Over the years, menstruation has been a taboo subject in all cultures, but especially in Africa.  Shame, stigma, and knee-jerk revulsion across the continent have often lead to misinformation and the promotion of dangerous menstrual hygiene practices.

 

Up until now, poor menstrual hygiene in developing countries has been an insufficiently acknowledged problem.  Leaders in low- and median-resourced settings are so keen to achieve other goals that they ignore the link between menstrual hygiene, education, and the development of the girl child – not least of all because the girl child is one of the most overlooked and underappreciated people in the world.

Teenage girls constitute a vulnerable group in relation to their health and societal status.  It is estimated that 1 in 10 girls in sub-Saharan Africa misses school at some point because she is having her period.  When a decision must be made between public mockery or foregoing opportunity, most young girls will make their decision more on the basis of avoiding humiliation than to embrace opportunity.  And even when a girl decides she wishes to go to school anyway, the issues do not end there:  there is a host of health implications that come with poor menstrual hygiene education, particularly when using makeshift or unsanitary alternatives to pads due to lack of accessibility.

Numerous studies have shown that providing free sanitary pads to school-aged girls can bring about a sharp drop in absenteeism.  Some months back, I led a small team of research enthusiasts as a side-line to a major project.  The aim was to provide washable sanitary pads for girls in the most deprived areas in Lagos, Nigeria.  Our purpose was to curb the high rates of menstruation-related absenteeism among school-aged girls by providing them something that they could use on an ongoing basis, and to understand the level of menstrual hygiene education that girls have before their first menarche.

This study happened at the Onike Junior School Makoko, a small community in the Yaba Local Government area of Lagos State, Nigeria, focusing on 105 young girls in Junior Secondary School who were randomly selected and within the 10-15  age range.

Of the total 105 girls that were present for the project, 101 girls decided to participate in this survey.  We found that 73 had attained menarche at the time of interview and only 13 of the total respondents were not at all aware of the details of menstruation before menarche.  It quickly became apparent that mothers, school counsellors, and female teachers had played a key role in providing information to them about their menstruation and menstrual hygiene – a valuable, though inconsistently-applied practice, given the proclivity for personal values to influence the information given.  The majority of the respondents stated that they had been strongly warned by their mothers not to allow boys to ‘touch’ them after menarche so as not to get pregnant.

Some of the misconceptions that we observed included the assumption that imbibing cold drinks during menstruation could create cramps, that for people to see a used menstrual pad can bring bad luck, and that people should not even dispose of used pads in the general waste bin due to lack of hygiene.

One girl shared that her father does not allow her cook at home during her period.  Other girls that attend certain churches were not be allowed inside the church when menstruating because they were perceived to be ‘unclean’.  Some of these misconceptions are often passed through their network of friends and communities, breeding shame.

Only two respondents reported using cloth and tissue as an alternative to sanitary pads during menstruation, as deemed necessary by financial constraints.  One commented that, “I was [really] tired and there was no money to buy pad and I use cloths”, whilst five girls who semi-regularly or regularly used sanitary pads would sometimes pad their underwear with clothes or foam if they felt that their parents were not financially buoyant, or if they did not want to ‘disturb’ them.

One of the respondents, who lives with her grandmother, saves her own money to buy disposable pads.

 “I do save my own money to buy [the brand] Always, from the day I started my period.  I don’t ask anybody for money; even my grandma.”

It was found that the awareness about menstruation is increasing; the aforementioned 13 of the total respondents who were not aware about menstruation were rapidly brought to speed during the course of the interviewing.  This revealed a serious need for consistent and evidence-based education on menstruation for young girls in the classroom.  If empowered and resourced, teachers can play a vital role in educating girls about menstrual hygiene and the associated misconceptions.  Resources such as pamphlets, radio broadcasts, narrative arcs on television and social media awareness could also be harnessed to educate the general public about falsehoods that appear to be perceived as fact.

To manage menstruation hygienically, it is important that school-aged girls have access to clean water and sanitation: this means clean toilets to change sanitary pads; clean water and soap for washing their hands, bodies and reusable pads; and facilities for safely disposing of used materials or a clean place to dry them if reusable.

In Lagos State, Nigeria, the state government is rehabilitating and building a vast number of schools that are provided with such sanitary needs, but the pace at which it is being done calls for improvement.

And with infrastructure for sanitary schools must come the most important thing: education and resources that empower menstruating girls to know what is happening to them, how to navigate having periods, and how to ensure that their normal, necessary human functions do not prevent them from education and opportunity.

 

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