By Tallulah Gordon
Like many others who menstruate, I started lockdown worried about how social distancing and bulk-buying would impact my ability to buy sanitary products. Yet a lack of adequate support for menstrual hygiene management (MHM) for women and girls in developing countries has been a reality long before the pandemic began. Around the world, lockdown restrictions have reduced access to water, sanitation and hygiene (WASH) facilities, sanitary products and information on menstrual hygiene management, and exacerbated the difficulties that women, girls and many transgender and non-binary people face in managing their menstruation. It is vital that efforts to challenge the barriers to access for people who menstruate are continued after Covid-19.
Globally, 2 billion people lack access to adequate water and sanitation. This means many have less ability to wash, change privately and clean or dispose of sanitary products while menstruating. Due to lockdown restrictions, WASH professionals in developing countries including India, Bangladesh and Zimbabwe have reported further reductions in access to facilities used by girls to manage their menstruation, which has a particular impact on those without WASH access in their home. In many African communities, for example, girls depend on public sanitation facilities, such as those in schools and churches, for MHM. In developing countries such as Uganda and Nepal, inadequate WASH provisions at work have also impacted healthcare workers – of whom 70% worldwide are female – menstruating while working long hours in restrictive PPE.
Access to menstrual hygiene products and reliable information during a pandemic
Worldwide, shop closures, disrupted supply chains and self-isolation have made accessing menstrual hygiene products more challenging. 62% of NGOs surveyed by Menstrual Health Alliance India reported that lockdowns had reduced access to sanitary products within the communities they work with. During the first week of India’s lockdown, sanitary pads – used by an estimated 36% (121 million) of the country’s menstruating women and girls – were not classed as ‘essential’ items, leading to shortages in their supply due to manufacturing restrictions. When sanitary products are not available, those menstruating often turn to unhygienic homemade alternatives.
Development initiatives have often tackled inadequate MHM by giving out free menstrual hygiene products in schools. School closures, however, have posed difficulties for those reliant on these services for their sanitary products, which have become increasingly unaffordable worldwide due to reduced incomes and inflated prices. Self-isolating women and girls may also feel uncomfortable asking male relatives to purchase sanitary products for them due to stigma around discussing menstruation.
Closures and self-isolation have also reduced access to MHM support and information, such as through schools, family members, and health clinics. For those without Internet access – of which there are more women globally than men – this can be particularly harmful. Access to factually accurate information on MHM is especially important given the stigma surrounding menstruation in many societies. For example, beliefs that menstruation is ‘unclean’ has meant women and girls are not allowed to enter places of worship in India, as well as misconceptions about how menstruation should be managed. This stigma means women and girls have reported feeling shame about their reduced ability to manage menstruation during the pandemic, especially around the increased presence of men at home during lockdowns.
How is this being addressed?
Organisations working in developing regions have responded innovatively to the challenges to effective menstrual hygiene management resulting from the global pandemic. In Kenya, NGOs Plan International and ZanaAfrica have distributed over 2,700 sanitary towels door-to-door for families living in the Kibera informal settlement, and are looking at ways to make access to public toilets free. In Mumbai, the ‘Red is the New Green’ initiative has spread MHM awareness among 14,000 women during the pandemic, including providing advice on how homemade sanitary supplies can be used hygienically. UNICEF has also called for menstrual hygiene to be integrated into national Covid-19 responses and for sanitary products to always be categorised as essential items.
Shortages have also called into question the widespread dependence of menstruators on single-use disposable sanitary products, leading to suggestions that reusable products should be promoted instead – although their feasibility in communities with poor WASH services and heavy stigma around menstruation must be examined. How these impacts are responded to has implications not just for the remainder of Covid-19 restrictions, but for how inadequate MHM continues to be tackled post-pandemic, as well as providing lessons for future health or humanitarian crises.
Tallulah is Blog Officer at Development in Action and has a degree in Geography from University College London.
The views expressed in this article are those of the author and do not necessarily represent the views of Development in Action.
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