Globally, people who menstruate are faced with a difficult question: Do I have enough money to buy hygiene products this month? For many, the answer to that question is no. Period poverty is a worldwide challenge for many women and girls who lack the resources to afford menstrual and hygiene products. The World Bank estimates that there are over 500 million people without access to menstrual products, 1.5 billion without a safe toilet, and 526 million women without any toilets. Where there is a lack of access to sanitary products, including pads, tampons, and toilets, there is a domino effect of adverse economic, educational, and health outcomes for women globally, specifically in low-income countries where families struggle the most.

At times, low-income families are often faced with the decision of buying food over period products. In part, this occurs mostly because of the increasing cost of period pads and tampons, particularly in countries like Ghana where period products prices have more than doubled in recent years, due to the stagnant economy and rising inflation.

Menstruation generally occurs every 28 days between the ages of 12-51. Every month for decades, women around the world face the difficult decision of choosing between buying some necessities over menstrual products creating a decades long cycle of poverty. As a result, some women are often forced to find alternative means for procuring their hygiene products. Some are coerced to engage in transactional sex, which creates long term harm and can lead to unwanted pregnancies, sexually transmitted diseases, and even violence. Transactional sex for period products is a widespread problem, particularly in low-income and marginalized communities. Transactional sex is not only considered an important contributing factor to the disproportionately high HIV infection rates, where hazard ratio – a comparison between the frequency of an event in one group and the frequency of that same event in another group– reached 2.71 in South Africa, but it is also a violation of human rights. It perpetuates gender inequality and leaves individuals vulnerable to exploitation and abuse.

Not being able to afford basic hygienic necessities often results in girls dropping out or missing school or using unhygienic alternatives. Menstruation usually lasts five to seven days, meaning that missing five to seven days of school every month due to menstruation has severe consequences not only for the individuals affected, but also for entire communities. Especially at the elementary and middle school level, missing school may result in girls falling behind and potentially failing, repeating, or not continuing their education. When girls are unable to complete their education, it becomes increasingly difficult for them to find employment potentially leading to limited financial stability.

Another consequence of period poverty is social stigma. In some communities around the world, women and girls may not be welcome to participate in certain places when they are menstruating because of the engrained stigma. For example, some cultures traditions in India and in African countries, women are not allowed to take a bath, cook during their cycle and are sometimes even forced into isolation. In these communities, it is often believed that people who menstruate are unclean or impure resulting in harsh and dangerous consequences. Furthermore, relying on unhygienic alternatives such as reusing pads and using homemade products can pose serious health risks to women and girls, ranging from urinary tract infections to infertility to life-threatening infections like Hepatitis B. It is important for communities to work together and overcome this false stigma to ensure that women and girls have access to the resources they need to maintain their health and achieve their full potential.

The United States has played a pivotal role around the world in reducing the negative health and educational impacts that period poverty brings. The U.S. Agency for International Development (USAID) has targeted several African countries that are the most affected by period poverty. Specifically, USAID has worked in West and Central African countries by offering women’s health services. For example, USAID’s Breaking Red Project, centered in Malawi, provides reusable sanitary napkins, teaches participants how to make their own sanitary napkins if store bought ones are unattainable, and trains them on menstrual hygiene and menstruation management. To date, 310 girls have been trained and 2,500 reusable sanitary pads have been distributed, resulting in an 80% increase in school attendance among girls after the culmination of the project.

Another contributing factor to period poverty is not having access to a safe and sanitary toilet. USAID has also worked to address this issue and has partnered with local communities in Guatemala to install a new water system. Additionally, USAID has partnered with the WASH project in Haiti to provide private toilets and changing rooms to meet menstrual hygiene needs

USGLC’S partners and other private sector companies alongside the public sector, are working to fight period poverty worldwide, including Sesame Workshop, Global Communities, Procter & Gamble, and Population Services International. PSI, for example, invests in programs devoted to raising awareness of menstruation and menstrual stigma and has trained clinicians to build capacity and address menstrual disorders. Through their Girl Talk program, Sesame Workshop implemented educational workshops in Zimbabwe for boys and girls for menstruation, hygiene management, and pubertal health. Global Communities has helped women and girls in Ghana and Botswana by organizing educational sessions around dieting during menstruation, management of menstrual cramps, and reproductive health. Additionally, Global Communities provided each menstruator with leak proof underwear, towels, and menstrual trackers. Through the Always Keeping Girls in School program, P&G has donated more than 13 million pads to menstruators in South Africa, Kenya, and Nigeria since 2008 and continues to send period products to this day.

Period poverty is a serious challenge that can have far-reaching implications for national stability, including for the economy. By addressing the consequences of period poverty, countries can positively impact economic growth by increasing the employment opportunities of all its citizens. The lack of access to menstrual products can prevent menstruators from leaving their homes, limiting their ability to work. However, by providing all people who menstruate access to these products, individuals can maintain steady employment and complete their education, increasing their ability to get and hold down a job. In addition to the economic benefits, ensuring access to menstrual products can also improve the overall health and well-being of menstruators which can lead to a stronger local economy.

Period poverty is a global issue and during Women’s History Month it is crucial to highlight its severity. Efforts are being made to address the poverty cycle, but we must recognize the life-changing impact of foreign assistance in supporting menstruators. Menstruation is a natural process and managing periods should not present obstacles. Individuals should be given support to maintain healthy menstrual hygiene. Through public-private partnerships and development investments around the world, the U.S. has taken a significant step forward to empower women and girls so they can safely break the cycle of period poverty and live healthier, more prosperous lives.