Poor menstrual health and hygiene: A threat to future productivity

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OPINION

By Elsie Kahunde

It is safe to say that Uganda’s untapped human potential lies in a dignified menstrual health and hygiene in girls and women who can acquire and invest in quality education, increased productivity, higher earnings and improved quality of life. This can essentially shift the narrative of our human capital index from the 39 per cent low contribution in future productivity to 61% in greater aggregate productivity, innovation and long-term economic growth.

Menstrual Health, a fundamental human right according to the World Health Organization (WHO), is an aspect of Menstrual Health and Hygiene Management (MHHM) defined by both the World Health Organization and United Nations Educational, Scientific and Cultural Organization (UNESCO) as the ability for menstruators to use clean and absorbent menstrual materials to collect blood while still being able to change to another menstrual material using clean water and soap as often as possible during their menstrual cycle.

Attached to its health, education, gender equality, and women’s empowerment implications, this natural occurrence and basic human right for any girl or woman’s life is not easily manageable for 52.1% of the menstruating girls across the country. 

Persisting challenges are discrimination and stigmatisation still attached to menarche and the menstrual period. Issues of period poverty, particularly the affordability of a pack of sanitary pads costing shillings 3,000 for girls, especially those in rural areas like Karamoja, West Nile, and Acholi, who are still living in greater poverty according to the 2024 Global Multidimensional Poverty Index.

In addition is the inaccessibility to safe and clean water, which can cause virginal infections, sexually transmitted diseases, and poor menstrual disposal mechanisms, harming the environment.

The 2024 value for money audit on management of menstrual health and hygiene in primary and secondary schools reports that poor sanitary facilities in 73% of the schools the Auditor General visited, had a pupil-to-latrine stance ratio of 1:110 (well above the national service delivery standards of 1:40) with no gender separation, making accessibility difficult given the long queues. This enabling environment encourages school dropouts, bullying, and gender-based violence. What efforts has the government made towards addressing the issue? 

To ensure effective programming of Menstrual Health Hygiene Management sensitivity activities, the five-year national strategic plan for Menstrual Health and Hygiene (2022/23–2025/26) was developed in 2015, and the 2017 Planning and Implementation Framework for Water, Sanitation, and Health in schools to ensure school management committees plan and budget for the provision of Menstrual Health Hygiene Management sensitivity support in awareness, menstrual products, and medication.

The Inter-Ministerial Committee on Menstrual Health and Hygiene (IMCMHH) was established to address the issues surrounding menstrual health and hygiene in Uganda and still, and in 2023, the Menstrual Health Management Guidelines for Schools and Education Institutions in Uganda were developed to manage menstrual hygiene in schools.

The greatly anticipated provision of sanitary pads to primary and secondary schools that the president pledged in his 2015 campaign and stated in his 2016–2021 manifesto of the National Resistance Movement ruling party for implementation in FY 2017/18 was broken in 2025 after nearly a decade of waiting.

Other significant challenges emerging from the 2024 value for money audit on management of menstrual health and hygiene in primary and secondary schools hindering Menstrual Health Hygiene Management sensitivity is the ineffective government planning to implement Menstrual Health Hygiene Management sensitivity activities where Ministry of Gender, Labour, and Social Development’s gender unit spent only 10% of its budget in FY 2023/24 on Menstrual Health Hygiene Management sensitivity activities especially when there is no financing from donors.

Poor inspection and monitoring of schools that are conducted with monitoring tools that lack Menstrual Health Hygiene Management sensitivity considerations. While schools are required to budget for and maintain the provision of sanitary pads, the Auditor General reports that 46% of schools do not provide emergency pads, as well as the lack of awareness among students, teachers, and parents about Menstrual Health Hygiene Management sensitivity.

The belief that menstruation is a sign of readiness for marriage still looms large in communities, contributing to child marriages and encouraging gender-based violence.

According to the 2020 Situational Analysis on Menstrual Health Hygiene Management sensitivity, women reported to being sexually violated by their intimate partners while on their period due to the lack of patience by their partners for the period to end.

The lack of capacity building to equip senior women and men with support for girls and sensitisation of boys on menstruation awareness exacerbates the problem of an unconducive and unsafe learning environment for girls and boys.

As such, girls miss up to 10 days of schooling every menstrual cycle, to the extent that some drop out.

The 2024 Global Gender Gap Report lists Uganda as having a 100 per cent gender gap close when it comes to the enrollment of boys and girls in primary schools, meaning that the number of girls enrolling in school is equivalent to the number of boys enrolling in school, yet the rate of transition from primary seven to senior one is lower among girls than boys. 

This silent but deadly block, hindering girls’ full attainment of education, if left unattended to will deteriorate the level of future productivity. Menstrual Health Hygiene Management sensitivity in budget planning and monitoring will go a long way in improving the learning environment for not only girls in school but also boys and teachers. 

The writer is the programme associate with Civil Society Budget Advocacy Group