HerWASH

Without the proper tools to deal with their menstrual needs, women and girls face significant barriers in accessing proper education and participating in the workforce.  With limited education and a lack of income-generating opportunities, girls and women become stuck in a cycle of missed opportunities. 

Menstrual health is a largely overlooked aspect of development and is a critical pathway for gender equality and female empowerment through integration with water, sanitation and hygiene (WASH) interventions. Addressing menstrual health enables women and adolescent girls to better deal with menstruation and acts as a starting point for discussions around Sexual and Reproductive Health and Rights (SRHR). When women and girls can better deal with their menstrual needs, they can go to school for longer, participate in the workforce more effectively and, contribute to their communities in more productive ways. 

Building upon a decade of experience delivering successful menstrual hygiene management programs in Pakistan and Burkina Faso, HerWASH was a four-year initiative, completed in 2024. This project was implemented with the help of our partners in Burkina Faso, Liberia, Sierra Leone and Pakistan. The program provided quality, gender-responsive and age-appropriate menstrual health and hygiene education in vulnerable communities across four countries. Our approach to menstrual health education aimed to create conditions for girls to stay in school throughout menstruation and promote their body integrity. Importantly, HerWASH supported women and girls to participate in daily life during mensuration without discrimination through improved social attitudes and an increased sense of personal freedom. With access to quality menstrual health, hygiene education,  and a reliable supply chain for menstrual products, women and girls were able to unleash their potential and change their lives for good.  

Increasing Government Responsiveness to the Menstrual Needs of Women and Adolescent Girls

Influencing all levels of government to recognize menstrual health created an enabling environment conducive to changing social norms and promotion of gender equality. Building responsiveness and political will for menstrual health acted as a fundamental step in discussions of SRHR and addressing barriers to the empowerment of women and girls. Responsiveness facilitated menstrual health considerations in national policies, plans, and investments, such as those for education, school infrastructure and workplace standards. Through informing and engaging duty bearers on an often-held taboo subject, such as menstruation, discussions and recognition of the critical role of menstrual health as a foundation of health and gender empowerment occurred. As a result, an entry point to engaging discussions on other aspects of SRHR was enabled.

In Burkina Faso, Liberia, Sierra Leone, and Pakistan there is often a limited capacity to overcome barriers to meet basic rights, such as health, water, sanitation and education. The limited capacity of government can compound social norms and traditional gender roles that inhibit sexual and reproductive health and rights and the empowerment of women and girls. The HerWASH project worked alongside civil society to inform, engage and hold local leaders accountable in terms of policy, investment and achievement of SRHR and human rights of women and girls. While issues of menstrual health are universal for the female population, the creation of enabling environments for inclusive menstrual health is unique to each country, cultural context, economic and social status and religious beliefs.

Improving sanitation and hygiene infrastructure 

In specific schools and healthcare facilities, WASH facilities – latrines in particular – were rehabilitated and adapted to enable inclusive menstrual hygiene practices. These facilities provided greater safety, health and comfort for women and girls menstruating. All construction work took into consideration environmental impacts and every measure possible was taken to reduce them, including proper disposal of waste and safe disposal of sanitary materials. In addition, when selecting the locations for construction, WaterAid took into consideration the changing climate realities and used adaptive measures and technologies, where appropriate. 

Changing behaviors and attitudes 

School and healthcare facility staff are trained on menstrual health, including training support staff on the maintenance and utilization of menstrual health services and facilities. All students were sensitized on the topic of menstrual health and SRHR through peer-to-peer learning and curriculum. To this end, youth leadership training for adolescent girl students was undertaken and youth clubs in schools were established. Female students who participated in these clubs received training on how to use menstrual health management (MHM) kits by healthcare professionals. Youth (boys and girls under 25) within and outside of school settings engaged in knowledge sharing and discussion about menstruation. Specific tools and awareness-raising materials were developed for these purposes and healthcare facilities were leveraged to reach out to school youth. Critically, each country and its cultural context were receptive to this approach of focusing on menstrual health in education and healthcare settings.   

WaterAid and menstrual health  

HerWASH was built on years of WaterAid experience improving menstrual hygiene management and menstrual health. WaterAid is a founding member of the Global Menstrual Health and Hygiene Collective, which aims to drive and guide investment in menstrual health and hygiene through evidence-based advocacy. We recognize that for communities to develop, women and girls must be able to reach their full potential; but with barriers inhibiting their capacity to properly manage their periods, that is impossible. As WASH experts, we clearly see how improving access to clean water, sanitation and hygiene provides a clear pathway to greater menstrual health and gender equality. For these reasons, menstrual health and the needs of women and girls are always prioritized in our projects around the world.

HerWASH in Action

Menstruation was taboo in Luawa Chiefdom in Sierra Leone before HerWASH, and open conversations on menstruation and menstrual hygiene management were discouraged. As was the practice, women and girls isolated themselves when they had their periods and could not openly ask for support. They also used pieces of clothing for pads, whether the cloth was clean or not. Through HerWASH workshops, trainings have been held to destigmatize menstruation and increase participants’ knowledge of menstruation and menstrual health and hygiene (MHH).

Elizabeth Vandy (65) is the Head of Sowei Community in Luawa Chiefdom and is one of the HerWASH workshop participants. As the head of the community, Elizabeth leads the traditional initiation ceremonies for girls as they transition into adulthood. She is also the voice of women in the Chiefdom, advocating for issues important to women and girls. Since participating in the HerWASH workshops, Elizabeth has begun sharing information about MHH in her community, using her influence as a community leader. Elizabeth has also participated in radio awareness campaigns and community meetings to emphasize the importance of proper menstrual hygiene.

“The HerWASH project served as an eye opener to us about menstrual health and menstrual hygiene management. Issues surrounding these topics were previously seen as taboos. Now, we have a better understanding as we have learnt that menstruation is not something to be ashamed of and we now discuss and talk about it.” - Elizabeth Vandy