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COVID-19: A Menstrual Health Crisis in sub-Saharan Africa

Author: Rina Rossi

The BRB Bottomline

While the COVID-19 pandemic has posed difficulties globally, menstruators and young girls in sub-Saharan Africa have been hit particularly hard by the pandemic due to period poverty. Sub-Saharan Africa’s financial struggles during the pandemic, which have exacerbated period poverty, is a threat to women’s healthcare, mental well-being, gender equity, and autonomy.


Period poverty, menstrual-related inequity resulting from lack of access to menstrual products,  affects sub-Saharan Africa at great scale due to the extreme levels of  poverty many women in the region face. In sub-Saharan countries only 27 percent of people have access to basic sanitation, with some women being forced to trade sex for menstrual products under extreme circumstances. As a result of the lack of basic sanitation, Sub-Saharan African menstruators are prone to developing reproductive diseases, like pelvic inflammatory disease. Also, 65 percent of women in Kenya find menstrual products too expensive to purchase. Some studies have found that girls miss up to 20 percent of school days annually in sub-Saharan Africa due to period-related complications. Period poverty is a health crisis in sub-Saharan Africa, and its detrimental effects are only being exacerbated during the COVID-19 pandemic.

Taboos against menstruation have existed across most cultures throughout history. Stigmatization against menstruation can be found in the Qur’an, Bible, and first Latin encyclopedia (73 AD). As a result of widespread historical precedent, women’s menstrual and reproductive health lack adequate resources and attention in sub-Saharan Africa, even when a large portion of their population’s menstruators cannot afford menstrual products. 

Though menstruation has been a taboo for eras, and period poverty has been disproportionately affecting developing regions like sub-Saharan Africa, menstrual-related inequalities  have been  exacerbated by COVID-19. Access to social services has declined during the pandemic, limiting access to education and resources that would normally help women  manage their periods. Women in the Sub-Sahara often rely on schools or community spaces to access free menstrual products, and, consequently, around 50 percent of school-age girls in Africa have not had access to menstrual products during COVID-19.

Further, because of social distancing, there is restricted movement in Kenya, which has led to the closures of businesses and damaged the national economy. Given  these financial circumstances, many Kenyan women cannot afford to buy food or care for their children, and therefore lack adequate money to afford menstrual products. Based on a recent Population Council study in which five informal Kenyan slum settlements were surveyed, it was discovered  that women cited the pandemic as posing difficulties on their personal menstrual product accessibility. One-third of women in the settlements stated they could no longer afford menstrual products. Additionally, school closures have had a detrimental effect in Kenyan menstruators’ access to free menstrual products. Due to the launch of the Sanitary Towels Programme in 2011, four million Kenyan girls receive free menstrual products at school through the government-funded project. Obviously, as a result of school closures, Kenyan girls are unable to take advantage of the resources the Sanitary Towels Programme provides. 

In order to combat this rising period poverty in sub-Saharan Africa during the COVID-19 pandemic, the Kenyan government needs to comply with UNICEF’s guidance on mitigating the impacts of COVID-19 on menstrual health which details “essential considerations to ensure continued [menstrual health and hygiene] during the pandemic” Specifically, the brief suggests  that communities have basic access to sanitation facilities, and urges countries to deem menstrual products as essential items, as well as eliminate barriers to the manufacture and supply of menstrual products. Interestingly, the Government of Kenya approved the Natural Menstrual Hygiene Policy (MHM) on 21 November 2019, prioritizing disadvantaged and vulnerable menstruators in the country. While the policy is new, it was not until the COVID-19 pandemic that the policy began to make measurable strides to combat period poverty. Since then, it is on a fast track to be implemented due to the unprecedented difficulties COVID-19 placed on menstruators. Additionally, Rwanda removed the Value Added Tax (VAT) on menstrual products in an effort to mitigate the effects of menstrual inequity. This is a huge step forward for menstruators, but many Rwandan menstruators still find it difficult to afford menstrual products, as each pack of menstrual pads still costs $0.325, a price that impoverished Rwandan menstruators find difficulty affording, especially as they need to buy multiple packs per menstrual cycle. Similarly, South Africa removed the value-added tax on menstrual products, but this has not removed the financial burden that menstrual poverty poses on South African menstruators. Dr. Victoria Feyikem, team lead of the NGO African Development and Empowerment Foundation, explained that, “removing VAT on menstrual hygiene products is a kind gesture, but it will not make the prices … fall to the level where everyone will be able to afford them without any government or donor support,” emphasizing the seriousness of menstrual inequity on impoverished menstruators. 

Period poverty is already an extremely stigmatized issue worldwide. With the COVID-19 posing employment and financial issues, the pandemic is resulting in more and more young women suffering from adequate access to clean products put into their bodies, missed opportunities for education, and even some young women entering prostitution when needing to trade sex for menstrual products. This is a threat to women’s healthcare, mental well-being, gender equity, and autonomy. However, menstrual inequity in sub-Saharan Africa is also a product of extreme poverty in the region. 40 percent of Sub-Saharan Africa lives in extreme poverty, and the region’s range of poverty rates has hardly narrowed from 1990-2018. Additionally, a 2020 Poverty and Shared Prosperity report shows that the Sub-Saharan African poor are more likely to be subject to threats of climate change and conflict. Furthermore, using the Gini Index, where there has been a 2 percent increase in the index, the additional poor in Sub-Saharan Africa is projected to increase from 32 million to 42 million as a result of the COVID-19 pandemic. As a result of extreme poverty being highly prevalent in Sub-Saharan Africa, period poverty seems like an inevitable issue, as period poverty is also widespread in Southeast Asia, a region that is projected to push 15 million people into poverty as a result of COVID-19. Thus, it is important that countries and NGOs like the International Monetary Fund provide aid to Sub-Saharan Africa in order to reduce regional poverty and mitigate the detrimental effects that extreme poverty has on its people, such as their low-income menstruators. Along with financial aid, schools and education systems must also work to de-stigmatize and normalize the natural cycle of menstruation, so that all menstruators can afford adequate sanitary products.