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Writer's pictureMidwife Evi K.

Menstrual Poverty (Period Poverty) - 9 Experts' Insight for 9 Countries

People who lack access to the safe, hygienic menstruation products they require, and/or who are unable to manage their periods with dignity, often, as a result of social stigma and repercussions, are affected by Period Poverty, which is a global problem. It doesn't simply apply to people without the availability of menstrual products; in certain instances, having limited access to these items results in using the same tampons or pads for an extended period of time, which can result in infection.

We have contacted experts from 9 different countries around the world in order to take a quick look into the situation of Menstrual Poverty in their countries. That made us realize that Period Poverty does not have borders and it exists in lower and higher income countries. We collected insights from Germany, Tanzania, South Africa, Sweden, Bulgaria, Canada, Lebanon, Pakistan and Scotland (UK).





Disclaimer: Midwifery is a very inclusive and safe space for everyone, where your identity and your needs are valid and important to us. Thus, the terms used in this article aim towards making everyone feel comfortable and included.


Female genitalia owner ↔ people with female genitalia regardless of their gender

Menstruating people ↔ people who have/experience menstruation/periods regardless of their gender


*This article includes the input of experts around the world. Their statements are not edited and may include non-inclusive terminology due to cultural differences.


[if you feel that you are not included at any point, please contact us and help us change that]


© PARASKEVI KAMPERI, SOME RIGHTS RESERVED 20/10/2022


Menstrual Poverty's long-term effects can be as follows:

  • During their periods, people frequently skip one or more school days, which severely impacts their education. For instance, in Sub-Saharan Africa, some girls may skip up to 20% of their academic year and some may even stop attending entirely. Girls may be more prone to be coerced into underage marriages if they lose their schooling.

  • When people are compelled to use filthy rags that can spread infection, there are significant health dangers. If a female genitalia owner has experienced female genital mutilation (FGM), the risks could be higher.

  • Some people may experience ongoing shame and dread during their periods as a result of societal stigma, and in some situations, they may also experience social repercussions (such as chhaupadi in Nepal).

  • Once they start having periods, a lot of girls from low-income countries quit school altogether.

The lack of ability to cover menstruation expenses includes, not only menstrual pads and tampons, but related costs such as pain medication and underwear, and it, also, affects people who experience periods in wealthy, industrialized countries. Period Poverty is not only an economic issue, but a social and political one as well. For instance, some advocates have called for menstruation products to be exempt from taxation. Such efforts in India and other countries have resulted in the elimination of tax on menstrual pads and tampons. Scotland was the very first which declared menstrual products as essential and gives them away for free, hopefully, followed by more countries within the near future. Unfortunately, menstrual products are still characterized and taxed as “luxurious” in many countries.


“Meeting the hygiene needs of all adolescent girls is a fundamental issue of human rights, dignity, and public health.” ~ Sanjay Wijesekera, former UNICEF Chief of Water, Sanitation and Hygiene


Menstruating people make up more than half of the world's population, so it is time to realize Period Poverty is a serious issue that affects everyone. Physical, mental, and emotional issues are caused by Menstrual Poverty over time. People are further discouraged from discussing periods due to the stigma that surrounds them.


Types of Period Poverty:

  • Access related

  • Affordability related

  • Embarrassment and fear of embarrassment

  • Culturally related alienation period exile

  • Environmentally (lack of supplies and sanitary facilities)

  • Loneliness


International Experts’ Insights


Bulgaria





Vera Markova

Founder and Brand Manager of Green Revolucia





Periods are a taboo topic in Bulgaria, we don’t even have sexual education classes as part of the curriculum at school, and periods are not part of the Biology lessons either, which leaves plenty of Bulgarians ignorant.

There hasn’t been any funding allocated to research assessing how many pupils are missing school due to being unable to afford menstrual products, but I can give you an insight into the conditions Bulgarians have for managing their periods:

  • The Bulgarian government regards period products as luxury rather than essential items and taxes them with the standard VAT rate of 20%; a curious thing to note here is that until the end of the year hotel bookings, restaurant and catering services will be taxed at 9% as if going to a restaurant/hotel is more essential than managing one’s period with dignity.

  • There are no donations of period products to crisis & refugee centers.

  • Most schools have squatting toilets and often lack soap, toilet paper and decent doors which makes managing one’s period at school extremely difficult.

  • There is no paid period leave in Bulgaria.

  • Reusable period products such as reusable pads and period pants are sold only in a couple of small niche shops which doesn’t make finding them easier.

  • There are no publicly funded campaigns addressing menstrual hygiene management and the benefits of reusable period products.

  • Even disposable period products are quite expensive for the standard of living with people spending 10.58 leva per month on average for 2 packs of regular pads – the minimum wage in Bulgaria is 710 leva which means that someone on minimum wage needs to spend 1.49% of their salary on period products.

The cost becomes even higher annually (126.96 leva) and 1,269.60 leva for ten years which is almost as much as 2 monthly salaries for someone on minimum wage.


Scotland, UK








Lauren Galligan (she/her)

Undergraduate Manager of Period Poverty University of Edinburgh








In the UK currently, 14.5 million people are living in poverty. Within this climate, menstruating people face the harrowing costs of an average of £4,800 on period products in a lifetime, an expense that is only rising as inflation rates soar. The detrimental effects of period poverty are widespread; around 137,700 young people in the UK miss school because they can’t afford period products. The Free Period Provision Bill, introduced by Monica Lennon MSP in 2021, is an attempt by Scotland to tackle period poverty, allowing for freely distribution of period products for people who need them. As a result of the Act, which came into practice in August 2022, councils and education providers are legally required to make period products available and accessible in public buildings. Furthermore, the PickupMyPeriod mobile app, launched by Hey Girls and supported by the Scottish Government, allows people in Scotland to easily track where products are available. Before the Free Period Provision Bill, Scotland had already put into practice the Period Products in Schools Regulations in 2020, ensuring that pupils could access products at school. In the rest of the UK, similar schemes are available in schools, yet more than 30% of young people still have no access to free products, demonstrating how, with the scheme not being essential, many schools are still choosing not to make use of something that could greatly improve the wellbeing of countless young people.

Period Poverty exists because of an array of reasons, but it fundamentally comes down to a failure by people in positions of power to take women’s health seriously. The demand for grassroot organizations and campaigners is only going to grow throughout the current cost of living crisis, as the need increases, and pressure on the government to enact further changes should grow with it.


Lebanon






Ghiwa Nassereddine

MPH






Since the beginning of 2022, greater than 15% of the value of the Lebanese currency has been lost contributing to the worsening of the different types of poverty faced by children, women, refugees and families from low socio-economic backgrounds. Because of that, more than half of the women in Lebanon have been suffering from the consequences of period poverty, as all sanitary product prices have increased by 500%. The prices of period products have been elevated from 2$ to 21$ in Lebanon from 2019 until 2021. Women who are not able to purchase period products are being forced to use nonhygienic and humiliating replacements during their periods such as tissue papers, cotton sheets, old cloth and newspapers. There have been women who indicated that they sometimes cut their children’s diapers in two to work as a pad during their periods. Luckily, there have been many charitable enterprises dedicated to combating period poverty by promoting the utilization of eco-friendly reusable pads, but the limited access to resources to wash the pads and socially accept them serve as essential challenges. Integrating period products with proper education and awareness is essential to tackle and beat period poverty. Voices that represent women’s rights at the decision tables are essential to be present to ensure their better well-being and quality of life as the country continues to pass through existential threats.


Sweden










Rebecka Hallencreutz

Co-founder and organizational manager at MENSEN









Sweden is one of the wealthiest countries in the world with a relatively strong welfare system. It’s a common misconception that period poverty doesn't exist here - but it does. Period poverty is undoubtedly worse in other places, but that doesn't mean that we can turn a blind eye to the problems in our immediate environment.

In 2021, MENSEN ordered a groundbreaking national survey about menstrual health experiences from the renowned research company Kantar Sifo. One of the main reasons was to find out how common period poverty is among young adults aged 16-21. Gladly, 95% of the respondents answered that they have never experienced it - but those last 5% have to some degree experienced period poverty in their life. In addition, the survey was done via the Kantar Sifos web panel and the most vulnerable and poverty-stricken groups in society, for example, the homeless, are not well represented.

Even if period poverty is not a problem for the vast majority of people in Sweden, it has major consequences for those affected - and this must be acknowledged if we want to solve the problem. As I said, Sweden is a wealthy country, we have the resources to easily end domestic period poverty. All it takes is political will. MENSEN will continue to raise awareness and be a loud voice for menstrual equity!


Tanzania




Sia Fred Towo

Working with Femme International since September 2020 to date as a Country Manager in Tanzania





Managing periods in Tanzania is very challenging due to sociocultural, individual, and systemic intersecting factors. Those resources include products, painkillers, water and soap, information, facilities for washing and drying both self and products, storage, and environments that are conducive to menstruating and not stigmatizing, shaming, or restricting, things like that. For example, 71% of adults in Tanzania couldn't afford disposable pads last period, and so had to make do with anything from fabric to things like dried leaves and grass wrapped in fabric, for example; One young woman in Marangu village where I was raised and grew up demonstrated to us how she wraps dried cow dung in fabric so it's more absorbent.

Additionally, menstruation is expensive, with costs for products, extra water, and soap, public toilet usage, motorcycle taxis because walking is too difficult, analgesics or other median cations, and sometimes even medical treatment. There are also costs of missed income due to pain or taboos. Accurate information and resources are nearly impossible to find, especially in more rural areas with little to no power and connectivity. Teachers, healthcare professionals, and community elders hold the same myths and taboos and continue to pass them on to subsequent generations.

WASH facilities issues are also another important figure when tackling/addressing period poverty in Tanzania. The facilities that exist are frequently a barrier to those children most in need of an education. According to the research done by UNICEF; 38% of water facilities are not available in Tanzanian schools and cases of water facilities not being operational were 46%. Lack of proper sanitation contributes to lower girls’ attendance in school and limits opportunities and potential for women in Tanzania.

Socio-cultural myths and taboos that restrict and diminish people whilst menstruating - for example that you're not allowed to touch produce or harvest, milk cows, fetch water, things like that mean that many women are excluded from income-generating activities and responsibilities at home for several days every period, directly impacting their and their family's financial status. Also becomes a tool to further exclude and silence women's equal and active participation, and their voices in decision-making, and this can result in lost opportunities for work and education.


Canada









Kiana Beharry

BA, BSc










Bread or Tampons? Canadians May Have to Choose. Severe inflation has resulted in a dramatic increase in the price of period products, contributing to period poverty.

Canada is no stranger to menstrual inequities, especially in a post-pandemic world where the price of period products has skyrocketed by almost 10%, causing greater inequities for those of low socioeconomic status. Canadians can expect to shell out approximately $6000 in their lifetime on menstrual products, causing a heavy burden for homeless, indigenous and gender-diverse populations.

Moreover, a 2019 study conducted by Nanos for Plan International Canada shows that many Canadians have had to cut something from their budget in order to afford menstrual products.

The Canadian government recently announced $25 million over two years to help menstruators receive the period products they need. While funding and government support are critical to fighting period poverty, a well-rounded and sustainable action plan is what is required to effectively fight for equity. For example, those with disabilities and those from gender-diverse backgrounds are often missed when action plan decisions occur, increasing menstrual inequities.

While Canada is making moves to improve menstrual equity, the nation should look at other countries, like Scotland, that have been able to make menstrual products free. It would be truly amazing to see a policy like that passed in Canada. Menstrual equity would finally be achieved.


Pakistan









Naidah Aqeel

Author of illustrated health book on Menarche “My body is Precious”









‘Mahawari’ is an Urdu description of menstruation, which means the monthly occurrence of menstrual blood. Menstruation is surrounded by different cultural and social biases in Pakistan and is considered taboo. The average age of girls for the onset of menstruation in Pakistan is 11-13 years old. In far-fledged areas where there is no awareness of menstrual hygiene, girls are missing school due to unhygienic menstrual hygiene management practices. According to a local NGO survey, 1 in 5 girls is missing school due to not having proper menstrual hygiene management products.

Underdeveloped areas of Pakistan, where poverty is at its peak and lack of education are an add-on to worsening the situation of period poverty. Women are opting to use whatever is available to soak the menstrual blood such as rags, dried cow dunk filling, sand and sometimes the skin of mammals. The situation is not different in developed areas, where women are fortunate enough to enjoy every sphere of life, but do not feel comfortable buying period products by themselves. It is essential for the physical and mental well-being of women to have proper menstrual hygiene products and facilitate taking care of them during this time.

Pakistan’s government seems ignorant on this side. Women’s daily life and economic participation are affected by the fact that they cannot have safe and affordable menstrual hygiene products. We need extensive academic research to have strong policies to provide affordable MHM to women to give them a safe and healthy lifestyle.


South Africa







Giada Bertola

Founder of Erotology, Sales Director at Menstruation Foundation, TiE Global Africa Winner







As an organization, we started a couple of years ago. Founded by Siv Ngesi and Marius Basson, our core belief and challenge is very clear in our slogan " if men had their periods, sanitary pads would be free" - just like condoms are government-sponsored here in South Africa. Whilst condoms and contraceptives are important, so is menstrual health. We do not choose to bleed, and millions of women every month in our country do not choose to bleed. Periods allow us to strengthen our uterus and, quite literally sustain the existence of humanity. The issue around menstrual health is layered within a history of patriarchy, colonialism and capitalism - it's complicated but not impossible to solve and we hope to make an impact and inspire others to do the same.

What is important to notice, is that sanitary pads/ menstrual care doesn't only provide dignity, safety and security to the woman that day, but it truly impacts her life in the long term. Period poverty affects a woman's private, educational and professional path in so, so many ways.

It is imperative to talk about menstruation and remove the stigma from the world. It is a beautiful thing billions of people experience every month, and something we should be thanking our bodies for – not something to hide nor shun away - or worse of all - shame.


Germany








Christine Marie Quigless

Menstruation Expert and Holistic Coach








As my focus, as a menstruation expert, revolves around ending menstrual pain and PMS for menstruators by directly addressing the womb's imbalance, I notice a lack of attention to the menstruators' wellness here in Germany. I don't think this is because Germans don't care about the human body or the plight of the menstruator who suffers, instead, this is about what Germans can control.

Both medical and menstrual-product industry messaging here revolves around the understanding that there is no way to end menstrual suffering, so to put attention on a non-existent solution, for them, does not help menstruators in any way.

In order to serve menstruators and to acknowledge the needs of menstruation that can be addressed, Germany, as recently as 2019-2021, introduced several governmental initiatives to initiate change. The German government has acknowledged that tampons and sanitary napkins (pads) are not a luxury and officially shifted the tax from the normal 19% tax, imposed on all goods, to the 7% tax imposed on necessities. This shift encouraged localized effects: municipal governments, like the city of Potsdam, and universities, like the University of Stuttgart, offer tampons and pads for free to those who menstruate.

Taking period poverty seriously goes beyond expense and materials; it means acknowledging our wholeness, a progressively nourishing task that many of us continue to avoid.


Conclusion


Menstrual Poverty exists and impacts the lives of many people around us. This is something we all need to realize and accept in order to help tackle the problem. It is important to note that it does not discriminate between wealthy and not wealthy countries and it affects the everyday life and future of numerous young and older folks.

We are could not be more thankful for our experts’ contributions and the chance they gave us to understand somehow better the situation of Period Poverty in their countries. You can find all of their information and ways to contact them on our Collaborations page.

We hope this article was helpful to you and can raise awareness among others. Therefore, feel free to share it on your social media and with your peers and colleagues, so that you can spread the word. We strongly encourage you to contact us in whatever way suits you and discuss the article, suggest ideas for upcoming content, tell us your strong and emotional stories or for any other reason you would like.



E-mail: beingamidwifeblog@gmail.com


Thank you for your support!









References

Action Aid. “Period Poverty.” ActionAid UK, 2021, www.actionaid.org.uk/our-work/womens-rights/period-poverty.

Lusk - Stover, Oni, et al. “Globally, Periods Are Causing Girls to Be Absent from School.” Blogs.worldbank.org, 27 June 2016, blogs.worldbank.org/education/globally-periods-are-causing-girls-be-absent-school.

Michel, Janet, et al. “Period Poverty: Why It Should Be Everybody’s Business.” Journal of Global Health Reports, vol. 6, 22 Feb. 2022, p. e2022009, joghr.org/article/32436-period-poverty-why-it-should-be-everybody-s-buisness, 10.29392/001c.32436.

Sanchez, Erica, and Leah Rodriguez. “Period Poverty: Everything You Need to Know.” Global Citizen, 5 Feb. 2019, www.globalcitizen.org/en/content/period-poverty-everything-you-need-to-know/.

UNESCO. “PUBERTY EDUCATION & MENSTRUAL HYGIENE MANAGEMENT.” Unesco.org, 2020, unesdoc.unesco.org/ark:/48223/pf0000226792.

UNFPA. “Menstruation and Human Rights - Frequently Asked Questions.” Unfpa.org, May 2022, www.unfpa.org/menstruationfaq.

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