On any given day, 300 million people around the world will be menstruating. This normal and natural biological process is a fact of – and fundamental to – life. Everyone who menstruates, including girls, women and non-binary people, has the right to a supportive environment in which to manage their menstruation.
The Human Rights Council formally recognised this in 2018 when they adopted a resolution on menstruation as part of the universal human rights to water and sanitation. This resolution calls on states to tackle menstruation-related stigma and negative social norms, lack of information, and poor access to products and facilities.
Efforts to break down these barriers to improved menstrual health and hygiene (MHH) are gradually gaining momentum, and visibility of MHH issues is starting to rise. In the global water, sanitation and hygiene (WASH) sector, for example, menstrual health and hygiene is becoming an increasingly mainstream component of WASH programmes around the world, with a wealth of guidance and learning now available to support policy makers and practitioners in this area.
However, much remains to be done to ensure these efforts are translated into tangible change for all those who menstruate. Whilst Kenya abolished value added tax on sanitary products in 2004, progress in other countries has been much slower.
In the UK, for example, longstanding campaigns to eliminate these ‘tampon taxes’ as well as to introduce education on menstruation in schools have only recently come to fruition. Other countries, including India, Australia, Colombia and Germany, have also only recently approved changes.
Menstruation is still hidden and shrouded in shame in societies everywhere, and a lack of access to the information, materials and facilities needed to manage menstruation safely continues to impact the physical and mental health of people menstruating.
Menstruation also limits people’s mobility, both as a result of practical constrains such as pain, lack of absorbents or facilities to change them in, and social barriers tied to harmful beliefs, norms and behaviours rooted in gender inequality.
In many societies, people who are menstruating are believed to be impure and their movements may be restricted to limit contact with others accordingly. This has implications on their school attendance and productivity, as well as health and wellbeing. In extreme cases, menstruation-related practices can even lead to death.
The lockdowns many of us are facing as a result of COVID-19 exacerbate these existing challenges and inequalities. For people living in crowded accommodation, managing menstruation privately is extremely difficult, particularly for those dependent on shared or external toilets or washing facilities to which access may be restricted. With many unable to work, shops and schools closed, and supply chains interrupted or overwhelmed, people are also finding it harder to find affordable menstrual products.
And getting enough water for bathing and washing reusable menstrual products may be an additional challenge, as utilities struggle to meet demand and maintain services; queuing at shared water points is restricted and potentially dangerous; and water consumption (and associated cost) increases with more people at home and conscious of the need to wash their hands more frequently. Whilst increased handwashing with soap and other hygiene behaviours are to be encouraged, this may limit the amount of water available for menstrual hygiene.
The world’s focus is rightly on tackling this pandemic but as we do so we must not forget issues that were important before it hit. Millions faced menstrual health and hygiene challenges every day previously and that has not gone away. In fact, for many they have been exacerbated.
Whilst principles of gender equality and human rights should be enough to drive improvements to menstrual health and hygiene, perhaps the fact that women make up 70% of workers in the health and social care sector globally will be a stronger incentive for change.
Unless these people are able to realise their right to a supportive environment in which to manage their menstruation, they will not be able to perform their vital work effectively. In these times of crisis and moving forward, we simply cannot afford not to address the inequalities associated with menstruation.