MHM and the Sustainable Development Goals
It is evident that the proper management of menstrual health is directly linked to the attainment of sexual and reproductive health and rights and several other human rights. These are aligned with the Sustainable Development Goals (SDGs). To advance the MHM agenda, the African Coalition for Menstrual Health Management is strategically positioned to facilitate and enhance coordination among its members so that they contribute towards the attainment of the SDGs through their advocacy, policy guidance and development, programme implementation, monitoring and evaluation, in their respective countries, as well as collectively across Africa and globally.
Menstrual health management (MHM) is critical for the attainment of at least nine of the 17 SDGs; hence the work of the ACMHM from 2019 to 2024 is guided by the SDGs as an overarching strategic framework.
Goal 3: GOOD HEALTH AND WELL-BEING
Menstruation is a normal reproductive health process, which also signals the development of the body. It is a sign of good health and well-being and should be acknowledged as such. It should be celebrated as a sign of growth, development and maturity, and not as a sign of shame, discrimination or stigma, as is currently the case in some societies.
As the goal calls for all to ensure healthy lives and promote well-being for all at all ages, it is apparent that this cannot be attained if the menstrual health and well-being of all people who menstruate is not promoted. This means that people should be able to menstruate in a way that promotes their health, with the appropriate and healthy products of their choice. Pain and discomfort should be addressed, if menstruators are to attain good health and well-being.
The social and economic effects of menstruation should be taken into consideration so that resources are accessible for all to maintain good health. In resource-constrained communities and households, access to menstrual products is usually a challenge, putting the menstruator and their family in the dire situation of having to prioritize resources for survival. This often leads to the menstrual health of those who menstruate not being prioritized, and further exposing those who menstruate to other health risks and challenges.
Goal 4: QUALITY EDUCATION
– Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.
The importance of education cannot be overemphasized. Even though education is not a privilege but a human right, many people do not have access to this right due to various reasons. These include social, economic, cultural, psychological, environmental and other barriers and challenges. High levels of social, economic and gender inequalities contribute to these challenges, and continue to place women and girls specifically in vulnerable and unconducive conditions to exercise their rights and gain access to relevant opportunities.
There are a myriad efforts and evidence linking education to menstrual health.
The African Coalition for Menstrual Health Management believes that education is one of the critical enablers for overcoming the prevalent inequalities, hence the need to ensure that all people have access to education without fear or prejudice and regardless of their socio-economic or other status. However, menstruation seems to be one of the issues or processes that continues to pose challenges for those who menstruate, and their families and communities. These challenges are also becoming national, regional and global as they are now affecting economies.
In their quest to ensure that menstruation does not continue to be a barrier to education, governments and partners are now developing appropriate programmes to respond to these challenges, therefore using national resources to ensure that the menstrual health needs of those who menstruate are met. These are commendable efforts, and we hope that they will be replicated and sustained across countries, regions and continents.
Our advocacy efforts for the integration of menstrual health management include the education sector, and we are encouraged by efforts to integrate MHM in interventions, initiatives and programmes such as comprehensive sexuality education (CSE).
Goal 5: GENDER EQUALITY
Women and girls continue to experience stigma and discrimination for stigma and discrimination they endure dur to various reasons. These include the low social and economic standing of women in most communities and countries, high levels of gender-based violence, and increased vulnerabilities due to biological and social factors.
Some harmful and negative cultural practices, such as child marriage, continue to be linked to menarche (the onset of menstruation), thereby putting adolescent girls and young women at an increased risk of HIV, early childbirth, and other socio-economic challenges. Our belief is that gender transformative responses to these challenges, including community involvement, particularly that of boys, men, and traditional and religious leaders, are key to changing perceptions, practices and policy. Menstruation needs to be managed with dignity, without ever having to feel ashamed or being mocked for a natural process. We need to continue efforts to socially and structurally advocate for the normalisation of menstruation – it is a normal process after all – as we firmly believe that Menstrual Health Management is crucial to achieving gender equality.
Goal 6: CLEAN WATER AND SANITATION
The goal calls for ensuring access to water and sanitation for all. Availability and access to water, sanitation and hygiene (WASH) services is fundamental to ensuring menstrual health management for all people who menstruate, as well as ensuring hygiene and preserving the health and well-being of menstruators and their families.
Menstrual health and water, sanitation and hygiene are interlinked. Women, girls, and all people who menstruate need facilities that are safe, clean and culturally acceptable where they can safely (and discretely) dispose of their menstrual products. They also require adequate water to safely clean their menstrual products and maintain their dignity.
Goal 8: DECENT WORK AND ECONOMIC GROWTH
Sustained and inclusive economic growth can drive progress, create decent jobs for all and improve living standards. However, women, girls and other people who menstruate continue to face health-related challenges and barriers to attaining economic growth – with some of these brought about by menstruation.
The challenges posed by menstruation do not only affect the education of girls and others who menstruate, but continue to hinder women from attending to, and enjoying their work, in a dignified manner.
Many cultural practices prevent women from participating in many daily activities, with the most severe practices forcing women to stay isolated and avoid human interaction during their cycle. In addition, more focus needs to be put on workplaces, as when workplaces do not have adequate sanitary facilities, women are unable to manage their menstruation, and are forced to remain at home and lose economic and other benefits. Furthermore, in order to maintain their jobs and provide for their families, some women are forced to engage in harmful practices to stop or disrupt their menstrual cycles in order to maintain their economic means. This mainly happens in instances where women and other people who menstruate lose their earnings if they are not at work. Such instances where women are unable to work include heavy menstrual flows, discomfort, pain brought about their menstruation and other menstrual disorders.
We therefore advocate for period-friendly workplaces, both in the formal and informal sectors, including ensuring that public places such as markets have the required infrastructure to allow those who menstruate to do so in dignity, without losing their economic means.
Goal 10: REDUCED INEQUALITIES
If inequalities are reduced and all people are involved in development initiatives, there is a high possibility that the Sustainable Development Goals will be achieved. The high of inequality within and among countries and communities is worrisome and these perpetuate the low socio-economic status of women and girls in particular.
It has become evident during the COVID-19 pandemic how deep the inequalities are in various countries and communities, in Africa and beyond. The limited infrastructure, services and products needed to manage menstruation continue to expose women, girls and those who menstruate to health and other socioeconomic risks.
Without proper facilities, there are few options for privacy and safety for women, girls and people who menstruate, especially those living in poverty. They usually have limited access to menstrual health products, which are primarily disposable and cost- prohibitive, posing problems for access, sustainability, and hygienic waste management. Menstruation has become an economic burden, undermining empowerment and promotion of the social, economic and political inclusion of all.
Goal 12: RESPONSIBLE CONSUMPTION
In order to ensure sustainable consumption and production patterns for all, the use of the natural environment and resources needs to be sustained in a way that does not continue to have a destructive impact on the planet and those who live on it.
Sanitary products and supplies are not only often taxed as luxury items by governments, but high import fees often make them far too expensive for the majority of women in Africa.
Menstruation should not place a financial burden on women, girls and people who menstruate – products need to be made available for all. We do, however, note that despite the challenges, some countries in Africa and globally are making efforts to ensure that those who menstruate can do so in dignity – using their products of choice, which are safe, accessible, acceptable within their sphere, and of acceptable quality.
The development of standards for menstrual health products is another step in the right direction, as this will help ensure that menstrual health products are safe and of an acceptable quality.
Goal 17: PARTNERSHIPS FOR THE GOALS
The complex and interrelated menstrual health challenges require a comprehensive, collaborative, and intergenerational approach that engages all partners – governments, civil society, private sector, communities, boys and girls. These partnerships must address all key menstrual health management issues, including social and cultural norms, access to water and sanitation, products, education, standards, human rights, marginalised populations, humanitarian settings, as well as research and Monitoring and Evaluation (M&E). It was in realizatdion of the multisectoral nature of menstrual health management and the need for coordinated, collaborative partnerships that the African Coalition for Menstrual Health Management (ACMHM) was established, to nurture these partnerships. These will provide and share solutions grounded in unique local contexts for transformative and rights-based menstrual health management responses.