Talking openly about menstruation is the only way to transform the lives of girls and women.

Barriers to women’s achievement are falling in every sphere. Women lead countries, corporations, and households. Globally, more girls are entering school, earning family income, and participating in public life. But one big taboo stands in the way of women’s full equality: safe, hygienic and private menstruation. 

For most women in wealthy countries, menstruation is an inconvenience, and sanitary supplies like tampons and pads are widely available. But for many of the 300 million women and girls menstruating on any given day (or, on average, for 3,500 days of their lives), this natural, life-giving process means illness, shame, the loss of educational and economic opportunity, and even violence.

In many developing countries, millions of women and girls are left to manage their periods with a dirty cloth, with no access to private toilets, water or soap. Infections are common. Sanitary products like pads are simply unavailable.

Myths, fear and shame about periods take a deep toll on girls’ sense of dignity and self-worth. In some villages, for example, girls and women are quarantined during their periods, prohibited from basic functions like cooking, washing and interacting with others. Menstruating girls are often taunted or bullied in school. For privacy, many women wait until nightfall to go outside and wash, putting themselves at risk of assault and rape.

The lack of access to safe, hygienic and private menstruation also has major societal consequences. In India, up to a quarter of girls drop out of school when they reach puberty; in part because schools lack private or gender-segregated toilets. Women frequently miss work because they have no place to change the cloths they use. In Bangladesh, most employed women miss about six days of work each month, stifling productivity and advancement.

So, if safe, hygienic and private menstruation is so critical to women’s lives and livelihoods, why don’t we hear about it more often? Why isn’t it higher on the international development or women’s rights agenda? The answer involves the difficulty of tackling deep-rooted customs, women’s position in society and the inherent discomfort in talking about normal but messy bodily functions. 

But, as we have learned from the fight against HIV/AIDS, it is essential to cast aside taboos in order to make progress. By lifting the veil of silence, we open the door to action that can transform the lives of women and girls around the world. A few steps can make an extraordinary difference.

Governments must prioritise this issue, putting in place urgently needed funding and policies. Girls and women must have separate, private toilet facilities in schools and the workplace, as well as access to essential products — cloths, pads and menstrual cups — and the means to dispose of and clean them. Today, for example, only 12 per cent of India’s menstruating women have access to commercial sanitary products, while many of the rest use dirty rags, newspaper or cotton. Innovative companies and organisations developing inexpensive, reusable sanitary products like the AFRIpad can help close this gap and must be supported.

Critically, and most difficult, national and community leaders must speak out to change attitudes, upend customs that hold back menstruating women and girls, and promote basic education about periods. A study in Karachi, Pakistan, found that half of girls aged 14 to17 knew nothing about menstruation and were scared of their periods, believing they were ill or dying. 

Inspiring projects are underway in many countries. In India, a non-profit called Utthan helps women establish household sanitation systems that offer them privacy and safety. And governments are increasingly recognising their responsibility to take action. The Kenyan government now exempts sanitary cloths from the national value added tax and, this past December, the Indian government amended the national sanitation policy to include language on menstrual hygiene management. These programmes show that change is possible, but progress is too slow and on too small a scale. 

It’s time to make safe, hygienic and private menstruation a priority, with dedicated advocacy, funding and policies. Removing this last taboo could do as much or more for women’s rights and opportunity than any other action. 

The writer is Executive Director, Water Supply and Sanitation Collaborative Council, which is a part of the United Nations Office for Project Services (UNOPS).

This article is exclusive to The Hindu.