Menstrual sanitation is not just a ‘lady issue’

Students in Nairobi: poor menstrual provision can keep girls out of school kyhm54 under a Creative Commons Licence

Like many other Western countries, my home country of Australia is reluctant to support development in all its forms. We liberally support causes like AIDS or infant mortality prevention, but equally important issues like female hygiene and sanitation attract minimal attention.

Yet investment in projects that directly support women and girls is essential to reducing poverty. In 2012, the UN Secretary General Ban Ki-moon said that ‘the greatest return comes from investing in girls and women. When they are educated, they drive development in their families, communities and nations.’

A single year of primary education correlates with at least a 10-per-cent increase in a woman’s wages later in life, with the returns on a year of secondary education estimated to be double that. Moreover, educating girls remains the single best policy for reducing fertility.

However, in Sub-Saharan Africa only 57 per cent of all girls attend primary schools, with only 17 per cent enrolled at a secondary level. A UNESCO study has found that about 150 million children currently enrolled in primary schools globally will drop out before they finish. At least 100 million of those will be girls.

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One reason young girls are not attending school is commonly overlooked: gender taboos and menstruation.

Ngeru, for instance, is a 14-year-old girl from Kenya. During her period, she has no access to sanitary pads. Instead, Ngeru will improvise with cloth, or bark tree lining, or mattress stuffing.

Needless to say, these DIY techniques are ineffective and humiliating. Health risks abound, including infections and genital sores. She will likely end up with blood on her school uniform or clothing, but attitudes to menstruation mean that Ngeru would rather drop out than confront the bullying of peers and male teachers alike. She enjoys studying mathematics, but her education is wholly subject to her cycle.

A study of the attitudes of Kenyan school-aged girls to menstrual health found that ‘one of the most effective ways to deal with menstruation is to go home’.

The Kenyan government, African women’s groups, NGOs and prominent UN bodies such as UNICEF and the World Health Organization have all publicly acknowledged that there is a significant link between the poor provision of menstrual hygiene solutions and female participation in education. The Kenyan government even dropped its import tax on female sanitary products in 2011 to help reduce costs by 18 per cent. Many NGOs across sub-Saharan Africa, including Kenya, have made the provision of sanitary pads their sole raison d’être.

But private attitudes toward menstrual health handicaps are very different. I recently met with the head of sanitation for UN Habitat in Kenya. Menstrual health was not mentioned in any of their policy papers. They awkwardly parried my questions about ‘the lady issues’. Similarly, the Inclusive Economic Growth & Social Development Unit said that they would not address menstrual health (although they avoided using ‘the m word’) because it was not part of their portfolio.

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The attitudes of top UN policymakers toward this ‘lady issue’ in Kenya are disappointing. But when aid workers do turn their attention to female sanitation, they are often ineffective.

Bono-style charity models from yesteryear are not working. Donating pads is not a sustainable solution, especially when it only reaches a fraction of women and girls.

Organizations such as the International Monetary Fund, the International Development Association, the Asian Development Bank, and the World Bank all agree that to grow Human Development Indicators, we need to finance small emerging enterprises. These should be run and owned by local stake-holders who cheaply borrow capital and engage in long-term capacity building with lender organizations. This model should be applied to the provision of female sanitation.

In Rwanda, for instance, an organization called SHE has taken a business model approach to local sanitary pad production. While producing pads around 30 per cent more cheaply than commercial counterparts, women are creating jobs for themselves. Financial success is a further incentive, after the repayment of their microloan.

Models like these multiply the effects of sometimes meagre foreign aid. Although Australia’s commitment to aid has remained relatively steadfast, whether that continues after the September 2013 elections is questionable. Moreover, it’s pertinent then that in many cases, gender-targeted initiatives have disproportionate economic returns compared to those which are gender neutral.

Prioritizing women’s health in the Global South, so girls can attend school and enter the work force, just makes economic sense.

Female sanitation is not just a ‘lady issue’. We need to get our hands dirty, so to speak, with some of the less fashionable development issues. Female hygiene should be at the top of this list. It means getting people to talk openly about menstrual health – in all parts of the world – and adapting to new aid models which encourage small business enterprises like SHE.

If the rights of girls and women are properly recognized, this generation of sub-Saharan Africans could experience improved education, health, livelihoods and equitable economic growth. These outcomes will be multiplying and sustainable. And there is nothing more important to the development sector than that. Period.