Menstrual hygiene in Africa: No pad or no way to dispose it

Women in sub-Saharan Africa still struggle to have a healthy and safe period
Women in Meru, Kenya, examine menstrual cups. Photo: Wikimedia Commons
Women in Meru, Kenya, examine menstrual cups. Photo: Wikimedia Commons

Period poverty is an overwhelming concept in sub-Saharan Africa. They either don’t have access to menstrual products and WASH (water, sanitation and good hygiene) facilities, or in the rare scenarios where they do, they don’t have any way of disposing menstrual waste.

This is when menstrual health management is linked to several Sustainable Development Goals —physical health and psycho-social well-being, quality education, gender empowerment and equality, water and sanitation, sustainable cities, and responsible consumption and production for the environment.

This was discussed at a four-day meeting organised by Centre for Science and Environment, a New Delhi-based non-profit, on sustainable sanitation for African stakeholders from March 26 to 29, 2019.

Women in resource-poor parts of countries in the region, owing to lack of availability of adequate products, use old clothes, paper, cotton or wool pieces, and even leaves to manage their menstrual bleeding. This situation is worse for school girls.

Schoolgirls, big sufferers

Various research papers have also reported that schools in countries like Ghana and Nigeria have insufficient toilets, inadequate privacy measures in there, and inadequate disposal facilities for used absorbents.

“The poor water, sanitation and hygiene infrastructure, including disposal, makes it difficult for girls to manage their menstrual cycle subjecting them to anxiety and stress,” says Martha Naigaga, sanitation coordinator, Ministry of Water and Environment, Uganda.

According to a 2014 United Nations Educational, Scientific and Cultural Organization (UNESCO) report, one out of every 10 girls in sub-Saharan Africa misses school during here menstrual cycle.

There are several such cases in the region. A Ugandan study conducted by Boosey et al in 2014 found that nearly two-third of school girls in rural areas miss school at least once a month owing to menstruation. Similarly, in Amhara province of Ethiopia, more than half the girls in secondary and preparatory schools remain absent during menstruation.

To address the problem of unavailability, many sub-Saharan countries have launched initiatives to better market penetration of sanitary pads. Kenya is the flag bearer in subsidising commercial sanitary products for rural girls and removing value-added tax on menstrual hygiene products.

“Our government is also on the verge of developing national guidelines for menstrual hygiene in schools, including proper hand washing facilities and places to dispose of sanitary products. Also, with the help of ZanaAfrica (Kenya-based social enterprise founded to respond to lack of access to sanitary pads and corresponding reproductive health education) the government has allocated money to distribute free pads to school girls,” says Vincent M Ouma, head of programmes, KEWASNET, a non-profit in Kenya.

What about the waste

For those who can afford and have access to adequate menstrual products, disposal remains a challenge.

The disposal practices are often influenced by deeply embedded socio-cultural norms and taboos. Women often throw menstrual absorbents in deserted open areas or in latrines or with the routine waste disposal system.

In Malawi, in the absence of any dustbins, women keep their used pads/clothes with them, under their bed. “In Swaziland, more than half the girls either burn their pads or dispose it in toilets as they believed this is the only way to remove all traces of menstrual blood and help them maintain their integrity,” says Ndumiso Cyprian Magagula, environmental inspector – waste management, Eswatini Environment Authority, Swaziland.

The policies and guidelines for menstrual hygiene management, products and waste disposal are quite limited in the entire sub-Saharan Africa. There should be documentation of laws to facilitate affordability and accessibility to sanitary pads, adds Naigaga.

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