Advocating for MHM public policies

Menstruation remains a taboo subject in Uganda — and many parts of the world. If it is discussed at all, many girls are taught that periods are shameful and should not be talked about openly. As a result, when girls start to menstruate, they are forced to skip school and improvise their own products, often resorting to unsanitary old rags and pieces of cloth. Some girls choose to exchange sex for money to buy manufactured sanitary pads, increasing the risks of early unwanted pregnancies and sexually transmitted diseases.

Anne Nkutu is well aware of this problem. A member of the Rotary Club of Kampala Nalya, Nkutu is a social scientist who focuses on reducing gender gaps. She started paying greater attention to menstrual health issues when free sanitary pads for school-age girls became an electoral campaign issue in 2015. “The argument put forward is that provision of free sanitary pads will reduce the high school dropout rates among adolescent girls,” she says. “However, menstrual health management has many tenets, and sanitary pads are only a small part.”

Nkutu has long believed that solutions must be systemic, so she joined others in Uganda, many of them Rotary members, in advocating for public policies related to menstrual health management.

This first required breaking down the silence and taboos around menstruation, so that members of Parliament could talk about it. “Menstrual hygiene was one of those things that until recently was not really spoken about,” she says. It was seen as a women’s issue, and “men don’t feel like they should be involved. Then when girls went to school, well, the schools are run by men who don’t even think about [menstrual hygiene]. So girls would rather stay home than possibly be the joke of the school.”

Nkutu and many others cheered in 2018 when the Ugandan government developed national guidelines, which still need to be formally approved, to promote and require menstrual health management standards. According to Uganda’s Ministry of Education and Sports (MoES), these guidelines establish minimum menstrual health management standards, guiding principles, and illustrative strategies for the country’s schools and institutions.

Nkutu and other Rotary members in Uganda are now focusing on the enactment of those guidelines. “We have been working to ensure we integrate menstrual health management in schools and also get parents and communities involved,” she says. “We hope that this endeavor will raise awareness so that parents begin to understand what girls go through and what kind of support and information they require.”

Rosette Nanyanzi, technical adviser for gender at MoES, says that one key challenge to enacting the new guidelines has been obtaining funding. “We have already come up with a national strategic plan that brings together many stakeholders because we realize we cannot do it alone,” she says. “That is why we are happy to work with partners like Rotary.”

But a girl’s plight doesn’t change until attitudes do, so MoES has developed a training manual to help teachers and other stakeholders promote menstrual health management within the school setting and in their communities; Rotary members and their partners are helping disseminate the information. “We realized that communities did not have information, and parents are also not comfortable discussing issues of menstruation with the girls,” Nanyanzi says. “We need to provide them with that empowerment.”

Reporting by freelance journalist Evelyn Lirri and photography by Andrew Esiebo