Menstruation is a naturally occurring physiological phenomenon in adolescent girls and pre-menopausal women. Menstruation necessitates the availability of material resources to absorb or collect menstrual blood, facilitate personal hygiene and dispose of waste, ideally with adequate privacy.
Menstrual Hygiene Management (MHM) is defined as “Women and adolescent girls using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required, and having access to facilities to dispose of used menstrual management materials.”
Women and girls in low-income settings have low awareness on hygienic practices and lack culturally appropriate materials for menstrual hygiene management (MHM) practices.
The materials used as adsorbents during menstruation in low income countries including Nigeria vary from reusable towels (cloth torn from dresses of women and cotton fabric) to commercially available disposable sanitary pads.
Menstrual hygiene needs and management of the menstrual period are basic reproductive health rights of women and girls, the lack of which poses negative clinical and psychosocial outcomes.
A report by UNESCO reveals that one in ten girls in Sub-Saharan Africa misses school during her menstrual cycle. This is estimated to be about 20 percent of a given school year.
POSSIBLE REASONS FOR LACK OF MENSTRUAL HYGIENE MATERIALS
Poverty is a leading cause as a lot of girls can’t afford the necessary menstrual products of their choice.
Lack of Awareness: Lack of awareness regarding the importance of menstrual hygiene, arising from a lack of education contribute in a major way to why menstruating women do not know the use of menstrual hygiene products.
Insecurity: Girls and women living in conflict zones especially in northeastern Nigeria have little or no access to proper menstrual hygiene materials as humanitarian organizations are unable to reach those areas. Those who managed to reach such remote and conflict-ridden areas have faced lots of challenges including kidnapping and killing of their staff.
Pandemics: In times of pandemics like this COVID-19 pandemic or disasters, there is limited access to reproductive health services and safe menstrual hygiene materials. During this time, operations and policies are geared toward “essential” humanitarian needs. Thus, there seems to be a lack of attention to menstrual hygiene needs of adolescent girls and women.
Cultural and Religious Taboo: Cultural and religious taboo surrounding menstruation is also another major reason why girls lack access to menstrual hygiene materials.
NEGATIVE IMPACT ON GIRLS
School absenteeism as a lot of girls who can’t afford menstrual products stay at home till their periods are over making them miss out of learning and many get discouraged and drop out of school permanently. A UNESCO report reveals that one in ten girls in Sub-Saharan Africa misses school during her menstrual cycle. This is estimated to be about 20 percent of a given school year. Lack of wash facilities in school buildings also discourages a lot of girls from attending school while on their period.
Poor hygiene which could lead to reproductive or urinary tract infection. It is the fundamental right of every woman to be able to manage her menstruation hygienically. However, poverty has caused women and girls in rural areas to result to the use of uncomfortable and often times unhygienic materials which poses a great risk to their reproductive health.
Social isolation happens when girls don’t feel comfortable on their period either because of offensive odours due to poor menstrual hygiene, unavailable menstrual products, a lack of menstrual education leading to a feeling of self stigmatization or from others, unavailable wash facilities and using uncomfortable and unreliable improvised menstrual products.
Teen pregnancies can occur when poor girls think it is cheaper to fall pregnant and not deal with the cost of menstrual products for 9 months. Also lack of menstrual education and awareness leave girls vulnerable to early and unintended pregnancies.
Women and girls should not feel any shame from menstruation or suffer in silence. The spread of menstrual awareness and use of hygienic products to deal with menstruation are the best ways to avoid negative clinical and psychosocial outcomes.
 Biran A, Curtis V, Gautam OP, Greenland K, Islam MS, Schmidt W-P, et al. Menstrual Hygiene. In: Background paper on measuring WASH and food hygiene practices–definition of goals to be tackled post 2015 by the joint monitoring Programme. 1st ed. London: London School of Hygiene and Tropical Medicine; 2012. p. 81.
 Sahin M. Tackling the stigma and gender marginalization related to menstruation via WASH in schools programmes. Waterlines. 2015;34(1):3–6.