A menstrual health revolution for the Africa We Want!

By Dr. Julitta Onabanjo*

ADDIS ABABA – A red revolution of a different kind is flowing across Africa, to the benefit of more than half of its people. The continent’s nations have begun to work together on a widespread challenge that, until three years ago, had not been tackled head on. It was considered a ‘private’ matter – until the wider consequences for the lives of individuals and the nation’s health and wellbeing were made apparent at a groundbreaking conference in Johannesburg, South Africa in 2018.

Africa’s first-ever Menstrual Health Management Symposium brought together key players across the continent to lead the charge for the menstrual health and wellbeing of women, girls and people who menstruate. They made explicit the challenges and consequences of menstrual ill health for individuals, communities and nations. As a result, much has changed.

This momentous groundswell for menstrual health in Africa is welcomed because for too long, the matter went unacknowledged as the human right that it is, and as essential to a person’s wellbeing. Millions of menstruators who deserve to be enabled to manage the bodily process well, from menarche to menopause, needlessly suffer indignity, discomfort and ill health from a natural biological process that is vital to the process of giving life, and should be celebrated as such.

I saw this first hand in a resettlement village in Cabo Delgado, Mozambique, where I spoke to a woman who had lost everything she owned when she was displaced by the ongoing conflict up north, but was motivated to restart her life with just the ‘small things’, such as clothing and bedding – and menstrual health products because, for these displaced women, girls, and people who menstruate, the need to manage their menstruation in comfort and with dignity is as essential as the need to be clothed.

Africa is fast waking up to the importance of menstrual health, on the back of the 2018 symposium, which was organized by South Africa’s Ministry for Women in the Presidency with support from UNFPA, the United Nations sexual and reproductive health agency.

The event culminated in a galvanizing Johannesburg Call to Action and the formation of an organizing body to drive change, the African Coalition on Menstrual Health Management (ACMHM), recently renamed the African Coalition on Menstrual Health (ACMH). In three short years, the efforts of the ACMH and its extensive network of member experts and organizations have forever changed the menstrual health landscape – notwithstanding the devastating impact of the global COVID-19 pandemic on African lives and economies.

The impressive progress to date was triumphally evident at the equally pioneering Africa Coalition on Menstrual Health Symposium, organized by the ACMH and UNFPA in May this year and which attracted the participation of President of Ethiopia, Her Excellency Sahle-Work Zewde, Malawi’s First Lady, Her Excellency Monica Chakwera, the Regional Economic Communities, and wide political support from across the continent. Here, the emerging issues were made manifest, as detailed in the coalition’s Stocktaking report, while a renewed Call to Action ended the life-altering deliberations on a rousing note.

To understand why this is a river flowing in revolution, let us consider the importance of these deliberations for a moment. An early yet significant battle won was the broadening of the concept of menstrual health to one of human rights, including the right to health and education. On another front, the formation of national coalitions on menstrual health – with South Africa and Tanzania trailblazing on this and more countries set to follow – has taken a leaf from the overarching success of the ACMH.

And in an equally concrete drive towards rights, resources have been dedicated to research into programming for menstrual health and analyses of the remaining gaps that need to be addressed. Researchers are considering, for instance, the symbolism of menstruation in African communities and how traditional practices such as child marriage, with a girl often being married off following her first menses, can be harmful. When we know on which fronts the battles need to be fought, we can truly advance.

Little may come of it if each thrust forward is unrelated, which is why we need solidarity of efforts to join the dots. To this end and on behalf of UNFPA, I launched a technical brief at the 2021 symposium that provides solid guidance on the integration of menstrual health into all relevant sectors to ensure cohesion and sustainability.

What happens in the health sector, for instance, will have a weak effect if there is no correlated effort in schools, where girls need access to toilets that are safe and private, with the WASH sector – water and soap to wash and bins to dispose of used products. Nor do programmes tackling the education sector help girls in refugee or resettlement camps, like the resettlement camp I visited in Cabo Delgado, if the displaced girls are temporarily out of school, potentially for years. A concerted multisectoral approach, is the only way forward.

All of this costs and will continue to do so, which means menstrual health must be mainstreamed into national and sectoral budgets to meet ongoing funding requirements, to ensure sustainability of action and results for the realization of menstrual health in Africa. Opportunities also exist for the private sector to make a substantial and lasting contribution, apart from ensuring quality and variety in availability of menstrual products.

The science of brands influencing social behaviour can be harnessed to powerful effect. Dispelling the stigma of menstruation and the reprehensible shaming behaviour for a natural, healthy process would be an excellent start.

For my friends in the resettlement camp, and for women, girls and people who menstruate everywhere in Africa, we at UNFPA pledge our efforts in service of them, to meet their menstrual health needs. The way forward is encapsulated in the renewed Call to Action made at the symposium in May. It concludes with a promise to broaden the membership of the ACMH to strengthen and expand this important work on the continent, to ensure that the most vulnerable are reached first and that we leave no one behind in our drive for a menstrual revolution.

UNFPA stands in solidarity with the leadership of the ACMH, to strengthen efforts on menstrual health in collaboration with them. By working tirelessly together, we will realize the goals of menstrual health as they contribute to the achievement of the SDGs within the Decade of Action, and to achieve the Africa We Want. Because the flow won’t wait for the right time. The time is now. Period.


The Author of the opinion, Dr. Julitta Onabanjo*, is a Regional Director UNFPA East and Southern Africa. Featured Image: Young Mozambican woman. [Photo UNFPA /Mbuto Machili]