Every day, an estimated 800 million girls and women around the world experience their menstrual flow. Commonly known as a period, menstruation is a normal biological process that girls and women go through to ensure good reproductive health.
However, a large number of menstruating girls and women continue to face persistent challenges in managing their menstruation safely and with dignity. This includes lack of access to menstrual hygiene products, lack of access to clean water and sanitation facilities, and lack of quality menstrual hygiene information. The World Bank notes that about 500 million women and girls lack adequate facilities for menstrual hygiene management globally.
Menstruation is regarded as a sign of good reproductive health in girls and women. Yet, it remains a taboo subject in many African societies. In Senegal, the topic is strongly marked by cultural beliefs, myths, taboos, and religious prohibitions, which affect the management of menstrual hygiene for girls and women.
In many Senegalese communities, people think menstrual blood is an “impurity, filthy, an evil substance,” and menstruating girls and women are contaminated. They are often forced into seclusion, prevented from participating in daily household activities such as cooking, and increasingly subjected to stigma and shamed. This directly affects their self-esteem, and in turn affects their education, health, and wellbeing. In a joint 2018 study by the Water Supply and Sanitation Collaborative Council (WSSCC) and UN Women, 27% of girls and women globally reported that bad menstrual hygiene practices negatively affected their sexual and reproductive health.
In Africa, some organisations have long identified menstrual hygiene management as a key public health issue. They advocate for, and implement, solutions towards tackling the challenges facing menstruating girls and women on the continent.
Founded in 2011, Speak Up Africa is a women-led nonprofit in Dakar, Senegal, working to catalyse dialogues, drive policy change and create awareness about health and sanitation issues in Africa. Since 2016, the organisation has been using strategic advocacy and communications to break the silence associated with menstrual hygiene and helping to shape policies and public perceptions around menstrual hygiene management.
The organisation launched a 3-year campaign in 2016 themed, “No Taboo Periods,” focused on enhancing public knowledge, attitudes, and practice relating to menstrual hygiene and ensuring that menstrual hygiene management becomes a public health priority in policy development. The campaign works to generate stronger commitments on the part of governments and leaders at all levels of Senegalese society. It leverages education as a key tool for fostering countercultural conversations around menstrual hygiene management, with the aim of changing people`s perceptions and breaking down myths surrounding menstrual hygiene, especially for teenagers and adults. To do this, the campaign uses informational and learning materials as well as specifically tailored communication tools.
Yaye Sophiétou Diop, Advocacy manager at Speak Up Africa, said they worked to gain insights into the perceptions of the community before launching the campaign. “Menstruation is a complex issue in Senegal, like in many other African countries; it is a taboo subject here and people don`t want to talk about it,” she said. “At the beginning of our campaign in July 2016, we carried out a study that helped us to understand the existing gaps in terms of knowledge, attitudes, and practices of menstrual hygiene management in Dakar, Senegal. We realised that many people, including girls and women, particularly in peri-urban areas, lack the right information on menstrual hygiene management.”
She said many Senegalese girls and women don’t have access to quality information on how to safely and properly manage their menstruation with dignity. “For many girls in Senegal, when they experience their first periods, the only information they get from their mothers and/or aunties is something like ‘be careful with boys.’ They don’t have information on what to do or how many times they need to change their menstrual pads, or even what types of sanitary pads to use,” she said.
This realization fueled the organisation’s vision to educate. “We created the Speak Up Africa menstrual hygiene labs where girls and women were trained and sensitized on menstrual hygiene management. And the labs serve as a ‘safe hub’ for them to freely have discussions on menstrual hygiene issues,” Diop said.
In 2018, Speak Up Africa established a menstrual hygiene lab in Pikine, a Dakar suburb with an estimated population of over 1 million inhabitants, where girls and women, boys and men were convened and sensitised regularly on menstrual hygiene management. They distributed about 300 sanitary kits to the girls and women, including to physically challenged persons. More than 22,000 community members were sensitised and equipped with the skills they need to facilitate menstrual hygiene management awareness activities. Speak Up Africa also supported the development of a website, a mobile application, and building of toilet facilities for menstruating girls and women in Pikine.
“Based on the strategy that we developed, we worked closely with the district medical centers and trained the Community Health Actors (CHA), and we gave them the tools they use for sensitisation campaigns. They carried out all the various menstrual hygiene awareness activities at the community level, and helped integrate communications on menstrual hygiene management into the districts` public health strategy,” Diop told Nigeria Health Watch.
KITAMBAA: A ‘piece of cloth’ to fight COVID-19 related period poverty
Globally, one fallout from the ongoing COVID-19 pandemic is the relegation of other existing health issues to the background, including menstrual hygiene management. Millions of menstruating girls and women are grappling with special challenges in managing their menstruation amid the pandemic.
A recent report by the UK-based nonprofit, Plan International, noted that global disruptions in the supply of sanitary hygiene products due to COVID-19 lockdowns and border closures has limited access to safe menstrual hygiene products. This poses a threat for menstruating girls and women. The pandemic has also disrupted women and girls` access to facilities for washing, changing, and cleaning during menstruation. As a result, it has become even more crucial to advocate for solutions to allow girls and women to overcome menstrual hygiene problems in light of the coronavirus crisis.
Sitting in a cafe in the bustling city of Nairobi, the Kenyan capital, Yaye Héléne Ndiaye read a story on her phone about the experiences of menstruating girls and women in Senegal. “When I read the article, I remembered how difficult it was for me to manage my menstruation especially in school while growing up. I was also sad to know that many girls don’t have access to sanitary pads, which made me wonder how difficult it would be for them to manage their menstruation,” Ndiaye, a young Senegalese social entrepreneur, recalled.
With colleagues Fatou Diallo, Aisha Dabo, and Fatou Seck, Ndiaye travelled to Dakar, Senegal, in 2017, and launched Kitambaa, a Kiswahili word meaning ‘piece of cloth’. Kitambaa is a social enterprise that works to keep young girls in school and empowers women by providing them with washable and reusable sanitary pads. As part of their activities, they develop training modules in menstrual hygiene management and advocate for the inclusion of menstrual hygiene management in public policies in Africa and Senegal in particular. Kitambaa also educates young girls and women about the harmful consequences that poor menstrual hygiene could have on their health, wellbeing, education and the environment.
In response to the COVID-19 pandemic, Kitambaa advocated for the inclusion of sanitary kits and menstrual hygiene management in Senegal’s COVID-19 plans and responses. Their advocacy helped influence the decision of some of the actions implemented by the Senegalese Ministry of Women, Family, and Gender and Child Protection together with the Ministry of Water and Sanitation to include the distribution of soap and sanitary kits to vulnerable households, and the inclusion of soap and sanitary pads manufacturing under the ministry’s annual work plan, Ndiaye said.
Between May and June 2020, the organisation secured funding to distribute nearly 100 Kitambaa kits — each Kitambaa kit contains five reusable sanitary pads, two panties, and two pouches to store used pads — to school girls. About 50 local officials and community managers were also trained on menstrual hygiene management in July. And recently, Speak Up Africa hosted Kitambaa to an online discussion on menstrual hygiene management in the context of the COVID-19 pandemic.
Num Fatiha, a 20-year-old fashion designer and law student at the African Institute of Management (Institut Africain de Management) in Dakar, Senegal, said she didn’t have any problem accessing menstrual hygiene products during lockdowns due to the pandemic. She noted, however, that this was not true for many young girls in her country.
“The reality in my country [Senegal] is that many girls, particularly in rural areas and even certain districts of the capital, can`t afford to buy sanitary pads, so they use pieces of old cloth, which can affect their menstrual health,” Fatiha said. “The Kitambaa kit has really changed my life and the way I manage my menstrual hygiene. I am no longer afraid of stains [during menstruation] – I’m more confident. And above all, I have access to sanitary pads at all times because they are washable and reusable.” Fatiha said.
Breaking period taboos and changing society`s perceptions of menstrual hygiene management remains a significant challenge across Africa, but it is surmountable. There is a need, however, for continuous advocacy to ensure the integration of menstrual hygiene management in water, sanitation, and hygiene (WASH) policies on the continent. New channels and ways of communication, particularly social media and storytelling, need to be effectively utilised.
“If we want to change the mindsets of people, we must ensure that everyone gets the right information – girls, women, boys, men, and parents – to break taboo circles in the society,” urged Diop. “What really helps us during our sensitisation sessions is the use of storytelling; it really helps girls to see that it’s not only their problem but everyone’s because we are all humans and if I can solve my own problems it means that you can also solve yours.”
More than ever before, the work of Speak Up Africa has now become necessary. There is a need to increase the duration of the implementation of “No Taboo Periods” campaign and refocus advocacy across other departments of Senegal, particularly in rural Senegalese communities. For Kitambaa, limited available resources and man-power remains a challenge. However, this can be addressed through increased funding and support from governments and donor agencies. “COVID-19 is both a limitation and an opportunity for us: it`s difficult to go to the fields now, but also it has enabled us to advocate more for menstrual hygiene management despite the ongoing pandemic,” noted Ndiaye.
As COVID-19 cases continue to rise across Africa, governments must ensure the inclusion of menstrual hygiene kits and the integration of menstrual hygiene management in COVID-19 responses and plans, respectively. African governments need to pay special attention to girls’ and women`s menstrual hygiene needs amid the coronavirus pandemic, and provide access to clean water and safe sanitation facilities to ensure proper use of sustainable menstrual hygiene solutions including reusable pads, which are easier to use and have a longer lifespan.
What other solutions for menstrual hygiene management should African countries consider and implement? Leave a comment below or drop us a line on social media; @nighealthwatch on Twitter and @nigeriahealthwatch on Facebook, Instagram and LinkedIn. Use the hashtag #TorchlightAfrica.
Author’s bio: Abdullahi Tsanni is a freelance science writer based in Abuja, Nigeria. He writes for science and development focused international media publications including Nature and African Newspage, covering topics such as scientific enterprise, technology, health, and agriculture across sub-Saharan Africa. He works voluntarily at Science Communication Hub Nigeria and the African Science Literacy Network (ASLN). Abdullahi is a Communications, Advocacy, Policy Opportunities and Outreach for Poop (CAPOOP) Media Fellow 2020. Follow him on Twitter @abdultsanni