Distributing menstrual kits to schools is just but the start of a long and complex journey
“Can you remember when you had your last period?”
“How was the flow? Colour?
“Did you experience any abnormal pain?”
These are just but a few of the questions asked by a doctor whenever a girl or woman of reproductive age seeks medical attention.
It cannot be emphasized enough that menstruation is a critical indicator of female health and vitality where a healthy cycle indicates overall health and well-being. It is a natural and healthy process. To put it bluntly, without healthy menstruation, the existence of humanity would be under threat.
Interesting statistics from an assortment of research studies on menstrual health in Kenya paint a heartbreaking picture. What hits hard is the realization that 65% of girls and women in Kenya can hardly afford safe and quality menstrual products. 45% (4.2 million in public schools) of Kenyan schoolgirls have never used commercial sanitary pads and worse 2 out 3 pad users in rural Kenya receive pads out of risky transactional sex. Further, less than 30% of rural schools have private spaces with running water and soap for girls to change their menstrual products. In addition, what affects most users of commercial sanitary pads is the lack of proper disposal facilities. Traditional taboos that links menstruation to being “dirty” “unclean” is still rife even despite numerous awareness creation efforts by the government and other stakeholders. Fear of shame and embarrassment still plague school girls forcing them to stay at home during their periods. This is especially where they cannot access sanitary products, or private WASH (sanitation) facilities, or even medical attention to manage menstrual-related cramps.
GOVERNMENT & MHM STAKEHOLDERS EFFORTS
Although there has been a concerted effort by the government and other players including SisterSpeaks Global charity arm (through Heels4Pads initiative) in promoting access to sanitary pads and menstrual education, there is still a lot more to be done. Granted, there have been some positives, for instance; the Kenyan government working with partners launched Menstrual Hygiene Policy 2019-2030 https://tinyurl.com/MHMpolicy with the aim of addressing the prevailing social, economic, cultural, and demographic context of MHM for girls and women in Kenya. The policy broadly links the rights of girls and women to healthcare, education, water, sanitation, hygiene, and decent work. This is a huge milestone for Kenyan girls and women. The Constitution 2010, Vision 2030, and SDGs 2030 informed the MHM policy. Another policy intervention, in 2004 the government repealed added tax on the sale of sanitary products to boost access. In 2017, the government decided to distribute free sanitary pads to all registered school-going girls in public school, not only to enhance access but to also curb absenteeism.
ACCESS TO MENSTRUAL PRODUCTS: THE "PRICE" OF LOW COST, QUALITY PADS
Looking at the ongoing efforts, the result finding of research, and reality on the ground, one can't help but wonder how barriers to managing menstruation with dignity will sustainably be addressed. The sheer scale of the issue is mind-boggling. On one hand, the sale of commercial sanitary pads is zero-rated but on the other affordability for the majority is a big stumbling block. The minimum cost of a high-quality commercial sanitary product with 8 pads is Kshs. 80 multiply that with 12 months for a low-income household. Fine, there are some locally produced low-cost pads going for Kshs. 50 for 8-10 pads, it's still high for many and worse quality is not guaranteed and has a high risk of leakage. One is forced to change more frequently resulting in using more pads beating the logic for a low cost. Local producers are heavily affected by the high tax on raw material thus compromising on quality. There’s also the cost of access, especially in rural remote areas. One could afford the sanitary pads but might be forced to spend more on transport to buy the products. The sobering fact here is, the effect of COVID on income has directly affected access to sanitary pads. Jobs have been lost especially in the service industry where it's predominantly female-based. There are a significant number of girls and women who are now forced to use homemade sanitary products or are financially dependent on males/partners for commercial ones. This compounds the dynamics of access. Can these factors of access of pads via transactional sex and loss of jobs during COVID lockdowns help explain the high number of schoolgirl pregnancies? Remember the shocking statistics shared by Education CS Magoha in August 2020, the 152,000 teenage pregnancies? I shudder to imagine the current statistics.
If less than 35% of girls and women across Kenya use homemade sanitary products, what does this actually mean? It means there is high usage of old rags, blankets, pieces of mattress, paper, leaves, mud, ash, cow dung, and cotton wool to name but a few. Where hygiene is not guaranteed for lack of clean washing water, soap, and private spaces for drying these homemade pads, there are high risks of urogenital, UTIs, yeast, vaginitis, and bacterial infections. To further paint a grim picture, there are high chances that these girls and women would not access- either because of affordability or availability- medication attention for these kinds of serious infections.
LESSONS LEARNED; THE PADMAN FROM INDIA
Speaking of which, and learning from each other, the story of Arunachalam Muruganantham (Padman) a social entrepreneur from India who invented the low-cost sanitary pad-making machine for girls and women at the grassroots should seriously be considered. He put girls and women at the fore of managing their menstrual health by empowering them to produce and sell high-quality, low-cost, safe sanitary pads using locally available materials. The mini-machines are operated with minimal training and can grind, de-fibrate, press and sterilize the pads using UV light before packing. Some of the absorbent materials used include cellulose fiber from pine bark wood pulp, banana fibers or bamboo. The mini-machine cost less than $800 and can produce over 200 pads per day.
FREE SANITARY PADS: SUSTAINABLE OR NOT?
Now, let’s say there is the free distribution of menstrual kits to school, does this cater for the supply for 12 months for the girls, or does this just cater for the 9 months when they are in school? Meaning when on holiday they result in the default of harmful homemade products? In addition to the sanitary pads, the menstrual kits come with soap and undergarments, however, many schools in rural areas still face WASH facility challenges- either there’s no clean water for washing after changing soaked pads, or taking bath or washing uniform in case of leakages. The default solution here is either, the girl opts to use the donated pads and stay at home to avoid the shame and embarrassment of dealing with potential leakage or in case of actual leakage at school, she is sent home to change beating the purpose of managing absenteeism. Hormonal changes that trigger the uterus to shed blood and tissue can cause painful period cramps and sometimes access to pain relievers such as buscopan, Ibrufen and others is not possible within a school setting. A girl might have the pads but lack of access to painkillers might deter her from going to school.
Studies indicate that although efforts have been in place to educate and reduce the stigma associated with menstruation, there still more to do especially in a school setting. Yes, girls may access menstrual kits but if the stigma is rife, they’d still opt to stay at home during their periods. I remember when I was in primary school; there were some male teachers and schoolboys who relished making relentless crude jokes about periods. Worse was when teachers would force us to engage in physically charged PE lessons despite our pleas for exemption. You can imagine the phobia of sprinting a 100-meter race while trying to manage a soaked homemade pad with no adhesive securing it to your pants. It was horror. Most girls opted to stay at home during their periods. There were many walks of shame- being forced to carry your chair to the school’s common taps to wash off the bloodstains, or forced to openly dispose off a soaked homemade pad that accidentally fell off your pants- amidst jeers and laughter of some teachers and pupils along the long corridors. There were many incentives to stay at home. There’s more to be done in the perception and behaviour of people to create safe menstrual spaces for girls at schools.
In a nutshell, yes, there’s have been some milestones in promoting menstrual health in Kenya but there are some key enablers relating to access to products, services, and facilities that are often overlooked. For the sake of ensuring safe and dignified MHM, they must always be at the fore.
Our guest writer for the MHM Day 2021
Public Policy & Communications Specialist
Blogger, Visual Artist, Equity Defender
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