How Menstruation Became Everyone’s Problem
16 years ago, while the world was dancing to My Humps, there were menstruating girls in school who had to pocket their used pads, tissues, or other makeshift menstrual products to discreetly dispose of them. Why? Because there were no trash bins in the bathroom. They and their families were alone in dealing with high-priced menstrual products, inadequate toilet facilities at school, and the lack of knowledge of their own changing bodies.
Today, however, there’s a growing coalition around the world that includes academics, donors, NGOs, the United Nations agencies, the private sector, and individuals who work to bring attention and resources to tackle menstrual-related issues experienced by schoolgirls. The cause even has its own powerful official acronym, MHM (Menstrual Hygiene Management).
So how did a problem that was once exclusively dealt with at home become a globally recognized public health issue, creating a global social movement?
What can we learn from this amazing progress in order to apply it to other neglected issues that we want to highlight?
Why everyone said “No” in the beginning
Traditionally, menstruation is an important rite of passage. It’s even something that merits celebration in some areas of the world. However, the blood itself and how it’s managed have been perceived as taboo even in 2021. Girls at school (or at home) have to be discreet about it. It’s like, so gross if like, boys know you are on your period, right?
The situation is pretty bad in low and middle-income countries. Not only the cost of menstrual hygiene products is high, but they also don’t have adequate access to private toilet facilities, clean water, and knowledge about menstruation itself. At the time, though, the public health and education sectors said nay to helping schoolgirls out with this issue. It was perceived as something that should be dealt with privately.
The people in the Water, Sanitation, and Hygiene (WASH) sector also didn’t take into account women’s and girls’ menstrual management needs at home or school in their programmings. This may be caused by the unintentional gender-related bias of the engineers, who were mostly men in the sector.
Managing menstrual hygiene was strictly a private matter. Can you imagine the stress and anxiety young schoolgirls have about their period each month?
Teamwork makes the dream work
So what changed? Well, collaborations and representations happened. Progress was achieved thanks to different players in the game.
First, representation. The increase in the number of women engineers in the WASH sector helped move this agenda forwards. NGOs representing the intersection of WASH, education, and child health began to advocate for menstrual hygiene interventions either through actions or research.
Next, we have private sector involvement. Proctor & Gamble was an early key actor in MHM as they were engaged in a range of menstrual-management activities early on. As an example, they supported the Forum of African Women Educationalists which advocated for the removal of value-added tax on the import of sanitary products.
Even if their primary goal was to expand their market or to build their brand, they played a big role in raising awareness about MHM.
The emerging partnerships between the private sector and the NGOs also didn’t hurt the cause. Everyone “got a car” in these collaborations. The private sectors built market share, brand awareness, and increased job satisfaction from “giving back” to the community; The NGOs got the much-needed resources to carry out their programs.
Stories and framing matter too
The advocacies on MHM were strengthened by real-life stories of struggling girls in low and middle-income countries. It contributed to the shift of the responsibility for MHM from individuals and families onto public institutions, like schools and governments to supply information and adequate facilities for menstruating schoolgirls.
What was once an individual problem now requires a structural response that addresses social, cultural, economic, and political factors of the issue.
Individuals who speak about this issue helped too. They presented the problem as a symbol of gender inequality — a universal experience confronting girls and women around the world.
Lastly, the acronym MHM along with the agreed-upon global definition is a handy advocacy tool. When you say MHM, you are referring to access to menstrual hygiene products, safe and private facilities to use or change the products, facilities to dispose of used products, and menstrual-related knowledge.
This definition provides a center for all the efforts. It institutionalizes the concept of MHM.
While we still have a long way to go today, menstruating schoolgirls in low and middle-income countries no longer have to face their difficulties alone because the world has finally taken ownership of the issue.
Now that we know collaboration, representation, stories, framing, and global definition of the issue work well in creating a social movement, what other neglected issues should we take as our own?
This article is based on a scholarly article, “Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue” by Marni Sommer, RN, DrPH, MSN, Jennifer S. Hirsch, Ph.D., Constance Nathanson, Ph.D., MA, and Richard G. Parker, Ph.D., MA
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