Menstrual Policy-Mapping: health policy, implementation, and global impacts



Menstrual Policy-Mapping: Looking at menstrual health policy, implementation, and impact across the globe


Background

Menstrual health can be defined as a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity, in relation to the menstrual cycle [1]. Menstruation is a normal and regular event for more than half of the world’s population, yet drastic changes are needed to encourage positive social norms and enact behavioural change. Over the years, “menstrual health” has gained traction in the sectors of research, advocacy, commerce, and policy [1]. However, little is known about who is doing what and to what extent these advances have translated into impactful change for people who menstruate across the globe.


Overcoming stigma related to menstruation as well as ensuring that people who menstruate are able to manage their menstruation sufficiently, is paramount to achieving the Sustainable Development Goals (SDGs) that are related to comfort, participation, safety, dignity and well-being [2]. In addition to this, regular menstruation between puberty and menopause is an indicator of good reproductive health. There are three main components required to effectively manage menstruation: 1) tailored assets (e.g. awareness surrounding the menstrual cycle and how to manage it, an adequate supply of water, soap and sufficient materials to collect blood) 2) services (e.g. access to specific educational materials) and 3) spaces (availability of convenient and safe facilities where people who menstruate are able to change and dispose of the material used during the duration of their menstrual cycles [3,4].

Until recently, interventions and policies to improve menstrual health were mainly developed by the water, sanitation, and hygiene (WASH) sector [5]. However, the cross-sectoral nature of menstrual health requires a holistic and comprehensive approach to policy making to improve menstrual health worldwide, integrating aspects including sanitation, education, menstrual health products, and social norms [6]. Recently, more and more countries have published national policies and guidelines dedicated to menstrual health, addressing tax reductions, free product distribution, product standards, and menstrual leave, among others [5]. There is growing momentum for a multi-sectoral approach to menstrual health at national policy levels. The launch of Kenya’s policy document on menstrual health in 2019 marks the world’s first policy solely dedicated to menstrual health [5,7]. Another leading example is Scotland, which in 2020 became the first country in the world to provide free period products, making menstrual health more inclusive and accessible [8].

In this policy report, we will comprehensively identify, describe, and access menstrual health related policies across the globe. We will also look at examples of both successful and unsuccessful cases of menstrual health policy implementation and develop a traffic light system to identify menstrual health friendly policies. We will conclude with recommendations on how to implement impactful policies in different contexts.


Authors


Bethan Swift is a 2nd year PhD student at University of Oxford investigating the epidemiology of women’s health conditions in Northern Cyprus.


Theresa Lemke is a 2nd year Master’s student in Public Health at Karolinska Institutet.


Mandikudza Tembo is a final year PhD research fellow at the London School of Hygiene and Tropical Medicine looking at the acceptability and effectiveness of a menstrual health and hygiene intervention within a community-based sexual and reproductive health service for young people among young women aged 16 - 24 years old in Zimbabwe


Citations

  1. Hennegan, J., et al., Menstrual health: a definition for policy, practice, and research. Sexual and Reproductive Health Matters, 2021. 29(1): p. 1911618.

  2. Loughnan, L. Mahon, T. Goddard, S. Bain, R. Sommer, M. 2020. Monitoring menstrual health in the sustainable development goals. The Palgrave Handbook of Critical Menstruation Studies. 577-592.

  3. WHO/UNICEF JMP. 2015. Progress on sanitation and drinking water: 2015 update and MDG assessment. Geneva: World Health Organization and United Nations Children’s Fund.

  4. Patkar, A. 2012. Preparatory input on MHM for JMP equity and non-discrimination working group by Archana Patkar. Water Supply and Sanitation Collaborative Council (WSSCC).

  5. Patkar, A. 2020. Policy and Practice Pathways to Addressing Menstrual Stigma and Discrimination. The Palgrave Handbook of Critical Menstruation Studies, 485-509.

  6. Geertz, A., 2016. An opportunity to address menstrual health and gender equity. FSG.

  7. UNFPA, 2021. Celebrating choice and options in the management of menstrual hygiene, Available from: https://kenya.unfpa.org/en/news/celebrating-choice-and-options-management-menstrual-hygiene

  8. BBC, 2020. Period poverty: Scotland first in world to make period products free, Available from: https://www.bbc.com/news/uk-scotland-scotland-politics-51629880


This blog post was prepared by members of the Polygeia Stockholm Branch.