We are committed: Making menstrual health and hygiene everybody’s business

A young girl in Nepal is dressed head to toe in a pink saree, she looks directly at the camera as she stands on an empty stretch of road in rural Nepal.

Water for Women's Gender and Social Inclusion Specialist, Jose Mott share insights on #PeriodAction for Menstrual Hygiene Day 2023.


We know the “why” of prioritising period action – let’s work on the “how”


We could start with a statistic. Every month, 1.8 billion people across the world menstruate – girls, women, transgender men and gender diverse people, of whom many, if not most, are unable to manage their menstruation with dignity and in safe and hygienic conditions (Menstrual hygiene | UNICEF). But most of us in the WASH sector should be well acquainted with many of these statistics by now. The “why” for ending period poverty is evident. We now understand the real costs to the lives, livelihoods, health and wellbeing of women, girls and people who menstruate if we fail to invest in menstrual health and hygiene (MHH) in our WASH programs.


Transforming lives and communities


We also better understand the broader transformative change that these MHH investments can bring to households and communities. Deputy Director of the Centre for Research and Advocacy (CFAR) in India, Juhi Jain, explains that MHH is an excellent entry point for transforming harmful gender norms at household, community and institutional levels. It paves the way for respectful dialogue to address long standing taboos and stigma that restrict women, girls and gender diverse people from fully participating in society.


Ending period poverty is everybody’s business


Zeroing in on the “how” is critical for real commitment. And a key part of the “how” is to make MHH everybody’s business. I have just returned from visiting WASH projects that are being implemented by Water for Women partners, CFAR in India and SNV in Nepal. It was on these visits that I was able to see first-hand how these projects are working towards making MHH “everybody’s business”. In this way, the burden of change does not rest only with women and people who menstruate. Menstrual health and hygiene-related taboos and stigma, perhaps one of the most significant barriers to ending period poverty, is a whole-of-community issue. As such, strategies for shifting them must involve everyone. If not, we cannot expect to see lasting positive change.


On my visits I was able to see how increased access to sanitary pads and menstrual hygiene friendly WASH facilities and information is made possible through active engagement of a wide range of stakeholders at community and institutional levels, alongside initiatives to support women’s self-reliance and empowerment.


Increasing access and participation


CFAR has supported the establishment of MHH Units and Pad banks through women’s self-help groups in informal settlements across Bhubaneswar and Jaipur, I was able to visit two MHH units and Pad Banks in an informal settlement in Bhubaneswar and in Jaipur. Members of the MHH Unit produce the pads, while the Pad Bank members work to distribute them in their communities. In Ward 63 in Bhubaneswar, one of the MHH Unit members, who is visually challenged, talked about how she likes to be an example to others, especially for women and girls with disabilities.


Menstruation is an issue for everyone, but I like to share information to those who have less access to information, like girls and women with disabilities


The women members spoke about the benefits of the MHH units and pad banks, not only in terms of increased access to sanitary pads and MHH information for women and girls, which was particularly critical during the COVID pandemic, but also in terms of their increased self-reliance and empowerment because of their newly gained skills and income. Changing mindsets about MHH-related stigma in their communities was also a common theme.


The members from one of the 10 self-help groups producing sanitary pads in Jaipur that I visited spoke of the CFAR supported training they received to establish their MHH Unit and Pad Bank. They emphasised how the pad is made of banana peel material, which is biodegradable and minimizes the risk of infection, and how they improved the quality of the product after initially trialing it themselves. In spite of the various challenges to get up and running, for these women, the benefits of their hard-earned work were numerous: a sense of purpose and happiness, as they no longer felt isolated at home on their own; new skills and a way to contribute to household income; increased resilience and flexibility (being able to work from home) and autonomy (earning income by themselves). A number of the women also talked about the value of being part of the group to laugh together, share ideas and learn from each other.


Visiting the Dungeshwar rural municipality in Dailekh district of Nepal, I was able to meet with members of a mothers group, of whom some were female WASH entrepreneurs. Mothers groups are institutionalised as part of the rural municipality’s WASH governance and service provision structure to support sanitation initiatives in their communities. The women in this group talked about how their awareness was raised through training supported by SNV Nepal about how to improve the sanitation and hygiene behaviours in their communities, including MHH practices. Disability help desks have also been integrated into the rural municipality’s WASH service delivery structure (as it has in seven other rural municipalities, with support from SNV). These help desks are jointly managed by a rural municipality official and a person from the Rural Municipality Network of people with disabilities. One of the many services they provide is supporting people with disabilities with access to WASH services and products, including MHH sanitary pads.


Engaging men and boys


A crucial way to shift norms that stigmatise menstruation is engaging men and boys as partners for change. I was struck by the creative ways both project partners have been working on this. Through  SNV’s action research on gendered norms relating to household care and domestic work in Dailekh and Sarlahi districts of Nepal, a five day masculinity training was developed and delivered by local partners to some of the men who participated in the research. I had the privilege of talking with the male youth group in Dailekh that was formed as a result of this training. The men spoke of the changes they undertook, mostly around sharing care and domestic labour with their wives, mothers and sisters and the changes they have seen because of this: women’s wider participation in community discussions, improved household income as women are more enabled to undertake paid work, improved family harmony and less domestic violence to name a few. They also shared how they are now advocates for challenging harmful taboos related to menstruation. A tangible outcome has been that women in their households are no longer isolated from their homes during menstruation. While these changes were initially met with backlash in their communities, some of the men pointed out that they were now seeing some of their neighbours and friends implementing the positive changes they have been role modelling. As one young man put it:


I am not only male, I’m also human. I want to accelerate changes in the community by demonstrating them as a change maker


CFAR has been supporting men as partners for change in MHH through the formation of male forums and MHH advocacy at community and institutional levels. One young male forum member of a multi-stakeholder discussion I attended in Jaipur talked about his role in changing people’s mindsets about MHH:


I was able to reach out to other boys. They’d say “but this is a woman’s issue, why do you want to talk about this?” I was initially hesitant, but then I started to understand that it is everybody’s business. I also reached out to school principals, and now pad banks are installed in their schools


And from another male forum member (shop keeper):


I saw children doing a play about MHH. Before I was not comfortable speaking about the issue. Now I have a pad bank next to my shop and I talk to other men about it to change their mindsets. It has changed my life
A blue graphic with the words 'Just launched' and a thumbnail of the cover of a WASH in Schools learning Brief

Strengthening the system by making MHH everybody’s business


As a result of SNV’s initiative described above in supporting the formation of young male gender champions, the Vice Chairperson of Dungeshwar rural municipality in Dailekh said that the local government hopes to support scaling out the youth initiative throughout the municipality.


While in Jaipur, CFAR brought a range of government and community stakeholders with whom they have been working on MHH initiatives, such as MHH training of frontline workers and MHH awareness raising in schools (including schools for students with disabilities), health centres and communities. These stakeholders consisted of frontline workers; officials from the Women’s Empowerment Department and workers from the Women’s Counselling services for police shelters; transgender rights activists, as well as young men, women and gender diverse people from the community.


All spoke about the positive results they were seeing from working at various levels to change harmful norms to strengthen systems that are supportive of the menstrual health and hygiene of women, girls and gender diverse people:


We are able to open conversations about MHH – break the silence among girls and women, men and boys, and gender diverse people. We can Integrate trans rights and issues into community MHH and hygiene activities, and support convergence and coordination across government departments and policies

Transgender rights activist


We really helped caregivers understand the MHH issues better

Worker and MHH Master trainer from Women’s Empowerment Department – delivered MHH training to 7 schools for people with disabilities


There are a lot of myths and misinformation (unpure, shouldn’t touch things). People say these are women’s issues, and people should not talk about it. Now people are talking – school girls, school girls who have dropped out of high school, men and boys, frontline workers, government departments, people with disabilities. 

Young female MHH advocate


I met a front-line worker and she said I should speak to one of the MHH advocates. I spoke to my mother, who was initially angry, but soon became supportive after she attended some of the MHH meetings

Young woman


We are committed – are you?


Commitment is stronger when everyone is involved. Making MHH everyone’s business requires concerted efforts across governments, civil society, institutions, workplaces and communities. The WASH sector has an important role to play in driving this commitment, as is demonstrated by the activities mentioned above. 


MHH has been forefront of the agenda of the global women's movement since the 1990s... but the relatively recent integration of MHH into WASH programming, shaped by communities most affected by the poor MHH services is making a big difference not only in mainstreaming this issue in WASH and in spaces for rural and urban development programs, but also in contributing to many innovations and different levels and quality of agency of women, girls and persons of diverse genders.

Akhila Sivadas, CFAR Director


As we know, poor MHH for women, girls and gender diverse people, is a critical barrier to their health, resilience and wider participation. We need to turn this around so that it becomes a critical entry point for their engagement in decision-making processes at all levels. The urgency of this cannot be underestimated, as we grapple with climate-related challenges that require everyone to be actively involved for finding contextually appropriate solutions for a climate-resilient future.

We know the “why”. The “how’ is where we are at now, and what we are doing, to show we are truly committed to action. The following principles can help practitioners guide their MHH interventions to ensure that processes and outcomes are well grounded in local realities and that support the health, wellbeing and resilience of everyone involved.

Respond to the context

Tackle taboos

Be guided by people with lived experience

Engage with men and boys

Collaborate with a range of stakeholders

Share practice and learning 


Learn more


Feature photo: Small but significant steps are gradually stripping away age-old taboos associated with menarche in rural areas of Nepal and improving menstrual health and hygiene (MHH) and gender equality for women and girls (SNV Nepal)

Making menstruation a normal part of life is creating a world where no woman, girl or person is held back because they menstruate.


From poverty reduction and stronger economies to healthier populations and better educational outcomes, the benefits of investing in Menstrual Health and Hygiene (MHH) are far-reaching.


On Menstrual Hygiene Day - 28th May - and every day, we are committed to #PeriodAction. Together with our partners, we are working to ensure sustainable MHH solutions through water, sanitation and hygiene (WASH) projects across the Asia Pacific.


We are transforming WASH systems to empower women, girls and gender diverse people, including those with disabilities, by shifting stigma and harmful norms, and strengthening access to menstrual hygiene-friendly sanitation services and products—so that periods can be managed safely and with dignity.


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