SEATTLE, Washington — At least 500 million girls and women worldwide suffer serious health risks due to period poverty. Proper menstrual hygiene management encompasses access to menstrual products such as pads and tampons; water, sanitation and hygiene (WASH) facilities; and an adequate and timely sexual health education. Period poverty correlates to a high prevalence of urogenital infections and poor mental health outcomes, such as elevated anxiety and depression. Furthermore, various studies find a causal relation between period poverty and school absenteeism, which disrupts the personal growth and economic empowerment of girls.
In Bangladesh, poverty and structural inadequacies limit access to menstrual products and WASH facilities. Also, false and negative beliefs about menstruation affect female education and community participation, demonstrating the negative effects of period poverty.
Period Poverty and Misinformation
Taboos and stigma surrounding menstruation create social and religious barriers for menstruating Bangladeshi women. In Char Bramagacha, a village in northern Bangladesh, menstruating women cannot use the kitchen or observe religious practices for fear of contamination. “We are taught that things will be spoiled if we touch them during our periods,” says 14-year-old Shopna. “And we can’t go to the temple or the mosque,” adds 17-year-old Monira. “Hindu girls can’t touch cows or even the cow-shed because cows are holy.” Many Bangladeshi people consider period blood polluting and dangerous and view the menstrual body as impure and sacrilegious.
Ashamed of their periods, girls and women often wash their blood-stained clothes in secret, taking pains to hide them from their brothers and fathers. This secrecy encourages behaviors that elevate women’s health risks, such as women hiding or burying their damp period cloths instead of drying them in open sunlight, which is the condition required to kill bacteria. Girls and women are also reluctant to seek medical help, despite severe vaginal itching and irritations, due to discomfort when discussing sexual health.
Lack of WASH facilities and Sanitary Products
A study by The World Bank found that only 23% of women in Bangladesh use appropriate menstrual materials. Tampons and pads are largely unaffordable to Bangladeshi women. Thus, most women resort to unhygienic rags and old cloths, often improperly dried in between use, that greatly increases their risk of urinary tract infections and bacterial vaginosis. Furthermore, lack of accessible toilets, handwashing stations and trash receptacles in public restrooms places pressure on women to stay at home while on their periods or develop coping strategies such as eating and drinking less to avoid using the washroom.
The Bangladesh WASH Alliance (BWA) is one of many organizations working to promote inclusive and sustainable water, sanitation and hygiene services in Bangladesh. Over the last six years, BWA initiatives have provided nearly 250,000 people with access to improved sanitation facilities and supplied clean water to almost 230,000 more. in addition, BWA initiatives also helped to reduce per capita WASH delivery cost and introduce gender and socially inclusive practices to WASH businesses. The increase of accessible WASH facilities would improve living conditions and reduce health risks associated with menstruation for Bangladeshi women.
Period Poverty and Girls’ Education
According to a 2019 WASH Poverty Diagnostic study, In Bangladesh, one in four adolescent girls skip school while on their periods. Due to lack of WASH facilities at school, 30% stay absent for three days or more each month, and many drop out of school when experiencing prolonged pain due to infections. Over one-third of girls believe challenges during menstrual cycles adversely affect their school performance. Multiple studies have shown that poor school attendance reduces girls’ life-long economic potential and lowers their self-esteem and mental health outcomes.
Only 6% of schools in Bangladesh provide education on menstrual hygiene management, and only 36% of women had knowledge about menstruation before experiencing their first period. To supplement school education, community hygiene promoters in rural Bangladeshi villages have been working to educate young girls about menstrual hygiene and dispel myths about the female body. “Earlier we would use whatever rags we could find, but now we are more careful to make sure they are clean,” says Shopna, one of the young girls in Char Bramagacha, who participates in educational sessions with SHEWAB volunteers. Funded by the Department for International Development of the U.K. and supported by UNICEF, SHEWAB promotes the importance of hygiene practices and clean water, while also tackling taboo subjects such as menstruation.
While women’s discrimination, lack of education and limited access to WASH facilities present challenging issues, Bangladesh’s national programs and international support have made promising progress. From health infrastructure to gender equity and sexual health curriculum, Bangladesh is poised to tackle persistent challenges and improve the health and wellbeing of citizens.
– Alice Nguyen