Advancing Menstrual Equity at the Intersection of Self-Care and Universal Health Coverage

Haley Millet, Advocacy and Program Manager, Days for Girls International

This year on Universal Health Coverage (UHC) Day, achieving the Sustainable Development Goal (SDG) of good health and wellbeing for all by 2030 may feel formidable — especially in light of the impacts of the COVID-19 pandemic. As the UN highlights, the pandemic has “exposed long-ignored risks, including inadequate health systems, gaps in social protection and structural inequalities.” On this day, we implore SDG stakeholders to focus on equity, to “leave no one behind: invest in health systems for all”.

For women, girls, and people who menstruate*, inequity in access to supportive health environments may seem rather self-evident: an estimated 500 million people worldwide do not have what they need to manage their periods. This impacts their ability to attend school, excel in the workplace, engage in family and community activities, and pursue their own goals. 

As a nongovernmental organization that seeks to eliminate the limitations associated with menstruation, Days for Girls International  (DfG) has witnessed firsthand how inequities exacerbated by COVID-19 impact women’s sexual and reproductive health and rights (SRHR) and safety. Working across 22 countries, DfG staff, social entrepreneurs, and community partners advocate to address barriers to menstrual equity in the midst of pandemic. Here, we share five key challenges that menstruators navigate on a monthly basis:

  1. Decreased access to healthcare providers for reproductive health services including care for menstrual discomfort and disorders.
  2. Decreased access to accurate and timely information about menstruation for students during school lockdown.
  3. Decreased access to menstrual products for students during school lockdown, especially for those accessing products through school programs.
  4. Increased risk of early marriage and early or unwanted pregnancy among women and girls due to school lockdown.
  5. Increased exposure to gender based violence (GBV) for women and girls quarantined in abusive households, where menstrual stigma may be cited by abusers as justification for GBV.

As the pandemic shed light on structural inequities in our healthcare systems and barriers to menstrual equity in particular, we also learned how self-care can play a major role in bridging that gap. In fact, women and girls enact an ongoing process of self-care throughout their menstrual cycle. However, the extent to which they are supported to practice self-care varies greatly.

When countries enact UHC policies and regulations to the health system that support people fully utilizing self-care, it puts care in the hands of people and helps reach vulnerable and marginalized groups who have historically been left out. This is especially true for women and girls, who regularly navigate care for the stigmatized conditions of menstruation and menstrual disorders. 

So, what do supportive self-care environments look like with regards to menstruation? Here, we identify three focus areas within UHC that government bodies and decision makers can address in order to bolster self-care for menstruators, paired with policy examples:

Focus AreaSample Policies and Regulations
Improve access to menstrual health information . When women and girls have access to accurate, timely and age appropriate information about their bodies, they are better equipped to make decisions about how to care for menstrual symptoms.
  • Institute a routine menstrual health questionnaire for providers to use during wellness visits, so that disorders may be identified early, patients are invited to ask questions, and patients are equipped with timely information about their MH experiences.
Improve access to a range of menstrual products. In order to manage menstruation with dignity, women and girls require access to a range of certified safe and effective menstrual products so that they can choose the product(s) that are right for them.
  • Implement product standards for all menstrual products on the market as essential products, similar to essential drugs. 
  • Disseminate information and train manufacturers in how to meet these standards. 
  • Develop public health campaigns to educate menstruators about menstrual product options
  • Subsidize provision of menstrual products in public healthcare facilities, secondary schools, universities, and government workplace washrooms.
Improve access to support for physical wellbeing. Women and girls may pursue both at-home remedies for menstrual symptoms including over-the-counter pain relievers, hot compresses, herbal remedies, nutrient-rich foods, and more; however, they may also pursue a healthcare professional which should be available to them.
  • Expand access to telehealth as a component of UHC, especially in rural areas, so that women and girls can discuss their symptoms with a healthcare professional and create a care plan before arriving at a facility.

When decision makers champion policies and regulations like the examples above as an integral part of UHC, women and girls are supported to practice self-care throughout the menstrual cycle. Supportive self-care environments make healthcare for women and girls more accessible, equitable, and user-friendly. Menstruators are equipped to make decisions about how to manage their menstruation, and empowered to act on those decisions, whether or not they involve seeking a healthcare provider.

Achieving health and wellbeing for all by 2030 will be strongly impacted by the extent to which women and girls are empowered to practice self-care. This is a call to decision makers towards supportive self-care policy environments, placing health care in the hands of people, so that no one is left behind.

Days for Girls International (DfG) is an international nongovernmental organization that works to advance menstrual equity by developing global partnerships, cultivating social enterprises, mobilizing volunteers, and innovating sustainable solutions that shatter stigma and limitations for women and girls. We envision a world where periods are never a problem, where women and girls can pursue their goals free from menstrual barriers and stigma.

*These terms are used in reference to people who menstruate, inclusive of all gender identities.

Banner Photo credit: Days for Girls International
Photo description: Students in Mombasa, Kenya hold washable menstrual pad kits produced by Days for Girls social enterprises.

OUR COMMITMENTS

The Future of Work

With overarching commitments to flexibility in our work, and greater wellbeing for our employees, we want to ensure PSI is positioned for success with a global and holistic view of talent. Under our new “work from (almost) anywhere,” or “WFAA” philosophy, we are making the necessary investments to be an employer of record in more than half of U.S. states, and consider the U.S. as one single labor market for salary purposes. Globally, we recognize the need to compete for talent everywhere; we maintain a talent center in Nairobi and a mini-hub in Abidjan. PSI also already works with our Dutch-based European partner, PSI Europe, and we’re creating a virtual talent center in the UK.

OUR COMMITMENTS

Meaningful Youth Engagement

PSI is firmly committed to the meaningful engagement of young people in our work. As signatories of the Global Consensus Statement on Meaningful Adolescent & Youth Engagement, PSI affirms that young people have a fundamental right to actively and meaningfully engage in all matters that affect their lives. PSI’s commitments aim to serve and partner with diverse young people from 10-24 years, and we have prioritized ethics and integrity in our approach. Read more about our commitments to the three core principles of respect, justice and Do No Harm in the Commitment to Ethics in Youth-Powered Design. And read more about how we are bringing our words to action in our ICPD+25 commitment, Elevating Youth Voices, Building Youth Skills for Health Design.

OUR COMMITMENTS

Zero Tolerance for Modern-Day Slavery and Human Trafficking

PSI works to ensure that its operations and supply chains are free from slavery and human trafficking. Read more about this commitment in our policy statement, endorsed by the PSI Board of Directors.

OUR COMMITMENTS

UNITED NATIONS GLOBAL COMPACT

Since 2017, PSI has been a signatory to the United Nations Global Compact, a commitment to align strategies and operations with universal principles of human rights, labor, environment and anti-corruption. Read about PSI’s commitment to the UN Global Compact here.

OUR COMMITMENTS

Environmental Sustainability

The health of PSI’s consumers is inextricably linked to the health of our planet. That’s why we’ve joined the Climate Accountability in Development as part of our commitment to reducing our greenhouse gas emissions by 30 percent by 2030. Read about our commitment to environmental sustainability.

OUR COMMITMENTS

Affirmative Action and Equal Employment Opportunity

PSI does not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, protected veteran status or any other classification protected by applicable federal, state or local law. Read our full affirmative action and equal employment opportunity policy here.

OUR COMMITMENTS

Zero Tolerance for Discrimination and Harassment

PSI is committed to establishing and maintaining a work environment that fosters harmonious, productive working relationships and encourages mutual respect among team members. Read our policy against discrimination and harassment here.

PSI is committed to serving all health consumers with respect, and strives for the highest standards of ethical behavior. PSI is dedicated to complying with the letter and spirit of all laws, regulations and contractual obligations to which it is subject, and to ensuring that all funds with which it is entrusted are used to achieve maximum impact on its programs. PSI provides exceptionally strong financial, operational and program management systems to ensure rigorous internal controls are in place to prevent and detect fraud, waste and abuse and ensure compliance with the highest standards. Essential to this commitment is protecting the safety and well-being of our program consumers, including the most vulnerable, such as women and children. PSI maintains zero tolerance for child abuse, sexual abuse, or exploitative acts or threats by our employees, consultants, volunteers or anyone associated with the delivery of our programs and services, and takes seriously all complaints of misconduct brought to our attention.

OUR FOCUS

Diversity and Inclusion

PSI affirms its commitment to diversity and believes that when people feel respected and included they can be more honest, collaborative and successful. We believe that everyone deserves respect and equal treatment regardless of gender, race, ethnicity, age, disability, sexual orientation, gender identity, cultural background or religious beliefs. Read our commitment to diversity and inclusion here. Plus, we’ve signed the CREED Pledge for Racial and Ethnic Equity. Learn more.

OUR COMMITMENTS

Gender Equality

PSI affirms gender equality is a universal human right and the achievement of it is essential to PSI’s mission. Read about our commitment to gender equality here.

Cover

01 #PeoplePowered

02 Breaking Taboos

03 Moving Care Closer to Consumers

04 Innovating on Investments

ICFP Q&A:
Let's Talk About Sex

icons8-linkedin-circled-240
icons8-twitter-circled-240