The shame of the sorry state of our menstrual hygiene facilities
A poster used to educate girls about menstruation and the female reproductive system.
What you need to know:
- The prevailing situation adds obstacles to women from participating in normal life activities such as education and sport.
- A newly released assessment report shows deeply inconvenienced women due to a lack of period facilities in communities, households, and schools.
Menstruation is a normal and healthy part of life for most women and girls. The experience should be a smooth and friendly one. It is, however, not so for millions of Kenyans, especially in resource-starved rural areas and informal settlements.
The lack of period facilities such as disposal bins, clean water, and toilets is adding "obstacles" to women from participating in normal life activities such as education and sport.
“We have a lot of challenges at the community level when it comes to access to issues such as clean water, soap, and disposal facilities for basic hygiene,” Lucy Wanyama, a nurse and Gem sub-county reproduction health coordinator, Siaya County, says.
Except for affluent homes, corporate offices, and institutions with a constant supply of clean running water, soap, and sanitary disposal bins, most homesteads, schools, and other public places in Kenya lack such facilities—compromising on the hygiene and convenience for millions of females within the menstrual age of 10 to 49.
“When you check around most households and public spaces and you realise how challenging it is for women. There is a lack of friendly facilities for periods from the basics such as private changing points to handwashing points or even disposal points,” Ms Wanyama adds.
Inconvenience
A newly released assessment report by the USAID-funded Western Kenya Sanitation Project (WKSP) captures the sorry state of period facilities in the region—a situation that widely replicates nationwide. The study—conducted in eight counties, including Siaya, Busia, Kakamega, Bungoma, Kisumu, Homa Bay, Kisii, and Migori—shows deeply inconvenienced women due to a lack of period facilities in communities, households, and schools.
The majority of women aged 15–49 covered in the survey changed their used menstrual pads in latrines (55 per cent), followed by bedrooms (32 per cent) and bathrooms (12 per cent).
Only 59 per cent had regular access to water for general hygiene in the household hence the limited supplies coupled with low knowledge of menstrual hygiene meant that only 37 per cent washed their hands every time before changing period materials, while 83 per cent washed after doing so.
Further, only slightly more than half (58 percent) used soap every time—an indication of the risks posed by lack of the item which is critical in limiting urinary tract infections.
A separate case study by the World Bank on the menstrual health and hygiene environment in Kenya confirms the challenges caused by the lack of friendly period facilities.
The multilateral lender says that although Kenya stands out with its comprehensive policies and regulations related to menstrual health and hygiene, including being one of the first countries to have introduced tax reforms to cut the of menstrual hygiene products, concerns remain about lack of period-friendly facilities.
“In relation to supportive facilities, for instance, a study of 62 rural primary schools found that most schools (84 per cent) had separate latrines for girls, but the majority (77 per cent) had no lock, which is critical for privacy,” it said in the case study report published in August 2022.
The World Bank study showed that only 13 per cent of schools provided water in or near the girls’ latrine, which is necessary for hygienic purposes, while only 32 per cent of schools surveyed had a private place for girls to change.
“Inadequate female-friendly infrastructure does not only cause an inconvenience for women and girls in managing their menstruation but also exposes them to the risk of gender-based violence. In an informal settlement within Nairobi, 68 per cent of women reported experiencing violence, in part due to limited access to private toilets,” it says.
Pads disposal
The shortage of period-friendly facilities also extends to waste disposal facilities such as special pits or incinerators. The WKSP study said the majority of women disposed of their preferred single-use menstrual pads into latrines or toilets (93 per cent), while almost all women (96 per cent) reported to have disposed of the materials the way they had wanted.
Before disposal, most of the respondents (45 per cent) wrapped them in plastic bags, while 28 per cent did not wrap them at all, then disposed of them in the latrine (85 per cent).
“Pit latrines dominated the waste disposal places for the used pads. Other places where used pads were disposed of included bushes, and rubbish pits, while for some girls in schools, it was in bathrooms and sometimes in hidden places of the school compounds. There were negative cultural perceptions attached to the disposal of menstrual hygiene waste in some communities,” the report said.
A World Bank report estimates that every year an average woman trashes about 150 kilogrammes of non-biodegradable waste.
“Poor menstrual waste disposal at the household level largely attributed to lack of facilities (garbage collection, pre-defined menstrual pits, etc.), negative cultural perceptions towards certain waste disposal mechanisms (e.g. burning the pads). This was exacerbated by lack of education on the importance of proper menstrual waste disposal and its impact on the environment,” the assessment report by Research Triangle Institute through WKSP said.
The predominant disposal of used non-biodegradable menstruation material such as sanitary towels in pit latrines is however becoming contentious amid growing concerns on the cost implications of recurrent emptying of the filled-up pits.
“Most exhauster service providers in Nairobi charge a minimum of Sh6,000 per latrine depending on the location though the charges tend to be more when the pits a filled with items such as sanitary towels. You realise the exhausters cannot suck out solid materials such as sanitary pads and we have to hire menial workers at an extra cost to first pull them out before the remaining waste could be pumped into our tankers,” Peter Methu, an exhauster service provider in Nairobi, says.
Many landlords, especially in the densely populated informal settlements, now prohibit their tenants from disposing of their used sanitary material into pit latrines to curb the cost of exhauster services—a shift that is fanning a waste management crisis for women that have no alternative points to dump such material.
Also read: Break barriers to menstrual health, hygiene
Angela Lukoye, a resident of Nairobi’s low-income Kariobangi North estate, says they now place a disposal bag in two shared tiny toilets and rely on a private waste collector to empty it for Sh20.
“Right now, one of the toilets is filthy, so we all are lining up to use the other toilet. But it is only a matter of time before this other one becomes dirty. Apart from throwing the pads on the floor, they stuff them in the tiny ventilation holes on the toilet walls, when the sack is full or when they don’t want to touch it,” the mother of three says.
The effect of the lack of waste management facilities is already being felt in many informal settlements and densely populated estates in Nairobi.
A spot check in estates such as Kariobangi North, Umoja, and Pipeline reveals hasty dumping of sanitary towels and other materials such as tampons. The materials have become a common site in trenches and rivers or even footpaths and back alleys across the city.
“They’re everywhere. When you walk around many parts of high population settlements in Nairobi today you will likely bump into material such as used pads or tampons because of lack of proper disposal facilities,” quips Ms Lukoye.
The World Bank, in its case, said inadequate female-friendly infrastructure also exposed women to risks of gender-based violence, especially in cases of shared toilet facilities as is widespread in informal settlements.
“Inadequate female-friendly infrastructure does not only cause an inconvenience for women and girls in managing their menstruation but also exposes them to the risk of gender-based violence. In an informal settlement within Nairobi, 68 percent of women reported experiencing violence, in part due to limited access to private toilets,” it said.
The WKSP study recommends a scale-up in the provision of menstrual health management facilities, including access to adequate and safe water, sanitary facilities, changing rooms, handwashing facilities, and designated disposal facilities for women and girls, including those living with disabilities.
“The goal is to attain favourable menstrual hygiene management outcomes that ensure women and girls manage menstruation hygienically, freely, with dignity and without stigma,” it says.
It urges county governments to establish and provide proper menstrual waste management systems and infrastructures for waste storage, collection, transportation, treatment, and final disposal.
