Africa: A Cultural Shift from Secrecy is Necessary to End Menstrual Shame

Menstruation is a topic handled with secrecy in many African cultures, perhaps to preserve the dignity of women and girls going through it. These cultural practices meant to protect sometimes end up doing the exact opposite. We are glad that this year's menstrual hygiene day is tagged as "making menstruation a normal fact of life by 2030 ."

While this idea is achievable in many other developed continents there may be challenges in Africa. African countries have foot dragged on sexual and reproductive health policies for adolescents and young adults and the worst are conversations around menstrual hygiene. Period poverty is an overwhelming concept in Sub-Saharan Africa. The term means the inability to access period supplies and facilities for menstrual hygiene management, which locks out women and girls from participating fully in economic and academic activity. Water, Sanitation, and good hygiene and access to menstrual products are some of the key challenges confronting women and girls in Sub-Saharan Africa.

While some African governments have made progress to end period poverty, much more must be done. In 2004, Kenya was a global pioneer after removing the tax and import duty on menstrual hygiene pads. In 2010, the government committed to supplying free sanitary towels in schools. In 2017, it amended the Basic Education Act to require the distribution of sanitary pads to schools; and a reported $3m was set aside in the national budget to fund the distribution of free sanitary pads. But even with subsidies easing access to pads, menstruation is still an uncomfortable topic in Kenya. It is shrouded in secrecy and associated with shame, yet it's a natural phase of growth that we should all embrace. Most importantly, parents should take the lead in the conversation with their children as early as possible for both girls and boys.

Ignoring such discussions opens doors for negative results such as period shaming from boys and transactional relationships with older males to buy sanitary pads. In Western Kenya, for example, 10% of young adolescent girls admitted to transactional sex for sanitary towels. The State Department for Gender, responsible for logistics, monitoring, and evaluation of the free sanitary towels program, acknowledges the existing culture of silence around menstruation. This silence leads to society viewing menstruation as a weakness and stigma for women and girls.

In Nigeria, this is no different. The culture of secrecy and shame makes girls avoid school during menstruation which is a setback for them to achieve their educational potential. The challenges faced by menstruating girls, cut across religions and ethnicity. Generally, according to a UNESCO report, one out of every ten girls in Sub-Saharan Africa misses school at least once a month owing to menstruation. A Ugandan study found that nearly two-thirds of schoolgirls in rural areas miss school at least once a month because of menstruation.

Juliet Otieno, the founder of Mwanadada Initiative, an NGO working with adolescent girls and teen moms in Kenya recently had a conversation with her mother, now a grandmother to teens, about whether it is appropriate to talk to boys about periods. She felt that parents shouldn't talk to boys about affairs that don't involve them. They had a long discussion about teenage pregnancies that involve underage boys. Juliet's mom saw the importance of involving boys in talking about menstrual health.

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Juliet recalls her primary school days when sanitary pad brands came to school to educate girls on menstrual hygiene. Teachers ensured that boys strictly stayed away from those meetings. This is the situation in schools even now. Boys are not privy to menstrual health discussions save from the shallow information in the curriculum.

Tijani Salami, a physician and founder of Sisters Caregivers Project in Nigeria have had some success in changing narratives about shame and secrecy by educating mothers on why they should start menstrual hygiene conversation with their daughters before menstrual onset.

Even as we wish to normalise menstruation in our society and achieve this in eight years, the way to start is to massively invest in education and campaign to discourage shame and stigmatisation so that boys, girls, and parents can discuss this issue without hesitation.

Periods are presented as a female experience when in reality, they are a biological experience. Silence and stigma surrounding periods is a global challenge that's slowly changing. The British government for example announced in 2019, that menstrual health will be a compulsory part of the school curriculum for all genders and argued that lack of education encourages stigmatisation.

Some may question why boys should know or be involved in an issue that does not concern them. Experience has shown that the culture of shame or stigmatization does not come from fellow girls or women with similar experiences of menstruation. Educating boys becomes necessary so that they can normalise menstruation in their minds. This can additionally help them understand how to support their wives when they eventually have partners. It would eliminate narratives, like 'menstruation makes women too emotional and not fit for leadership.' When we normalize these conversations, we would eliminate period shaming and bullying.

The boys we are trying to protect from seemingly 'unnecessary' conversations will soon have relationships with teenage girls. They need to understand the consequences of their actions as they prepare to enter their teens. Menstrual health education for boys will foster a supportive culture rather than the indifference created by the existing silence and mystery.

African governments can work on making menstrual health education available to boys and girls in schools and raising awareness campaigns on menstrual health and hygiene. All NGOs working in the SRHR field in Africa should make provisions for menstrual hygiene education in their programmes. Additionally, African governments need to end period poverty targeting school girls and poor women by subsiding menstrual products and provision of WASH facilities.

We need a cultural shift to end period shame if we want to make this year's menstrual hygiene day theme "making menstruation a normal fact of life by 2030" a reality.

Juliet and Tijani are both 2021 Aspen New Voices Fellows.

Juliet Awuor Otieno is the founder of Mwanadada Initiative, a non-profit organization that provides teenagers in Kenya with age-appropriate, comprehensive sex, reproductive, and mental health education

Tijani Salami is a physician and founder of Sisters Caregivers Project in Nigeria which provides medical and social support for women and girls

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