Putting an end to period poverty

It’s a normal part of life for half the world’s population. Indeed, on any given day some 800 million women and girls are menstruating. But they often do it in shame and secrecy, while many lack access to water, sanitation, hygiene facilities and products so they can manage their menstruation with dignity.

There is a growing Canadian movement to combat this “period poverty”, from providing free sanitary products in some school boards to removing taxes on such items in stores. And a recent documentary film as well as new podcasts are shining a light on the taboos, stigmas and costs of menstruation.

These social and financial constraints remain particularly stark in low-income countries, forcing girls to miss school and marginalizing women in their own families and communities. Such challenges are aggravated by the COVID-19 pandemic, which has exacerbated gender-equality barriers, further deepened women’s isolation, disrupted product supply chains and reduced access to health and education services.

Canada supports global programs focused on maternal and child health that address cultural norms and practices surrounding menstruation and their impact on individuals and societies.

“Monthly there are hundreds of millions of girls and women and people who are dealing with menstruation, and it connects to their mental and their social well-being,” says Abena Thomas, the monitoring, evaluation, accountability and learning specialist for World Vision Canada. With funding from Global Affairs Canada (GAC), the organization’s Enhancing Nutrition Services to Improve Maternal and Child Health (ENRICH) program in Kenya, Tanzania, Bangladesh and Myanmar aims to increase adolescents’ access to sexual and reproductive health services and information, including menstrual-hygiene management. 

Girls taking power

Sumi is the founder and secretary of the Adolescent Girl Power Group in Thakurgaon, Bangladesh. Photo: Paul Bettings / World Vision

In schools, ENRICH provides “dignity kits” of menstrual products, sensitizes teachers and establishes menstrual-hygiene management rooms for girls to use when they have their periods. Adolescent Girl Power Groups (AGPGs) bring together young women to learn about sexual and reproductive health and menstruation. They also develop life skills and carry out projects that better their communities.

Sumi, 18, founder and secretary of the AGPG in the remote community of Thakurgaon in northern Bangladesh, says its teenage members develop small businesses and save money for their school fees, health needs and unexpected expenses. They also speak up on issues, for instance fiercely advocating against child marriage.

“It’s hard to bring change with just one person…It can be done as a group,” says Sumi, who is in her second year of post-secondary science studies, with plans to become a doctor. She says the biggest value of girls learning about menstrual health is they can speak to their families about it. “Parents need to be involved and let them know about their periods, so they understand what’s happening.”

Members of the Adolescent Girl Power Group showing piggybanks they made and decorated to give to peers who can’t afford menstrual products. Photo: Paul Bettings / World Vision

Her club talks to area leaders about issues such as enhancing women’s decision-making power and prioritizing girls’ education, Sumi says. The AGPG also led a mass signature campaign to stop sexual and gender-based violence. The girls support peers who can’t afford menstrual products, saving the funds in clay piggy banks they make and decorate, and they organize neighbourhood health clinics.

“They are thinking about social justice issues; they’re also being empowered to be actors in the community,” comments Thomas. Understanding the taboos related to menstruation and “the feeling of being unclean or there’s something wrong during that period of time” also gives the girls a better “sense of self,” she adds. “It opens a lot of doors.”

Learning that menstruation is normal

Adolescent girls in Kigutu, a rural village in southern Burundi, are learning about menstrual health and hygiene through the Mutima (Integrity) project, under the All Mothers and Children Count program. In school workshops, girls and boys learn to sew economical reusable sanitary pads out of brightly coloured local cloth called kitinge, strips of absorbent towel and sheets of plastic. They also learn how to properly use and clean the pads with soap and water and then dry them to kill bacteria.

Students in Kigutu showing reusable sanitary pads they made in Mutima project workshops. Photo: Village Health Works

The project is supported by GAC through a partnership with the Primate’s World Relief and Development Fund, a Canadian non-governmental organization, and implemented locally by Village Health Works. It holds sessions on sexual and reproductive health and rights for adolescent boys and girls as well as parents, which include information on family planning, menstruation, hygiene, malnutrition and family values.

Cherissa, 15, is reassured to know that menstruation is normal, “something that I can talk about with my family and don’t have to hide.” She’s now better able to ask for information, identify signs of menstruation and care for herself when she has her period.

Learning about the menstrual cycle has helped Anne-Marie, 16, count the days and predict when her next period is likely to start. “That way I can prepare materials ahead of time, which I think is important for girls to do.”

Dacia learned how to understand herself through the Mutima project.

Dacia, 20, says that through the Mutima project, “I first learned to understand myself, to understand the change in certain aspects of my body.” She enjoys making the menstrual pads and says the sessions help her to know “how to avoid having an unwanted pregnancy and giving up my studies.”

Sophie Matte, senior program manager for Village Health Works, says girls from impoverished families often can’t afford school fees and menstrual care, and sometimes request assistance from older men in the community. “Unfortunately, they sometimes fall pregnant and then have to drop out of school.”

Involving boys in the Mutima sessions makes them realize that girls are smart and have value, she says. “They’ll become fathers, and they won’t raise their daughters with the same perspective or cultural lens and…context they grew up around.”

When girls and women look after their health, it often improves their standing in new areas, she says, such as participating in household decision-making. This change in dynamics is critical in Burundi, which she notes is ranked as one of the lowest countries on the Human Development Index.

Community health workers spread messages around gender equality in remote areas, and there are sessions with community leaders to explain the importance of “empowering girls and boys and parents—and pretty much all levels of society—through education,” she says.

“It will change the future generation altogether and break the intergenerational poverty cycle,” Matte says, noting that women and girls must have a voice. “If we don’t listen to over half the population, then we can’t fix anything.”

Dismantling taboos

A project supported by GAC called HerWASH, which is being implemented in Pakistan, Burkina Faso, Liberia and Sierra Leone by WaterAid Canada, focuses on improving menstrual hygiene to enhance the sexual and reproductive health and rights of women and adolescent girls.

Sarah Schattmann, project manager for WaterAid Canada, says it’s important to ensure that sanitation and hygiene facilities in schools and health care centres are accessible, safe, gender-sensitive and equipped to meet the menstrual-hygiene management needs of women and girls. “It’s all-encompassing,” she says.

Youth leaders dispel myths and misconceptions around menstruation, holding sessions where they help girls understand their menstrual cycles and the changes in their bodies. “We’re dismantling taboos and conventions around menstrual health at the community level,” Schattmann says, adding that it’s especially important for men and boys to be “more welcoming of women who are menstruating.”

She says the program is working to change attitudes at the government level so that the importance of menstrual health is explicitly stated in policy guidelines. This would mean that girls and women would have access to water and sanitation facilities even in the most remote and vulnerable communities, adds Schattmann, who is optimistic that change is possible. “We have made an impact,” she says.