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 opportunity and poverty.

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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, is a four-year initiative that we are implementing with our partners in Burkina Faso, Liberia, Sierra Leone and Pakistan. This program will provide quality, gender-responsive and age-appropriate menstrual health and hygiene education in vulnerable communities across four countries. Our approach to menstrual health education is designed to create the conditions for girls to stay in school throughout menstruation and promote their body integrity. Importantly, will support 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 and hygiene education and a reliable supply chain for menstrual products, women and girls are able to unleash their potential and change their lives for good.  

Women are smiling and carrying water
Some of Tombohuaun's women at the water pump in Tombohuaun, Kailahun District, Sierra Leone.
Image: WaterAid/ Nana Kofi Acquah

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

Influencing all levels of government to recognize menstrual health will create an enabling environment conducive to changing social norms and promoting gender equality. Building responsiveness and political will for menstrual health is a fundamental step in introducing discussions of SRHR and addressing barriers to the empowerment of women and girls. Responsiveness can result in menstrual health considerations in national policies, plans and investments, such as those for education, school infrastructure and workplace standards. Informing and engaging duty bearers on an often-held taboo subject, such as menstruation, can help to launch discussion and recognition of the critical role of menstrual health as a foundation of health and gender empowerment and, in turn, an entry point to engage discussion on other aspects of SRHR.

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 project will work alongside civil society in informing, engaging and holding local leaders to account 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.

Young women sitting at a desk
Iqra, student of class 10, in her class during a hygiene session in Government Girls High School, Province Punjab, Pakistan.
Image: WaterAid/ Sibtain Haider

Improving sanitation and hygiene infrastructure 

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

Changing behaviors and attitudes 

School and healthcare centre staff will be trained on menstrual health, including training support staff on the maintenance and utilization of menstrual health services and facilities. All students will be 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 will be undertaken and youth clubs in schools will be established. Female students participating in these clubs will receive and be trained on how to use menstrual health management (MHM) kits by healthcare professionals. Youth (boys and girls under 25) within and outside of school settings will be engaged for knowledge sharing and discussion about menstruation. Specific tools and awareness-raising materials will be developed for these purposes and healthcare facilities will be leveraged to reach out to school youth. Critically, it is assumed that each country and cultural context will be receptive to this approach of focusing on menstrual health in education and healthcare settings.   

Girl washing her hands at a sink
Misbah, 13, washing her hands at the WaterAid installed girls' friendly WASH block in Government Girls School, Province Punjab, Pakistan.
Image: WaterAid/ Saima Allah Bachaya

The village of Phul Shoro, Pakistan

The remote village of Phul Shoro is one of the villages where the project activities will be implemented. It is a farming village in Pakistan where both men and women work in the fields to make a living. The only source of water in this village is a contaminated canal that is used by villagers for drinking, bathing, and washing clothes. It is also used by animals for drinking and bathing. People in Phul Shoro do not have toilets at home and practice open defecation.    

In Phul Shoro women and girls are responsible for all household activities. Girls will stay home with their mothers, while young and adolescent boys go to school. Bilquees, a mother living in Phul Shoro, says that she keeps busy during the day by looking after cattle, washing, cooking and cleaning. Her daughter, Saleemat, helps her mother with the household chores and will sometimes help with harvesting. She has never gone to school, despite having an interest to attend. When asked what she uses during menstruation, Saleemat said that she has never been taught about menstruation or menstrual hygiene, and like her mother, does not use any menstrual cloth or material and wears darker coloured clothes during her period.    

Women in Phul Shoro with cattle livestock.
Image: WaterAid/ Pakistan
Girl preparing food in Phul Shoro, Pakistan
Image: WaterAid/ Pakistan

WaterAid and menstrual health  

builds 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.