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JOHANNESBURG, South Africa—Tremendous progress has been made in menstrual health management (MHM), including the establishment of the collaborative platform in the form of the African Coalition for MHM, but much more remains to be done, said UNFPA Regional Director for East and Southern Africa, Dr. Julitta Onabanjo.

Sociocultural factors, religion and other taboos in the formation of negative attitudes and beliefs around menstruation have led to sectoral policy documents for health, education, environment, gender, water and sanitation being silent about MHM. Consequently, the needs and rights of all people who menstruate are being compromised.

The strengthening of partnerships remains a priority to facilitate joint advocacy efforts to counteract inequalities, the persistent discriminatory practices and social norms, political instability, other health and humanitarian crises, and climate change.

She was speaking at a policy dialogue on the ICPD25 theme of “What’s Changed?” to commemorate the International Menstrual Hygiene (MH) Day in Johannesburg, South Africa, on 20 May.

The event was a critical opportunity to increase political will among decision-makers and catalyze action for menstrual health management (MHM) on the continent. Policy changes were highlighted, and experiences from governments and the MHM network were reflected on.

This year is a special one as  it marks the 25th anniversary of the International Conference on Population and Development (ICPD), plus the golden jubilee of UNFPA as it celebrates 50 years, said Dr. Onabanjo. In November governments, advocates, health organizations, women’s and youth activists will gather in Kenya for the Nairobi ICPD Summit to identify clear commitments to advance the goals of the ICPD and secure the rights and dignity of all, she said.

The policy landscape for Menstrual Hygiene and Health at global level was highlighted by Ina Jurga from WASH United. Countries have made strides in strengthening MHM, including policy decisions such as the removal or reduction of taxes for menstrual products or the provision of free or subsidized product distribution among those who are deemed to be in most need.


The participants at the MH Day 'What's changed?' dialogue.
© UNFPA ESARO/Sven Meela

What has changed in menstrual health management since 1994?

The dialogue was moderated by Dr . Onabanjo. Panellists included Christine Ndegwa, First Lady of Kwale County (Kenya); Priscilla Misihairabwi-Mushonga, Member of Parliament (Zimbabwe); Chieftainess ‘Malerotholi Mathealira Seeiso, Chairperson of the Queen’s Trust (Lesotho); Dr . Ntsiki Manzini-Matebula, Chief Director, Social Empowerment and Participation, Department of Women (South Africa); Eric Mlambo, Chief Executive Officer, The FootPrints Foundation (South Africa); and Cleopatra Okumu, a United Nations Volunteer and young person (UNFPA ESARO).

In Kenya, advancements have been made in education, menstrual products, collaborative partnerships and establishing linkages between MHM and sexual and reproductive health and rights (SRHR), said Christine Ndegwa. The focus has shifted from basic menstrual health product distribution to a more holistic approach that includes breaking the silence, de-stigmatizing menstruation, and ensuring safe disposal of products.

In Lesotho, the need for comprehensive MHM programming has been identified, said Chieftainess ‘Malerotholi Seeiso. In the absence of a specific MHM policy, the need was elucidated by the increasing number of child-headed households, the high HIV prevalence and increasing levels of poverty. There are sporadic efforts to respond to the menstrual needs of girls, hence the Queen’s National Trust through its leadership identified MHM as a critical need.

In South Africa, for the first time the provision of sanitary products for indigent girls is now a funded mandate, as the government has committed R157 million for the rollout of the Sanitary Dignity programme. This will enable the provinces to implement the programme, and advocacy for more resources continues, said Dr. Ntsiki Manzini-Matebula from the South African Department of Women.

UN Youth Volunteer, and young person, Cleopatra Okumu said that “menstruation back then was a difficult and confusing experience”, but thanks to advocacy and education towards normalizing it, platforms are available to discusses SRHR issues. Parents and community leaders have a critical role in advancing the SRHR agenda, she said. She advocated for implementation and application of proven programmes such as comprehensive sexuality education (CSE) beyond the school as they should be shared and implemented at household level.

Much has changed in MHM and WASH generally, said Eric Mlambo. Implementation of policies in schools has made a considerable difference in reaching out to women and girls. However, there is an urgent need for proper WASH facilities in schools and in the absence of such facilities, it might not be possible to reach the desired targets and aspirations of managing menstruation with dignity.

In Zimbabwe, the results of advocacy for MHM are becoming evident as there are more MHM and SRHR discussions in parliament and at policy and legislature levels, said Priscilla Misihairabwi-Mushonga. There number of MHM male champions has increased and due to the critical need of menstrual products, distribution and donation of menstrual products is becoming more prevalent.

Key challenges that were emphasized were the myths and misconceptions surrounding some products, like menstrual cups, as well as the fact that current tax cuts and subsidies do not cover other menstrual products beyond disposable pads.

Six recommendations came out clearly:

  1. The need to break the silos and strengthen existing and new collaborative partnerships.
  1. Policy – the need for policies to be in place and jointly implemented across sectors.
  1. MHM programmes need to be brought to scale and integrated within SRHR programmes.
  1. The need to strengthen accountability through working with communities and governance structures.
  1. Menstrual products need to be available to those who need them, hence the continued advocacy for variety and providing options and choices of products.
  1. Partnerships are critical for joint advocacy, collaboration and holding leaders and each other accountable.