According to the World Bank (2018), at least 500 million women and girls lack adequate facilities for menstrual hygiene management (MHM). Inadequate privacy measures and inadequate disposal facilities for used absorbents may cause anxiety and stress among them. This problem may lead to absenteeism from school and work which could have severe economic costs on the girls’ and women’s lives and on the country. According to a 2014 United Nations Educational, Scientific and Cultural Organization (UNESCO) report, one out of every 10 girls in sub-Saharan Africa misses school during her menstrual cycle. With little access to menstrual products, women in resource-limited countries resort to using old clothes, paper, cotton or wool pieces, and sometimes unsanitary rags which may lead to health problems. Some Sub-Saharan countries have launched initiatives to address this problem. For example, Kenya and South Africa have removed value-added tax on menstrual hygiene products.
Focusing on poor menstrual hygiene for school girls, some research studies have shown that in countries like Ghana and Nigeria, some schools have insufficient toilets, inadequate privacy measures, and inadequate disposal facilities for used absorbents. “The poor water, sanitation and hygiene infrastructure, including disposal, makes it difficult for girls to manage their menstrual cycle subjecting them to anxiety and stress,” says Martha Naigaga, sanitation coordinator, Ministry of Water and Environment, Uganda. According to UNICEF, poor menstrual hygiene has been linked to reproductive and urinary tract infections. Young girls who miss out on school because of poor menstrual hygiene are more likely to enter child marriages which may sometimes lead to early pregnancy, malnourishment, domestic violence, and pregnancy complications.
The World Bank is committed to promoting MHM as a step towards enhancing gender equality. The taboos and stigmas associated with menstruation have led to an overall culture of silence around the topic, leading to limited information on menstruation and menstrual hygiene. This issue could affect the health and dignity of women and girls. A World Bank Group study, “The Rising Tide: A New Look at Water and Gender”, illustrates how a disregard of women’s hygiene needs serves to establish the lower status of women. The World Bank has set up programs worldwide to address MHM. For example, in Ghana, the World Bank is providing sanitation infrastructure and hygiene education in over 260 schools. The World Bank is also collaborating with WASH United during Menstrual Hygiene Day to increase global awareness on MHM and catalyze social norm change.
Some U.S. states have passed laws mandating schools to provide period products to students, regarding these products as essential as toilet paper. As of 2018, U.S. federal prisons made menstrual products free. Water Supply & Sanitation Collaborative Council (WSSCC) is working to break menstruation stigma through education and behavior change involving initiatives such as menstrual waste workshops in West and Central Africa, and promoting toilet designs that can handle menstrual waste in India. Many organizations such as Sustainable Health Enterprises (SHE) Innovates, AFRIpads, WASH (Water, Sanitation and Hygiene) Advocates and Be Girl are also working to promote menstrual hygiene in developing countries.