By Sophie Nyongesa
Menstrual Hygiene Day is celebrated on 28th May each year; a symbolic number of the average 28 days of the menstrual cycle and 5 days of the menstrual period. Menstrual Hygiene Day gives a chance to highlight the importance of menstrual care for women and girls, and raise awareness about the issues faced by those who don’t have access to sanitary products. The theme for this year’s MHD celebration “More action and investment in menstrual health and hygiene now!” is calling for increased integrated efforts towards menstrual hygiene management.
Menstrual health and hygiene is fundamental to the dignity and wellbeing of women and girls and an important part of the basic hygiene, sanitation and reproductive health services to which every woman and girl has a right to. According to the 2019 census, females cover 50.5% of the total population of Kenya: which means a significant number of women and girls in Kenya menstruate every month for between two to seven days. UNICEF states that Menstrual Hygiene and Management (MHM) is an issue that is insufficiently acknowledged and has not received adequate attention in Water, Sanitation and Hygiene (WASH) and reproductive health sectors in developing countries. It is documented that a large number of girls miss school; averagely 4-5 days of school per month, due to lack of sanitary pads and underwear, combined with inadequate sanitary facilities in their 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. Poor practices coupled with lack of knowledge is responsible for a significant proportion of school absenteeism, seclusion from social activities, illness and infection associated with menstruation among adolescent school girls and young women in developing countries.
There are also more jarring statistics signaling that menstruation is tied to more fundamental risks and issues of gender inequity, with studies showing 2 out of 3 of pad users in rural Kenya receiving sanitary towels from sexual partners who in turn demand for a sexual favor. This act not only exposes the adolescent girls and young women to the dangers of unwanted pregnancy but also increased risks of HIV infection and Sexually Transmitted Infections. Lack of a safe place or ability to manage menstrual hygiene as well as lack of medication to treat menstruation-related pain can all contribute to higher rates of school absenteeism and poor educational outcomes for girls. UNFPA reports that menstruation stigma can also prevent women and girls from seeking treatment for menstrual related disorders and pain, adversely affecting their enjoyment of the highest attainable standard of health and well-being. According to UNICEF, poor menstrual health may heighten the risk of urogenital tract infections. These infections pose risk to other aspects of sexual and reproductive health, such as risk of acquiring HIV and infertility.
Despite being an important issue concerning women and girls, Menstrual Health Management is often overlooked within the framework of national development strategies and more so in pandemic response. Menstrual health is not a standalone issue as it impacts directly on other issues such as access to education, food security, economic opportunities and reproductive health. COVID-19 pandemic and its response has worsened inaccessibility to water, sanitation and hygienic products. UNFPA reports that these challenges are further augmented by an economic meltdown that has significantly affected the populations in informal settlements with women losing their livelihoods that allow them access necessities such as sanitary products. With the COVID-19 containment and restriction measures, product availability for girls who rely on the government supplies distributed through the school system has been affected. Consequently “period poverty” has become a reality for women and girls living in poor and marginalized communities, emergency and humanitarian contexts; with most of them resorting to using leaves from trees, the insides of mattresses, cloth rags, socks or even reusing dirty sanitary pads.
In order to address the challenges experienced by women and girls regarding menstrual health and hygiene during and beyond COVID-19, the Menstrual Hygiene Management Policy (2019-2030) outlines various strategies and priority actions that need to be put in place by the government of Kenya in partnership with private and public sectors including and not limited to;
- Integration of MHM into already existing National and County Governments’ programs and projects and ensuring that all government ministries and departments mainstream MHM in their policies and guidelines.
- Development of guidelines and strategies on MHM in learning institutions, health facilities, workplaces, public places and households.
- Counties to include MHM in their County Integrated Development Plan and County Health Strategic Plan and have a dedicated budgetary allocation for MHM activities.
- Enact legislation on MHM under the following sectors; health, water, environment, education, gender youth and sports and treasury to provide funds and technical support for the implementation of the national MHM interventions.
- Development and enforcement of systems for construction and maintenance of standardized water, sanitation, hygiene facilities and waste disposal facilities in households as well as in public institutions such as schools, health centers, workplaces, public places and correctional facilities.
- Developing a communication and media strategy, key messages and instruments such as training guidelines and manuals, needed to provide education on MHM for boys and girls, men and women as well as mainstream MHM awareness with the community Health strategy and school hygiene education.
- Developing of an effective MHM advocacy initiative that targets influential persons within the society and develop MHM champions to advocate for good menstrual management practices.
- Reviewing of existing standards and guidelines for WASH facilities in public places, work places, correctional facilities and health care facilities to integrate MHM as well as provide of WASH facilities in all households, learning institutions, public places, health care facilities, workplaces and correctional facilities. Ensure provision of an adequate number of gender responsive WASH/MHM facilities with water, soap and disposal bin in all public and private institutions (learning institutions, workplaces, public places etc.).
A world without period poverty and stigma is possible. The national and county governments in partnership with the private sector stakeholders need to step up action and investment in menstrual health and hygiene now, starting with this Menstrual Hygiene Day! The progressive strategies outlined in the Menstrual Hygiene Management Policy need to be fully implemented to ensure all girls and women in Kenya have access to commodities and proper sanitation but that their rights are not only protected but upheld!