The Importance of Menstrual Health and Hygiene
Menstrual health and hygiene (MHH) plays a fundamental role in enabling women, girls, and other menstruators to reach their full potential. The negative impacts of a lack of good menstrual health and hygiene cut across sectors, so a multi-sectoral, holistic approach is essential to improving menstrual hygiene management (MHM) globally.
On any given day, more than 300 million women worldwide are menstruating. Yet an estimated 500 million still lack access to menstrual products and adequate facilities for MHM. To effectively manage menstruation, individuals require access to water, sanitation and hygiene (WASH) facilities, affordable and appropriate menstrual materials, information on good practices, and a supportive environment free from stigma and shame.
However, the challenges menstruators face go beyond a basic lack of supplies or infrastructure. In many societies, the experience of menstruation continues to be constrained by cultural taboos and discriminatory social norms. This lack of information leads to unhygienic practices and creates misconceptions, motivating shaming, bullying, and even gender-based violence. For generations, poor MHH has exacerbated social and economic inequalities, negatively impacting education, health, safety, and human development.
To address these multidimensional challenges, approaches that effectively combine information and education with appropriate infrastructure and menstrual products, in a conducive policy environment, are most successful.
Addressing Inequalities in Menstrual Health and Hygiene
Education
In low-income countries, half of schools lack adequate WASH services crucial for girls and female teachers to manage menstruation. Inadequate sanitary facilities affect girls’ experiences at school, causing them to miss classes or even drop out entirely. Schools that provide female-friendly facilities and incorporate menstruation education can reduce stigma and contribute to better education and health outcomes.
Health
When girls and women have access to safe and affordable menstrual materials, they decrease their risk of infections, which can have cascading effects on sexual and reproductive health. Poor MHH, however, can pose serious health risks, like reproductive and urinary tract infections, which can result in future infertility and birth complications.
Gender Equality
Promoting MHH is an important means for safeguarding women’s dignity, privacy, bodily integrity, and self-efficacy. Awareness of MHH contributes to an enabling environment of non-discrimination and gender equality in which female voices are heard, girls have choices about their future, and women have options to become leaders and managers.
Economy
Improving MHH and providing access to affordable menstrual materials can help improve girls’ and women’s access to education, opening more options for jobs, promotions, and entrepreneurship. Feminine hygiene products are also a multibillion-dollar industry, which, if properly tapped into, can generate income and boost economic growth.
Environment
Disposable sanitary products contribute to large amounts of global waste. Ensuring access to sustainable and quality products, and improving menstrual waste management, can make a big difference to the environment.
Community-Based Approaches to Improving Menstrual Health
Enhancing opportunities for women to access adequate menstrual health and hygiene is central to the World Bank Group’s development agenda. The Bank addresses this through collaboration and a holistic approach, as demonstrated in recent examples from its operations:
Bangladesh: The Rural Water, Sanitation and Hygiene for Human Capital Development Project is giving women access to microfinance loans and sanitation grants for WASH facilities. The project is also facilitating behavior change sessions, training on MHH, and constructing MHH-friendly facilities in public places. Women entrepreneurs will receive financing to market and sell menstrual products at the household level.
Eswatini: A Water Supply and Sanitation Access Project is promoting gender-separated school facilities with door locks, lighting, disposal bins, and handwashing stations to meet the needs of girls and women. Behavior change and hygiene promotion campaigns on MHH will target students, teachers, parents, and the larger community.
Ghana: The GAMA Sanitation and Water Project constructed sanitation facilities at over 260 schools, including separate toilets and changing rooms for girls, with locks, handwashing, and hygienic disposal spaces.
Lao PDR: The Scaling-Up Water Supply, Sanitation and Hygiene Project aims to address low attendance of adolescent girls by ensuring school sanitation facilities have functional single-sex toilets with water and soap. Educational materials on hygiene and MHM will also be provided.
Mozambique: The Urban Sanitation Project is financing the construction of 78 sanitation facilities in schools and markets, with MHH amenities. MHH and hygiene promotion activities, including teacher and student training, will be conducted.
These examples demonstrate how a holistic, community-based approach can improve menstrual health access and education, contributing to better health, education, and gender equality outcomes. By partnering with local organizations, investing in infrastructure, and delivering tailored training and behavior change campaigns, these initiatives are tackling the multifaceted barriers to menstrual health.
Conclusion: Driving Sustainable Change through Community Action
Addressing inequalities in menstrual health and hygiene requires a paradigm shift towards a holistic, multi-stakeholder approach. While access to menstrual products and WASH facilities is critical, sustainable change also necessitates breaking down stigma, empowering women and girls, and working with communities to reshape social norms.
The case studies from the World Bank’s operations reveal how local, context-specific interventions can drive progress. By partnering with communities, investing in infrastructure, and delivering tailored education and behavior change initiatives, these programs are improving menstrual health access and paving the way for more gender-equal, empowered societies.
As the examples demonstrate, communities themselves are powerful agents of change. When provided with the right resources and support, local organizations, schools, and leaders can challenge harmful social norms, increase access to menstrual supplies, and foster an environment where menstruation is recognized as a normal, healthy process.
To build on this momentum, continued investment, research, and multi-sectoral collaboration are essential. By working in tandem with communities, policymakers, and other stakeholders, we can tackle the root causes of menstrual health inequities and unlock the full potential of women and girls worldwide.
