Access to menstrual products for girls: a strategy for achieving development goals

by Jay Gribble

Over the past few days at the RHSC General Membership Meeting in Accra, my eyes have been opened. I’ve had tunnel vision for far too long, focusing on family planning policies and supplies without realizing that the larger set of reproductive health commodities warrant more attention than they get. One set of commodities that has caught my attention at the meeting is menstrual products. As I start thinking about this set of supplies, my biases have become clear to me: through my job, my sex, and my position of privilege, I’ve overlooked a situation that impacts the lives of millions of school-age girls around the world.

Why now?

What has struck me about advocates’ positions is that menstruation is part of a woman’s life — it’s the sign that pregnancy and childbearing are possible. Yet it tends to be a taboo topic — off limits for discussion in most professional contexts — and certainly in polite company. Yet there is an unstated reality: as millions of girls around the world reach menarche, their lives change — and often not for the better. Educational achievements may drop off, as running water or bathrooms aren’t available in many schools, especially in rural areas. With higher rates of absenteeism while having their periods, many girls fall behind in school and eventually drop out. We know that out-of-school girls are more vulnerable to a set of adverse outcomes, including unplanned pregnancy, early marriage, poor health for their children, and limited economic opportunities. So, while addressing menstrual health may not resolve all gender-based biases against girls, it is an important place to start thinking about access to menstrual products as a development strategy.

At the same time, as the development sector continues to draw attention to goals such as the demographic dividend and gender equality, we must recognize the inherent links between girls’ needs and these larger goals. The focus on accelerating economic growth through investments in youth empowerment has at its heart the need to ensure that girls understand what menstruation is, how it might affect them physically, and how to care for themselves during their periods. Without this basic information, girls will continue to get left behind, which affect them individually, while also limiting their countries’ economic growth.

My work

For decades, I have focused my professional work on improving the policy environment for family planning. I’ve worked with lots of country stakeholders to support policy development and implementation. From a health and gender perspective, this work has been critical to improving access to and uptake of modern contraception. Yet, there has been virtually no attention paid to menstrual hygiene products, which seem to be the stepsister of family planning. In my job, I need to consider a broader set of reproductive health supplies — and I’d put menstrual hygiene products at the top of the list.

My sex

Being a man, I have had no first-hand experience with menstruation. In school, talk about menstruation outside science class was pretty much a taboo topic. I think this treatment of the topic leads men not to be sensitized about menstruation or menstrual products. And, because of gender biases, most decisionmakers (who generally are men) lack empathy and understanding of the plight to school-age girls reaching menarche, the ongoing needs for sanitary products, and the ongoing physical and socio-economic impact on the lives of women and girls that menstruation brings. Empathy and understanding among the health sector, employment sector, and decision-makers could change the way society treats menstruation and the need for menstrual supplies.

My position of privilege

Finally, from where I sit, I’m often oblivious to the hardships of people living in other parts of the world — especially the reproductive health needs of school-age girls. Women I know buy menstrual products at the drug store; they have access to clean bathrooms; they have access to information about what is happening to their bodies. The idea that girls lack access to menstrual products crosses the minds of few people where I live. Yet the reality that millions and millions of school-age girls around the world face reflects the failure of health, education, and employment sectors to prioritize a fundamental women’s health need, as well as an inadequate commercial market for affordable and accessible menstrual products.

This RHSC meeting has come as a wake-up call to me. We need to understand that underlying development goals are a host of gender and culturally focused norms that must be addressed. If girls leave school because they don’t have access to menstrual products, then something needs to change. Access to menstrual products can be a critical development strategy for girl’s empowerment, while also contributing to economic growth. In recognizing this possibility, we must also think creatively about sustainable solutions, share programmatic successes, and foster well-functioning supply chains that get products to where they are needed.

Jay Gribble is senior director at Palladium and deputy project director of PROPEL Health; views expressed here are his individual perspective