Menstrual hygiene management remains a critical public health challenge in East Africa, with far-reaching social and economic consequences. Addressing the stigma around menstruation requires effective strategies that improve health and education outcomes as well as foster economic empowerment. By learning from successful policy interventions, there is an opportunity to reframe menstrual hygiene as a public health priority and drive transformative change across the region.
Millions of women and girls face economic and social disadvantages, including disrupted education and negative health outcomes, due to persistent stigma, inadequate facilities, and limited access to affordable sanitary products. Girls’ education suffers significantly due to menstrual stigma and the lack of safe, private sanitation facilities. Research shows that Kenyan schoolgirls often miss five school days each month due to menstrual challenges, which account for 20% of the academic year. The lack of proper sanitation facilities forces girls to use unsafe substitutes like rags or newspapers, increasing the risk of health problems.
Menstruation and education policy strategies
National education strategies should include menstrual hygiene management (MHM) as a fundamental policy intervention. Ethiopia offers a compelling example, where the government has implemented school-based initiatives to improve menstrual hygiene management with support from UNICEF Ethiopia. School sanitation infrastructure has improved through initiatives, such as setting up private toilets, handwashing stations, and safe disposal facilities. The WASH in Schools program has led to lower student absenteeism and improved educational results. The inclusion of comprehensive menstrual health education in school programs for both girls and boys is a crucial component. Menstrual education can reduce girls’ feelings of shame and encourage boys to challenge harmful stereotypes. A UNICEF project in Kenya demonstrated that menstrual education is linked to improved school attendance and greater gender equality.
Health policy interventions
Inadequate menstrual hygiene practices elevate the likelihood of developing urinary tract infections and other reproductive system infections. Adolescent girls in Tanzania who cannot access adequate sanitary products face a heightened risk of infections due to similar MHM challenges. Social isolation and psychological distress are common consequences of the fear of menstrual leakage. Period poverty can also negatively impact mental well-being.
Policy measures to reduce health risks should focus on subsidising menstrual products or removing their associated taxes to make them affordable for low-income communities. Tanzania is assessing reforms to make sanitary products both accessible and affordable. It is crucial to combine menstrual hygiene management with reproductive health services. Adolescent girls are more likely to seek medical help when healthcare providers are trained to address menstrual health with sensitivity and professionalism.
However, more action is needed. Research on MHM in Tanzania calls for strengthened policies that include providing emergency menstrual pads in schools, well-targeted subsidies, tax incentives, and quality monitoring of locally produced menstrual products and technologies.
Economic impact of poor menstrual health
Women and girls in Rwanda face substantial economic burdens because of poor menstrual hygiene management. Lack of affordable menstrual products and proper sanitation facilities creates barriers that force women and girls to miss work. This leads to income loss and reduced prospects. Absenteeism from work reinforces existing gender-based economic inequalities and lowers national productivity.
Rwanda has implemented several policy measures to address these challenges. In December 2019, the government eliminated the value-added tax on sanitary products to improve affordability and accessibility. It recognised that around 18% of Rwandan women and girls missed educational and professional engagements due to unaffordable menstrual hygiene products.
Sustainable Health Enterprises (SHE) has played a crucial role in empowering women by developing affordable, eco-friendly menstrual pads. Local women receive training from SHE to produce these products using locally sourced materials, creating job opportunities and fostering economic self-reliance. These initiatives expand access to menstrual products, boost local economies, and promote gender equality.
Rwanda’s approach to menstrual hygiene management combines comprehensive policies and community programs, using targeted interventions to deliver substantial public health improvements and economic benefits.
Recognition of menstrual hygiene as a policy challenge
Menstrual hygiene management extends beyond individual awareness to represent a critical policy challenge with significant economic, educational, and health impacts. To effectively address this crisis, we must implement targeted interventions, such as free sanitary product distribution, improved sanitation facilities in schools and workplaces, tax benefits for menstrual products, and the integration of menstrual health into reproductive healthcare services.
Policymakers who study the strategies employed by Ethiopia, Tanzania, and Rwanda can develop reforms that address menstrual stigma while simultaneously advancing gender equality and sustainable development. Addressing menstrual health is essential to removing the barriers women and girls face due to stigma and lack of resources.
