Managing menstrual hygiene is a challenge for all women. However, gender inequality, extreme poverty, humanitarian crises and cultural traditions complicate access to basic products, especially in developing countries.

Authorities in India have ended a controversial sanitary napkin tax. Photo: INDRANIL MUKHERJEE / AFP
Authorities in India have ended a controversial sanitary napkin tax. Photo: INDRANIL MUKHERJEE / AFP

According to the NGO WaterAid, about 800 million girls and women of reproductive age worldwide are menstruating on any given day. Menstruation is a universal, biological reality: on average, a healthy woman will menstruate for between 2,555 and 3,000 days during her lifetime. However, this time can be a major ordeal for many women, especially those in particularly vulnerable situations.


Inequalities and Menstrual Hygiene

Not all women are equal when it comes to menstrual hygiene management. Period poverty is exacerbated by the social and economic deprivation which is a part of daily life for the most vulnerable women in society. The United Nations Population Fund (UNFPA) defines period poverty as “the struggle many low-income women and girls face while trying to afford menstrual products.”

Throughout her lifetime, a woman will spend anywhere between €1,730 and €5,360 on menstrual hygiene products, according to British estimates. A number of governments have attempted to address this financial issue. In February 2020, Scotland’s autonomous parliament passed an unprecedented law, guaranteeing free period products for anyone who needs them. In India, a country where 60% of young women aged 16 to 24 do not have access to such products, the authorities scrapped a controversial tax on sanitary pads, a move instigated by lobbying from activists and public figures.

UNFPA adds that the term ‘period poverty’ “also refers to the increased economic vulnerability women and girls face due to the financial burden posed by menstrual supplies. These include not only sanitary napkins and tampons, but also related costs such as pain medication and underwear.” This economic vulnerability forces girls and women around the world to resort to rudimentary forms of sanitary protection. In some parts of rural India, women use scraps of used cloth, leaves, sawdust and even ash when menstruating, putting their gynecological health at risk.



These women risk contracting urogenital infections (vaginal thrush, bacterial vaginosis, and urinary infections) which often go untreated due to limited access to care in certain countries. In Kenya, young girls from slums and rural areas turn to prostitution in order to pay for menstrual products. This practice then leads to other issues such as sexual violence, STDs and teenage pregnancy.


Menstrual Hygiene: A Struggle for the Most Vulnerable Populations

In relief camps, menstruation is not treated as a right of human dignity in the same way as other issues. However, for the 30 million girls and women currently in refugee camps, managing their periods is an overwhelming problem. Without access to culturally-appropriate sanitary products and secure facilities to protect their privacy, these women are deprived of dignity during their periods.

This lack of privacy creates barriers to education for girls in many developing countries. According to UNESCO, in sub-Saharan Africa, one girl in ten skips school during her menstrual cycle and many are taken out of the education system altogether as soon as they start menstruating. This disengagement is due to a lack of hygiene products and adequate toilet facilities in schools.

Poor menstrual hygiene management also results in self-isolation from society or coerced exclusion, when its roots lie in restrictions based on negative socio-cultural perceptions. To resolve these issues, international organizations, with the help of civil society groups, are working to break this taboo.


Significant and Recent Progress to Ensure Greater Dignity for Women

Many NGOs are tackling the problem by distributing menstrual hygiene kits. In Vanuatu, Care distributes soap, washable and reusable sanitary pads, underwear and laundry detergent. In Uganda, Plan International is raising awareness in communities about the importance of menstrual hygiene. In Nepal, Wateraid provides support for girls and women with disabilities, in managing their menstrual hygiene.

In refugee camps, UNFPA distributes “dignity kits” and is working to improve the security of toilets and sanitation facilities. The Fund also promotes education and information on menstrual health. The NGO Elrha, through its Research for Health in Humanitarian Crises program (R2HC), has developed a toolkit designed to make menstrual hygiene management an integral part of the humanitarian response.

These initiatives have intensified and have grown in number over the years, particularly through the awareness campaigns organized to mark International Menstrual Hygiene Day, on May 28.


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