In much of Sub-Saharan Africa, keeping a child in school, particularly a girl, is an uphill battle. The lack of accessible education facilities and extreme poverty keep many children from consistently attending school. But the main reason keeping approximately 1 in 10 school-aged girls home is not a lack of pencils and paper, chores to do, or miles to walk.
It’s their menstrual period.
For many girls, getting their first period means the start of a life-long struggle. In rural and underserved areas, feminine hygiene products may be hard to access and unaffordable. Many schools in rural areas do not have latrines or any sanitation facility that offer privacy for girls. And in some countries, like Zimbabwe, menstruation comes with a stigma that, when combined with struggles for hygiene items and toilets, keeps girls and women at home, not just from school, but also from jobs as they grow older.
That’s why International Medical Corps launched a pilot study and then a subsequent program that provides school-aged girls with reusable sanitary pads in Mashonaland Central Province. International Medical Corps has been implementing water and sanitation programs in this isolated and rural area in Zimbabwe following a devastating cholera outbreak in 2008 that killed some 4,200 people. The first program of its kind in the province, the initiative facilitated the first time many of the girls received feminine hygiene products making what was once an isolating and humiliating experience discrete and non-disruptive.
“Girls in this underserved area often start their menstrual cycles without the information or resources they need to feel comfortable,” said Dianah Chioreso, International Medical Corps field officer in Bindura. “For most girls, getting your period is something to be ashamed of, rather than a milestone to be celebrated.”
For one 11-year-old girl in the province, her period was such a source of shame and embarrassment that she had concealed it from her mother and everyone around her for a year. Unlike her older sisters, who got their first periods at 15, she started to menstruate at 10 and worried that it would be interpreted as a sign of being sexually active, even though she was not. To hide her period, she wore multiple pairs of panties to not spoil her school uniform or clothes.
“Girls that mature earlier than others are often stigmatized by the elders,” said Chioreso. “There is a widespread suspicion that early menstruation and maturation means that a girl is sexually active, which shows the knowledge gaps that exist and the work that needs to be done in terms of community education and outreach.”
In addition to cultural beliefs around menstruation, hygiene products are so expensive that many women in the province cannot afford to use them. As a result, many girls and women are often forced to use raw cotton, rags, or newspapers, which often come with stigma as these substitutes are associated with a poor social standing.
“When we visited the schools, we found that many of the girls were ashamed to even admit that they use rags in private,” said Chioreso. “They were afraid that they would be teased if other girls found out.”
International Medical Corps augmented the reusable sanitary pad distribution with community education, so that those who received them knew how to use and clean them. The impact of such a program could be wide-reaching. Studies show that with feminine hygiene products and sanitation facilities, girls are more likely to stay in school. However, while the sanitary pads are a significant step, much more needs to be done to change cultural beliefs around menstruation and sanitation facilities and personal hygiene items, such as soap, are greatly needed.
“While it is still too early to fully understand the impact, the preliminary results from this pilot indicate that we should expand this program to include more girls and more schools,” said Chioreso.