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Menstrual hygiene and health

When periods accentuate inequalities

A period, or menstruation, is a physiological phenomenon by which blood and tissues are released from the uterus through the vagina. It is a monthly, natural, healthy process experienced by people of reproductive age who have a uterus and are not pregnant (whether women, girls, transgender men or non-binary people). Over the course of their life, a menstruator spends between three and eight years on their period. For many, periods are something of an inconvenience. For millions of others, taboos, stigma and a lack of infrastructure and period products during menstruation mean that their dignity is violated, their rights are breached (especially the right to education), their health is endangered, and their food security is put at risk.

Today, an estimated 500 million women and girls in the world do not have regular access to period products, painkillers or underwear during their period. This figure in France stands at almost four million. We call this period poverty. Elisabeth Borne, the French prime minister, announced in March 2023 that reusable period products would be refunded by the country’s health system for all women under the age of 25 from 2024, but this is still not enough. Periods and poverty do not stop at 25; this measure should be extended beyond this age. Furthermore, according to Règles Élementaires (an association that fights period poverty), disposable materials should perhaps not be excluded from this scheme, so that it can reach more people.

Access to appropriate care and menstrual hygiene is at the heart of the struggle against gender inequalities and of social justice endeavours, and it is an effective way of promoting women’s and girls’ empowerment. In order to fight gender discrimination, practices must evolve, suitable infrastructures must be developed, and we must put an end to stereotypes that prevent people from taking part in cultural, educational, social and income-generating activities during their period.




To ensure proper menstrual health and hygiene,² anyone menstruating should have access to:


  1. Period products to collect menstrual blood (as many as needed)
  2. Safe facilities for changing in private, as often as needed
  3. Soap and water to wash as often as needed
  4. Functional facilities for using, throwing away or cleaning period products
  5. Access to health services and comprehensive sexuality and menstrual hygiene education




Social norms and the stigma caused by menstruation-related stereotypes can lead to discrimination and have serious repercussions on menstruators’ dignity and right to equality, health, education, security, access to work and participation in cultural, religious and public life without discrimination.  (UN)




A lack of physical or financial access to period products forces menstruators to think up alternative solutions, which are often less effective and discreet than traditional products. The use of cloths, newspaper and other materials causes discomfort and leaks, which are a source of embarrassment and shame in our societies, where periods are taboo.

United Nations experts have signalled that, in some countries, women and girls who are menstruating are considered contaminated and impure. Restrictions are imposed on them: they can be forbidden from touching water or cooking, attending religious and cultural ceremonies, participating in community activities and working. They can even be barred from outdoor spaces. This reinforces the idea that women ‘belong’ less in the public space and constitutes another obstacle to gender equality.




Dealing with menstrual hygiene has a direct impact on menstruators’ education.

Approximately 13% of schools across the world do not have sanitation facilities; this affects more than 240 million children (JMP 2021). Almost 100,000,000 girls miss up to a week of school every month due to a lack of safe, suitable water and sanitation infrastructures and of access to the appropriate intimate hygiene products. This missed school time forced upon them has a clear impact on their education, and therefore on their economic prospects, thus compromising gender equality. (UN)


Some figures

A third
of girls in South Asia miss between 1 and 3 days
of school per month due to their period
1 in 10 girls
in Sub-Saharan Africa miss school
during their period
71 %
of girls in India do not know what menstruation is
before they get their first period




The use of unsuitable menstrual products poses a health risk. As cloths and paper dry slowly and cannot be washed properly and regularly, they can cause infections. Approximately 1 in 10 women in the world have been unable to access period products, and 12% have been forced to improvise with alternatives that can be ineffective, unhygienic and dangerous for their health.

Access to safe, functional toilet facilities is not guaranteed for almost half of the world’s population (WHO/UNICEF), while a third of people have no access to basic hand-washing facilities at home (WHO/UNICEF).

Menstruation can also cause pain that is sometimes debilitating without suitable medication or treatment. Endometriosis (a disease where tissue similar to the lining of the uterus grows outside the uterus), for example, affects around 10% of women and girls of reproductive age globally (WHO) and causes acute pain during menstruation.




As menstrual hygiene management has an impact on menstruators’ attendance at school and work, it threatens their income and empowerment, and therefore their food security. In certain regions of the world, women are even forced to isolate themselves; as a result, they cannot attend the workplace and they lose income (PSEAU).

In addition, the cost of period products can be high compared to women’s financial means. In South Africa, for example, ‘up to 7 million girls do not have access or are unable to afford sanitary products’. They therefore have to make an unthinkable choice: between buying food and buying period products (Humanium). In Niger, women often depend on men financially and, by extension, to be able to access menstrual products. Men are sometimes ‘reluctant’ to make these purchases, in part because of the social norms that discriminate against women (PSEAU). 




Approximately 26 million displaced women and girls are currently menstruating around the world (Public Health Columbia). When people leave their home due to a conflict or climate phenomenon, menstruation can become a heavy burden: menstrual hygiene management is all the more difficult in emergency contexts where hardship is exacerbated, access to infrastructures is complicated and private space is limited.

During their period, menstruators need constant access to basic hygiene products (including soap and period products) and safe, private facilities for changing, washing and throwing away used materials. Sanitation structures must therefore fulfil these needs.




Today, Action contre la Faim incorporates cross-cutting, multidisciplinary promotion and implementation of menstrual hygiene projects into its efforts to fight hunger, poverty, social and economic inequalities and gender injustice.




In Jordan, Action contre la Faim leads activities to improve access to water and sanitation in the Azraq refugee camp built for Syrian refugees. Our teams work with the community to raise awareness of and facilitate best menstrual practices, reduce stigma, promote access to period products and guarantee a safe, private space for menstrual hygiene management.




In Chad, Action contre la Faim works with local women’s associations to carry out menstrual hygiene awareness and sanitary towel making activities, especially in schools, places of worship and health care structures.

Action contre la Faim works with an education centre that provides training and certification in the production and sale of reusable sanitary towels. The women who complete the course can then produce menstrual hygiene kits and sanitary towels and sell them to Action contre la Faim, which distributes them free of charge.

ACF has also put forward a chapter on menstrual hygiene management and helped it to be included in the school curriculum and in teachers’ training on the subject.

20221212_140159-min © Action contre la Faim Tchad
20221213_111644-min © Action contre la Faim Tchad



Action contre la Faim has been a part of the technical working group on menstrual health and hygiene management on a national level and in the states of Borno, Adamawa and Yobe since 2019, in collaboration with the Nigerian Federal Ministry of Women Affairs. We provide technical and strategic WASH (water, sanitation and hygiene) support to organisations in the North East region.

In Nigeria, Action contre la Faim leads menstrual hygiene awareness campaigns among girls, women and men. Focus groups are organised according to gender in order to create safe, free spaces for expression and to help boys and men understand girls’ and women’s experience so that they can support them better and stop the perpetuation of stigma. In 2022, our message reached 15 million people thanks to campaigns in schools and radio adverts.

The issue of menstrual hygiene is also included in our sexual and reproductive health activities in the 105 medical centres we support. We work with the Nigerian Federal Ministry of Health and local health agencies so that gender inequality can be tackled within health structures. We also make sure that 80% of community health volunteers are women, which has led to better access to menstrual hygiene services.


Demostration of how to use hygiene materials by one Adolescent girls in Dalori-min © Action contre la Faim Nigeria
Adolescent girls in Dalori Community excited to received their hygiene products from ACF-min © Action contre la Faim Nigeria


  1. In order to provide an urgent response to period poverty, period products must be widely available for free or at an affordable price.
  2. Action contre la Faim calls upon the international community to commit to funding and supporting national health systems, as this will promote good menstrual health and hygiene and access to treatment for women and girls suffering from menstrual disorders.
  3. Action contre la Faim calls for the implementation of community awareness campaigns – especially campaigns involving and targeting men – and of comprehensive education for women and girls in order to remove the taboo and stigma surrounding menstruation.
  4. Action contre la Faim calls for the creation of water and sanitation infrastructures in all situations so that users can maintain good menstrual health and hygiene



¹ Le Monde
²  « WASH in Schools – Empowers Girls’ Education – Resources • SuSanA » sur


Definition of menstrual hygiene :

Menstrual health and hygiene (MHH) encompasses both menstrual hygiene management and the broader systemic factors that link menstruation with health, well-being, gender equality, education, equity, empowerment, and rights.

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