Human management

Menstrual health and hygiene management remains out of reach for many

NEW YORKMay 26, 2022 – Stigma, poverty and lack of access to basic services like toilets and water lead to unmet menstrual health and hygiene needs and increase the risk of infection for women and men. girls, UNICEF warned ahead of Menstrual Hygiene Day. These challenges are particularly acute among the poorest, ethnic groups, refugees and people with disabilities.

“Menstrual health and hygiene management, when accessible to everyone, can help break down barriers and help adolescent girls become healthy, educated and empowered women,” said Kelly Ann Naylor , Director of Water, Sanitation, Hygiene (WASH) and Climate at UNICEF, Environment, Energy and Disaster Risk Reduction (CEED). “Yet until recently, little attention has been paid to defining, monitoring and investing in menstrual health.”

The importance of menstrual health and hygiene management is slowly but increasingly being recognized and monitored. In 2020, 42 countries had nationally representative data on at least one of the four indicators*, of which 31 had information on at least three indicators. Almost half of the countries are in sub-Saharan Africa. No high-income country had national data on any of the indicators.

According to the latest analysis, limitations in participation in school, work, and social activities during menstruation varied by geographic, socioeconomic, and individual characteristics. Among those retained, stigma and lack of access to menstrual hygiene products were common factors. Many girls were also unaware of periods before their first cycle, which can affect their perception and understanding of menstruation.

  • On average, non-participation was higher among girls and young women: 15% of girls in Burkina Faso; 20% in Ivory Coast; and 23% in Nigeria had missed school in the past 12 months because of their periods.
  • More than half of women in Bangladesh and more than two-thirds in Nepal said they did not participate in daily activities during their period. In Chad and the Central African Republic, one in three people said they were missing something.
  • Of the two countries with national data, only 32% and 66% of girls were aware of menstruation before their first period in Bangladesh and Egypt, respectively. In Egypt, 74% of girls who were unaware felt shocked, scared or cried at the first event. Similarly, in Bangladesh, 69% were afraid.

The use of menstrual materials and the availability of a private place to wash and change are high in most reporting countries. However, the most vulnerable women and girls continue to face major challenges.

  • Use of menstrual products ranged from 81% to universal in most countries. However, 6% of women used paper in Niger; 12% only used underwear in Burkina Faso; 11% did not use anything in Ethiopia.
  • The availability of a private place to wash and change ranged from 80-99% in most countries with data. Yet in Niger, Tunisia and Burkina Faso, only 52%, 56% and 74% had such spaces, respectively.
  • There was little variation in menstrual pad use between urban and rural areas, except in Lao People’s Democratic Republic, Ethiopia and Niger, where pad use was more than 10% higher in urban areas compared to rural areas.
  • Private institutions, however, were less available in rural areas than in urban areas. In 12 countries with data, at least 1 in 10 women and girls in rural areas had no private place to wash and change during their last menstrual period.

Ethnic groups and those living in emergency situations face even greater challenges, with less access to menstrual products and basic facilities and more limitations to participation than the rest of the population.

  • In the Lao People’s Democratic Republic, there was a gap of more than 30% between Mon-Khmer and Lao-Tai in the proportion of them having a private place to wash and change and using menstrual pads. In the Central African Republic, Hausa women were about 20% more likely to participate in daily life during their periods than Mboum women.
  • Data from refugee camps in eight countries show a range of levels of satisfaction. Almost all women said they were satisfied with menstrual equipment and facilities in Mozambique and Iraq, compared to less than half of women in refugee camps in Cameroon, Malawi and South Sudan.

“Investing in menstrual hygiene management will benefit girls today, the women they will become tomorrow, and the next generation,” Naylor added.


Notes to editors:

* The UNICEF-WHO JMP report on WASH in households includes data on efforts to provide households with water, sanitation and hygiene services, including menstrual hygiene management (MHM). This is the first time that national MHM data from 42 countries has been collected and harmonised, where possible, for cross-country comparison. The national household surveys included separate questionnaires for women and girls aged 15-49.

The four indicators related to menstrual health and associated WASH service are:

  1. Awareness of menstruation before menarche (first period).
  2. Use of menstrual products to catch and contain menstrual blood, such as sanitary napkins, cloths, tampons or cups. These can also be grouped into single-use and reusable materials.
  3. Access to a private place to wash and change at home.
  4. Participation in activities during menstruation, such as school, work, and social activities.