a substantial proportion of them lack the knowledge and the means to manage their menstrual health safely and with dignity, the result of gender inequality, cultural taboos, poverty, and a lack of basic sanitation and hygiene. Restrictive and discriminatory practices, such as being forced to live in a “menstruation hut,” impact the ability of girls and women to fully participate in their communities and to access educational and economic opportunities.

This situation is unacceptable. Globally, approximately 130 million girls are out of school, according to Unesco. And while there are many reasons for this, periods and a lack of sanitation, hygiene and menstrual health play a major role, as girls from resource-poor environments attribute frequent school absences to difficulties managing their menstruation, with absenteeism being associated with lack of privacy and limited availability of water and sanitation facilities at schools.

Period poverty – defined as lack of knowledge of menstruation and an inability to access necessary sanitary materials – is widespread. But girls and women in some Least Developed Countries are disproportionately affected, where often a majority of adolescent girls are not told about menstruation before experiencing their first period and where sanitary products are all too often unaffordable. Lack of access to basic hygiene products has also led women to use unhygienic materials, such as rags, leading to an increased risk of reproductive and urinary tract infections.

Stigma, taboos, and inadequate knowledge also mean that girls and women are poorly equipped to make informed personal decisions and choices about their own health, including their sexual and reproductive health, thus contributing to a cycle of early pregnancy and child marriage. According to the United Nations Population Fund (UNFPA), approximately 7.3 million girls under the age of 18 give birth each year (a number that is much higher if all pregnancies are included, not just births) and according to Unicef, 21% of young women were married before their 18th birthday in 2020.

It is time for social and governmental attitudes toward the human right to sanitation, hygiene and menstrual health to change.

Periods need to be accepted as a normal biological occurrence, not a shameful secret. Girls need to be able to remain and succeed in school. Women must have equal access to economic and social power. And girls and women both need to be able to make informed decisions about their sexual and reproductive health.

Ensuring menstrual hygiene and health – beyond being a basic human right, as outlined by the Human Rights Council in 2018 - also makes good economic sense. Investing in girls’ and women’s menstrual health is a cost-effective development intervention that has long-term benefits for the reduction of child and maternal mortality and leads to stronger economic growth.

At the heart of this issue is the right of women to have autonomy over their own bodies. This requires societal change. Societal change requires strong political leadership with a clear vision backed by national strategies and costed plans that integrate policies on sanitation, environment, health, education, and gender. Success is reliant on ensuring that all girls and women are reached with credible information, have access to the products that they need, and can rely on safe and dignified facilities.

On this year’s Menstrual Hygiene Day, we strongly urge collective action on the part of governments, development partners, civil society, the private sector, and academia. We ask for your voice of support and your commitment to act for girls and women everywhere.

Progress on the SDG target for sanitation, hygiene, and menstrual health is lagging. This is not acceptable. To this end, we underscore the urgency of long term investment in women’s health – in robust sanitation, hygiene, and menstrual health services. We therefore lend our voices to the success of the Sanitation and Hygiene Fund, a new global financing mechanism that will work tirelessly to ensure that no one is left behind.

The Sanitation and Hygiene Fund

The Water Supply and Sanitation Collaborative Council is evolving into the Sanitation and Hygiene Fund (SHF). Working with donors and other partners, the SHF aims to fill a void in the international response to the sanitation, hygiene, and menstrual health crisis, providing countries with the means to achieve sanitation and hygiene for all.


Rt Hon Helen Clark, chair of the board of the Partnership for Maternal, Newborn & Child Health and former prime minister of New Zealand

Elhadj As Sy, chair of the board of the Kofi Annan Foundation and chair, advisory group of the Sanitation and Hygiene Fund/WSSCC.

This article was first published in the Guardian,