Menstruation – Education changes everything

The theme of this year’s International Menstrual Hygiene Day (MHD) was education. The founders of MHD argue that education on menstrual hygiene changes everything. They call for improved information and menstrual hygiene education   for boys, men, teachers, health workers and other professionals so that they can break down negative social norms and provide accurate information and support.

They have argued for the inclusion of menstrual hygiene management as a critical component of reproductive health training for adolescents, building the capacity of teachers to teach about MHM with comfort, the breaking down of taboos around periods, the availability of water and sanitation facilities in schools and work places in order that women and girls have privacy and dignity as well as policies that reduce the cost of menstrual absorbents and are kind to the environment.

sanitary towels

We have spent the past year looking at access menstrual hygiene in schools in Ntungamo district SW Uganda . The program focuses on the provision of information on menstrual hygiene as well as ensuring that girls can access menstrual absorbents.

In the course of the year we learned that 53% of girls we spoke to did not know what a period is before they experienced it. 42% of the girls regularly miss between 2-5 days of school each month during their period because they do not have access to sanitary products.

We also learned that some amongst the girls use unsanitary products such as old rags, mattress stuffing etc. during their periods.

Syson- Team Leader MHM program

Education about menstrual hygiene should concern us all. As part of this year’s MHD activities in Ntungamo, we distributed free Menstrual Hygiene kits to women in the village of Rwentojo SW Uganda. We have been working with this group of women on income generation

Education on menstruation

This got me thinking about the role of business in the promotion of menstrual hygiene. For instance, how and where does business fit into the promotion of menstrual hygiene? Is it through their supply chains or perhaps in places of work? Is this even an issue that business concerns itself with?

Do employers for instance, provide flexible working conditions that enable women that suffer painful periods to take time off or work from home should they need to? What about access to female only washrooms?

These are things that we in the West might take for granted but what about elsewhere in the world? For instance, a study entitled Menstrual Hygiene Management-The experience of nomadic and sedentary populations in Niger  found that 55% of women in Niger miss work as a result of their period. You can read the full report  here .

In my opinion, that sort of statistic would have huge implications for a business’s bottom line because it would impact productivity and outputs.

Menstruation hygiene matters to business in other but perhaps subtle ways such as the availability of skilled workers. Businesses need skilled people to grow and thrive and this cannot be achieved if the education system is not producing the necessary skills or female employees miss workdays due to periods.

With respect to education, in countries such as Uganda, access to Primary School Education is free under the Universal Primary Education initiative, but gaps exist in addressing issues that prevent girls from dropping out of school and some of these reasons are to do with poor menstrual hygiene management in schools.

This includes the availability of water, toilets, washrooms and hygienic menstrual products. It is not enough to increase school registration for girls who then drop out due to a lack of menstrual hygiene management.

In the long run this has direct implications for a country’s economic development due to a large number of girls who become adults that are trapped in poverty due to a lack of skills which they can use to create their own employment or access employment elsewhere.

The founders of MHD have argued, that in order for countries to achieve Sustainable Development Goals 3, 4, 5, 6, 8 and 12, nation states must pay attention to menstrual hygiene management. This being the case; Governments, Civil Society as well as Business should take menstrual hygiene management seriously.

Our fight to enable women and girls to access information on menstruation and hygienic absorbents continues and you can be part of it by making a donation to our campaign at



Menstrual Hygiene in rural Uganda

The Millennium Development Goals (MDGs) have come to an end and world leaders are currently in New York where they are discussing the Sustainable Development Goals (SDGs) that will replace them in January 2016.

There is a specific goal about women,

Goal number 5: Achieve gender equality and empower all women and girls

Rural women and girls in Uganda still face huge challenges including, availability of jobs, not being included in the decision-making process, inability to negotiate individual rights in and outside the home as well as political discourse.

It is my view that some of these challenges persist due to social and economic exclusion of women, as well as political will that means resources are not set aside to address women’s issues.

An example of an issue that impacts women and girls that but is often neglected is menstrual hygiene.

After hearing and reading about rural girls missing several school days a year due lack of access to sanitary towels we decided to explore how this issue could be resolved.

It seemed to us that, if girls are missing school days, this implies poor school results or girls dropping out of the education system leading to inability to access formal employment and in turn high incidences of poverty amongst rural women and girls.

Menstrual Hygiene
Seamstress and the girls cutting up fabric for homemade sanitary towels

Our approach was mostly practical. We provided fabric for making sanitary towels and sewing machines and a local woman started making up homemade sanitary towels for school age girls.

By the end of 6 months, 37 girls had received free homemade sanitary towels and we wanted to find out what impact if any the towels had on their lives.

Menstrual Hygiene
These are some of the girls that benefited from the trial

Alex, our colleague in Uganda sat down with some of the girls to find out how they got on with the homemade sanitary towels and here is their discussion

Impact of reusable pads on the welfare of girls in Ruhanga

The girls reported the following to have been the impact of reusable pads on their welfare and the welfare of the community.

  • Missed school days: There has been reduced school absenteeism as a number of girls used to miss lessons during their monthly periods. This would stem from the fact that their peers would bully them when bloodstains are seen on their dresses.
  • The reduced school absenteeism has slightly increased the performance of girls.

One respondent had this to say.

“There was a time I missed a midterm test because I didn’t have sanitary pads. I live with my father and when I asked for money for sanitary towels. He told me, he had no money to waste on “useless” materials. I was afraid of being humiliated. I had recently witnessed the humiliation of a girl in my class due to an accidental leak that left a blood mark on her chair.  I didn’t have to face such humiliation because of free sanitary pads. As a result, I performed well last term having been able to attend all the lessons including the days I was in my periods. ”

  • Cost: The free sanitary pads distributed to the schoolgirls around Ruhanga have helped their parents financially and the savings were put towards scholastic materials. A packet of disposable sanitary pads in Uganda costs 4,000 Ugandan shillings (0.79 pence’s). On average a girl uses 6 packets in a term, at a cost of approximately 24,000,Ugandan Shillings (£4.72). With the free reusable sanitary pads, parents have been able to save some money that is put towards other things that girls needs.
  • Environment: The girls further point to the sustainability of the environment. One of them said the re usable sanitary pads were helping them to conserve the environment around their school since they did not need to throw away used pads.

This what one of the girls had to say;

We have been having problems with our latrines getting filled quickly (and sometimes having a funny smell) because some girls would dispose their used sanitary pads therein.[1]

Some girls reported that disposable sanitary towels left them with infections and this had improved as a result of using re usable sanitary pads. One respondent said;

The disposable towels did not always keep me dry. I used one towel a day as I didn’t have enough money to buy enough towels to enable me to change several times a day. As a result, I suffered infections.

Having access to reusable sanitary towels has meant, that I can change as often as I need to and this improved hygiene has meant I no longer have infections resulting from the over use of one towel. These towels have saved me money too.

The girls love the red colour of the sanitary pads and some reported that it has helped them the mood swings associated with monthly periods. One respondent had this to say;

I like bright colours as they build my confidence and personality. The red colour of the reusable towels lifts my mood and doesn’t show stains.

 Challenges faced when using the re usable sanitary pads


Menstrual Hygiene day
Homemade sanitary towels

The respondents cited the following challenges experienced in using the reusable sanitary towels made through Skills Development Initiative;

  • The re usable pads are not yet of good quality as there are hand made by girls who are learning on the job. Consequently some users found the towels uncomfortable to use
  • There are issues of privacy for those in boarding school as to the towels had be washed and hang out to dry.
Baby Lock sewing machine
Our girls checking out their new sewing machine

Following this feedback, Paige and I had a chance to meet some of the girls and their mothers in Ruhanga. Through our conversations, we learned that some women had no income for most part of the year and as such, have no access to disposable towels and have to improvise during that time of the month.

This means using old pieces of cloth as sanitary towels and for the girls 2 or 3 days off school.

When we explored the issue of cost and hygiene, it became apparent that both women and girls are prone to infections because they do not change soiled towels throughout the day.

We were unable to determine precisely whether this was due to the cost of the towels or general knowledge/understanding of menstrual hygiene but concluded that it was a combination of the two.

Whilst I appreciate that SDGs are merely a development framework, I worry that issues such as, menstrual hygiene that impact women in profound ways will continue to fall through the proverbial development crack if we don’t take action to address them.

The next steps for us are to find ways to scale this programme to enable women and girls to enable women to access low cost sanitary towels.


You can support our journey by making a donation at


[1] From the Focus Group Discussion held on 3 July, 2015 at Ruhanga Skills Centre.

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