Period poverty: Understanding and addressing an urgent human rights issue

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▲ Photo by Paula Bronstein for Getty Images on Images of Empowerment

Today, the Kulczyk Foundation is launching a new report, carried out in collaboration with Founders Pledge, looking into menstrual health and hygiene and how we can end period poverty around the world. We're really excited about the Foundation’s plans and our work with them to date. You can find the full report here and a summary below.

An overlooked global problem

Despite the fact that 1.9 billion people around the world menstruate, around 500 million live in period poverty, meaning they do not have access to complete menstrual health and hygiene. The issue is severely underfunded; although roughly $449 billion is donated to charitable causes annually in the US alone, only $10-100 million is spent directly tackling period poverty each year.

The key components of complete menstrual health and hygiene (MHH) are access to your preferred menstrual management products, like tampons and pads; a safe and hygienic space to change and dispose of sanitary materials and wash; knowledge and understanding of what menstruation actually is and how best to manage it; and a supportive environment where menstruating is not stigmatized by others.

A life without complete MHH is one that can lack opportunity, dignity and confidence, making period poverty a human rights issue that must urgently be addressed. Despite its prevalence across the globe, the problem is often overlooked, something currently exacerbated as the world fixates its gaze on the COVID-19 pandemic. Worryingly, the pandemic will likely push more people around the world into period poverty, particularly women and girls in low-income countries where COVID-19 is damaging economies and stretching already taxed health systems to cut programs deemed less important.

Not only can inadequate MHH affect a person’s mental health through stigma and feelings of shame or embarrassment, but it also has the potential to cause physical harm such as urogenital infections and untreated pain. Meanwhile, it can have wider effects on a person’s life, such as limiting education through missed school or reducing income due to lost workdays. Still, as period poverty is an overlooked and under-researched problem, evidence regarding these effects and their severity is lacking.

This is why we must continue to build the evidence base and fight to give everyone who menstruates access to complete MHH, so they may manage their periods safely, confidently and with ease. With this in mind, the Kulczyk Foundation, a private family foundation working to end inequality and discrimination against women and create a barrier-free world, has partnered with Founders Pledge to produce the first-ever report on effective funding recommendations to address period poverty. With the help of Founders Pledge researchers, the Foundation identified what they believe to be the most impactful organizations working to address incomplete MHH, and we hope philanthropists passionate about ending period poverty will consider donating to these exciting funding opportunities.

The findings

There are multiple, intertwined solutions to lack of MHH, and interventions can be either direct or indirect. Direct interventions include things like developing and distributing products such as mooncups, educating people about menstruation and how to deal with it, and providing adequate healthcare and creating WASH (water, sanitation and hygiene) facilities. Meanwhile, indirect interventions include activities like movement building, raising awareness of the issue and combating stigma, advocacy and policy, and research. Due to a lack of focus on MHH by the global research community, we still lack enough evidence to know which interventions are the most impactful, although a combination of different solutions is likely key.

When searching for cost-effective organizations implementing solutions to lack of MHH, a number of findings informed the researchers’ approach. First, evidence on MHH is hugely lacking when it comes to determining the global scale of the problem and details of its associated harms, so they prioritized organizations that we know will add to the limited pile of evidence through their work.

Second, as incomplete MHH is a multi-faceted problem, with different elements more prevalent in certain circumstances, the team selected organizations that implement a variety of activities and address a number of different components of incomplete MHH. Third, as the field of MHH is young, the researchers looked for organizations that can build and scale sustainable programs to grow and improve work in this space. These kinds of programs include collaboration with governments and efforts to develop local markets.

Finally, although inadequate MHH affects women, girls, and people who menstruate all over the world, those in low- and middle-income countries are more likely to experience multiple deprivations at once, such as a lack of washing facilities and difficulties affording sanitary products. For this reason, the team chose to focus on organizations working in these countries, although they did not entirely rule out work in high-income countries.

Where to give

During this research, the Kulczyk Foundation, in partnership with Founders Pledge, identified eight organizations that they believe philanthropists passionate about ending period poverty should consider supporting. Together, they have a funding gap of $10 million. The selected organizations are listed below. For more information about this research, the organizations’ funding gaps and why they were chosen, you can read the full research here.

Days for Girls

Founded in 2008, Days for Girls is an organization headquartered in the US with offices in Uganda, Nepal, Ghana, and Guatemala that is focused exclusively on increasing access to complete MHH, chiefly through education and product distribution. Days for Girls distributes kits containing its patented reusable menstrual pad as well as supporting products such as undergarments, transport bags, and soap.

Days for Girls is active in product manufacture and distribution – both through free distribution and sales from local enterprises. They provide education to accompany distribution and work to dispel menstrual stigma among boys and men as well as in the wider community.

Inua Dada Foundation

Inua Dada Foundation is a Kenya-based organization founded in 2014 working exclusively on menstrual hygiene issues via product distribution, advocacy work, and building awareness for girls and women in Kenya. Currently, Inua Dada is working with other grassroots partners to deliver kits including menstrual hygiene products and other basic supplies to women and girls impacted by the COVID-19 lockdown in Kenya.

Irise International

Irise is a UK- and Uganda-based organization founded in 2011 focused exclusively on MHH. Irise uses multiple approaches to increase access to complete MHH, including:

  • Designing and implementing direct interventions
  • Advancing the MHH knowledge base through research and dissemination
  • Developing and advocating for policy changes to improve menstrual health

Currently, Irise is testing a menstruation-friendly schools program in Uganda that combines product distribution, WASH improvements, education, and partner and community engagement to decrease absenteeism and improve menstrual health among girls in school. The pilot for this program has so far reached 6,000 children in 10 schools. They are also working to solve last-mile delivery challenges for menstrual products in Uganda, and are looking to develop and pilot new interventions in the UK to help end menstrual stigma.

NFCC

NFCC is a Nepal-based organization founded in 1988 that works on a spectrum of sexual and reproductive health (SRH) issues. NFCC’s mission is to work with the government to ensure that good policies are enacted and implemented to advance the government’s agenda on SRH.

NFCC began working on MHH in 2008 and has worked on the area in partnership with the government, health sector, UN agencies, bilateral funders, NGOs, and civil society organizations. NFCC works through a variety of different mechanisms including research, policy and advocacy, health service provision, training, and behavior change communication and awareness-raising. NFCC is committed to conducting research related to menstrual health nationally while contributing their experience to international working groups designed to improve monitoring, evaluation, research, and learning for MHH more broadly. They have worked on a variety of studies related to menstrual health, ranging from testing uptake of new products to assessing the forms and intensity of menstrual stigma in different regions. They have been instrumental in establishing a place for MHH on the national agenda and continue to work to ensure access to complete MHH country-wide.

Population Services International (PSI)

PSI is an international non-profit founded in 1970 working on global health issues throughout Africa, Asia, and Latin America. PSI is headquartered in the United States, Europe, and Kenya and has additional country and regional offices in more than 40 locations. PSI is known for its work in marketing, distributing, and creating demand for health information, products, and services to promote broad uptake of needed tools and approaches. Originally focusing on contraception, PSI now works in the areas of SRH, WASH, malaria, HIV & tuberculosis, non-communicable diseases, and safe abortion, with focuses on digital health approaches and reaching adolescents and youth. Much of PSI’s recent work to improve access to complete MHH is embedded in sexual and reproductive health and rights (SRHR) work designed to reach adolescents and young women.

Sesame Workshop

Sesame Workshop is a US-based nonprofit founded in 1969 that aims to improve children’s education and development through media and education. Sesame Workshop estimates they reach 180 million children in 150 countries worldwide. Their flagship program – Sesame Street – has been tailored for 30 different settings and the puppet characters from the show are used to help communicate difficult topics to children and educate them more broadly.

Sesame Workshop aims to improve MHH through their Girl Talk program, which is an educational program implemented in partnership with World Vision in schools as an addition to a WASH program called WASH UP! Girl Talk is aimed at both girls and boys aged 10-14 and has been piloted in Zimbabwe.

Simavi

Simavi is a Dutch NGO working in six countries in Africa (Ethiopia, Ghana, Kenya, Malawi, Tanzania, and Uganda) and four countries in Asia (Bangladesh, India, Indonesia, Nepal). Founded in 1925, Simavi’s mission is to improve the well-being of women and girls by bolstering health, self-determination, and economic empowerment. Simavi’s work is focused at the intersection of SRHR and WASH, as they believe these components are essential to improving and sustaining the health of women and girls worldwide.

Currently, Simavi is running the Ritu program, which aims to increase knowledge, improve facilities, and fight stigma for in-school girls in Bangladesh. It is also running a program in Indonesia called Perfect Fit to bolster local and sustainable manufacturing of menstrual products and provide accompanying education.

WoMena

WoMena is an NGO founded in 2012 with offices in Denmark and Uganda. It aims to drive innovative solutions to SRH challenges by applying effective research and program development techniques to reproductive health work. An extensive portion of WoMena’s portfolio deals with MHH, particularly with work surrounding acceptability and uptake of menstrual cups. WoMena has been working in partnership with other implementing organizations (such as Save the Children and International Rescue Committee) to promote uptake of menstrual cups in Uganda.