A quality high-school education can transform a girl's future, yet around the world, many adolescent girls miss school or even drop out altogether for one simple reason: menstruation.
Schools often lack the supplies and sanitation facilities girls need for managing their periods. Girls without adequate health care may feel discomfort or pain. Shame, stigma and misinformation may discourage girls from attending school while menstruating and prevent schools from teaching healthy attitudes about menstruation. Many girls stay home to avoid being teased. For girls growing up in refugee camps and conflict areas, the challenges are even greater.
Gender inequality, cultural taboos, poverty and lack of basic services undermine many girls’ and women’s ability to meet their health and hygiene needs. Emergencies like the COVID-19 pandemic can exacerbate these deprivations — especially among the most vulnerable — with far-reaching adverse effects.
Girls and women with confirmed or suspected cases of COVID-19 who are quarantined or isolated at home may not have what they need — disposable or reusable sanitary napkins, safe water, soap — to manage their monthly periods. In areas where the poorest women and girls rely on disposable sanitary napkins, price hikes due to the coronavirus’ supply chain disruptions may force families to prioritize food and other essentials over menstrual hygiene materials.
Periods don’t stop for pandemics. That's why UNICEF is now working to help ensure that health workers, patients and women and girls living in refugee camps or institutions for the disabled have access to menstrual health and hygiene supplies along with water and sanitation facilities required to manage their periods safely and with dignity.
Girls should not feel ashamed of their healthy, normal development
UNICEF has a proven track record of supporting menstruating girls and helping them get what they need so their periods don't get in the way of their daily lives. First of all, girls need information for themselves, their classmates and their communities about what menstruation is, and sometimes what it is not. They also need clean supplies, privacy, disposal facilities, soap and clean water, and access to health care — basic things that can make a great difference to a girl.
Many girls greet their first periods with alarm, without knowing anything at all about menstruation. Others are burdened with misinformation and superstition. In Nepal, for example, local superstitions prevent menstruating girls from going to school, looking in the mirror, trimming their nails or touching flowers, fruit, drinking water or pickles, among other things. Some communities still follow the traditional Nepali custom of sending menstruating girls to live alone in unheated chhaupadi huts, leaving them vulnerable to exposure to the cold, smoke inhalation and attacks by animals, with sometimes fatal results. Lack of accurate information leaves room for confusion and embarrassment, the repercussions of which can be far-reaching for girls and their communities.
Everyone — including boys — needs to learn about menstruation
Shame and misinformation about menstruation are a global problem, in both high- and low-income countries. A recent report found that menstruation taboos in East and Southern Africa can keep girls and women from touching water or cooking, attending religious ceremonies or engaging in community activities. Involving whole communities fosters a better understanding of menstruation. Communities are more successful at questioning taboos and reducing stigma when parents and leaders, and boys as well as girls, share in the effort.
UNICEF focuses on and empowers girls and women. An important way to do that is to educate boys. Comic books and video programs, peer mentoring and group activities reduce teasing among young people. Community-wide measures help prevent menstruating girls from being restricted in their activities. Better understanding buoys up girls as they grow, with support from their peers and communities.
Schools can help by providing a healthy physical and social environment
UNICEF offers school-based solutions that achieve a double purpose. In addition to education — including education about health and hygiene — schools can be a place to find water, toilets, privacy and support. At the Kaswenthe Primary School in Chitipa, Malawi, UNICEF and partners built a private changing room for adolescent girls, equipped with soap, buckets and clean water at all times. Volunteer counselors from the school's "Mother Group" also offer advice and handsewn sanitary pads to ensure every girl remains in school.
"Most of the girls were encouraged to stay home by their parents upon reaching puberty," says Mercy Gondwe, Vice Chairperson of the Kaswenthe Primary School Mother Group. "The next thing you hear is the girl is pregnant or she is married. And that was really sad for our community. We realized that during our days, we did the same thing and now we are struggling with poverty. We didn't want our children to go through the same. We wanted things to change in our community and we realized that we are the people that can make a difference in the lives of these girls."
All students need to talk about puberty. At schools that offer information and provide for privacy and cleanliness, girls gain dignity and self-respect along with an education. "Girls have learned since childhood that talking about menstruation is innappropriate and shameful," says 17-year-old Aigerim, who participated in a UNICEF-sponsored peer-to-peer training program on menstrual hygiene management in Kyrgyzstan. "But the training opened my eyes; I began to see that it is a natural biological process, and nothing to be ashamed of."
Age-appropriate education about hygiene, cleanliness and sexual and reproductive health develops knowledge and encourages positive attitudes and behaviors. Health education also helps foster the expectation that relationships should be supportive and equitable. Clean water and private toilets also contribute to a safe social environment where girls are treated with respect and understanding.
Education is key to a partnership UNICEF formed with Duke University in Feburary 2019 to support six start-ups that are taking innovative approaches to improve girls' health and menstrual management. The yield on the investment ranges from a mobile chat service that answers questions and gives advice via private, two-way SMS-messaging to an initiative that uses storytelling in the form of animated videos to raise public awareness and change prevailing attitudes and behaviors around menstruation.
Communities around the world need better education about menstruation. Programs that have been successful need to be expanded and adapted to different cultures and conditions.
At schools that offer information and provide for privacy and cleanliness, girls gain dignity and self-respect along with an education.
With help, UNICEF can increase access to:
- Information, so that people — especially young people — know that menstruation is normal and healthy and can be managed without fear or shame, and without missing out on an education
- A healthy environment, with clean water, soap and private disposal, along with access to health care
- An adolescence that is easier and safer for girls growing up
Top photo: Adolescent girls speak candidly about menstruation and learn how their bodies work at a UNICEF-backed health education initiative in India's Jharkhand State. © UNICEF/UN0215391/Vishwanathan