In Ghana, 9% of women and girls in their menstrual age do not use sanitary pads, and 35% do not have convenient space for changing at home and out of home due to poverty, social taboos, and the lack of policy drive.

As the world strives to achieve its Sustainable Development Goals in 2030, something as basic and natural as menstruation is still a topic shrouded with misconceptions, taboos, and stigma. While menstruation is biological and a way of life for many girls as they enter puberty, there is a disturbing number of girls around the world, to date, who do not have access to menstrual hygiene products. This inability of girls and women to access menstrual products including inadequate access to toilets, hygiene, and waste management is termed period poverty.

Period poverty is important yet often ignored and a public health crisis in many African countries including Ghana. A recent study indicated an estimated 200 million women and girls from developing countries struggle on a daily basis during their menstrual period to get access to not only menstrual products but also access to clean water for washing and convenient places to change their pads confidently and comfortably.

This gap and the limited adequate support in this area are largely due to stigma and beliefs associating menstruation with uncleanliness rather than recognizing menstruation as a biological, natural, and healthy way of life for women and girls.

Stigma also makes it uncomfortable for people to open up and talk about period poverty which prevents dialogues about access to menstrual products, including the option for a user and environmentally friendly products and the provision of facilities for menstruating girls to change their products. This stigma found expression in the uproar and superstitious reactions when a previous government in Ghana tried to expand access to menstrual hygiene products.

Access to affordable menstrual products is a right issue, not a privilege and menstruating girls feeling clean, confident, and capable during their period is a necessity. The lack of these services is a violation of human rights and has physical and psychological effects on menstruating girls. Girls who are unable to access menstrual hygiene products become vulnerable as they feel left without a choice and so are forced to use unhygienic materials such as rags to collect their menses. Some other girls risk transactional sex to raise money to buy hygienic products like sanitary pads.

Unhygienic products and space for changing products are drivers that heighten the risk for urogenital infections, such as urinary tract infections and bacterial vaginosis among girls. Unhygienic products are also associated with outcomes such as skin irritation, vaginal itching, and white or green discharge. All of these have serious implications in later life on women’s reproductive health. The daring girl who engages in sex becomes vulnerable to harmful physical (including early pregnancies and the risk of contracting STIs), and poor mental health outcomes further widening the already existing health challenges Ghana is battling.

The lack of convenient places for girls to comfortably change their menstrual products and the lack of sanitation facilities to appropriately dispose of used pads coupled with shame all point to indiscriminate disposal of menstrual waste products. Mention is made that millions of menstrual waste products end up in water bodies and landfills in Ghana.

A single pad is said to contain an abundance of plastics, which takes hundreds of years to decompose and as they slowly break down, their microplastics contaminate the soil and water bodies that are being consumed by households. This unfortunate situation further leads to a public health crisis in the country. However, as a matter of fact, the environmental effect of inappropriate menstrual waste disposal of sanitary pads is downplayed by governments.

To address period poverty in Ghana, there is the need for a multi-sectoral approach that will bring together the different stakeholders to dialogue on the way forward toward menstrual equity and environmental protection.

This can be done through awareness creation using social media to spread period positivity and the importance of menstrual waste management, host donation drives for girls in need of menstrual products on radios and televisions, and mobilization of coalition of advocates and the general public to push for a reduction or removal of taxes on menstrual hygiene products in Ghana.

We can also advocate for government and relevant stakeholders to support the provision of free sanitary pads in our schools and also support entrepreneurial innovativeness for local production of standard reusable sanitary pads as a long-term measure to ensuring period poverty equity.

An appeal should be made to the district assemblies and NGOs to allocate funds and invest more in sanitation facilities at schools and within the community for changing pads and proper disposal of used pads. There is also the need to educate boys and girls on menstruation to destigmatize perceptions, and beliefs about menstruation. The smallest ripples of these programs have the potential to cause huge changes in these areas and we can all work together to make this happen.

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Justina Agula is a member of the Health & Equity Pillar of the Centre for Social Justice, an Accra-based think tank. (jagulasenyo@outlook.com)