Female health and hygiene issues surrounding menstruation are a serious public health concern in Pakistan. Owing to the prevalent patriarchal culture and conservative mindset, female menstruation is often thought of as something unclean and dirty. Myths and taboos surrounding the issue make it impossible for it to be openly discussed and as a result, Pakistani women remain deprived of proper hygiene and menstrual education. In South Asia, 66%13 of girls reported being unaware of menstruation before they experienced their first period. Period poverty in Pakistan is not only limited to financial accessibility to sanitary products but also extends to social poverty where women are deprived of opportunities to discuss their health problems and get educated about their bodies. Period poverty can thus be defined as the lack of access to sanitary products and the lack of awareness of menstrual hygiene education. In urban and poverty-stricken rural areas alike, lack of awareness about Menstrual Hygiene Management (MHM) is a challenging issue. Women and young girls are not only misinformed about many issues regarding their periods but are also made to feel ashamed and embarrassed of discussing their issues openly. Successive governments have also failed to make any significant changes in this regard since the issue has never been part of the mainstream public discourse and has been overlooked. Women make up half of Pakistan’s current population; for them to contribute towards a better society, their health needs should be properly addressed. The following article aims to highlight how period poverty affects the lives of Pakistani women, especially young teenage girls and what potential measures the Pakistani government can pursue to alleviate period poverty in Pakistan.
Factors affecting female livelihoods
Due to lack of proper menstrual hygiene products, the majority of women confine themselves to their homes or their rooms. Not having access to sanitary products like pads, tampons or menstrual cups, affects their mobility to a great extent. Often they become dependent on others for tasks they could otherwise carry out themselves. In a study carried out in urban Karachi, 60%14 of the participants admitted to have avoided social interactions and limiting their movement during menstruation.
Countless young girls suffer academically because they are unable to afford sanitary pads or lack adequate knowledge about how to deal with symptoms that occur during the premenstrual and menstrual stage of their cycle, for instance, they would be unaware of what medication should be taken to alleviate menstrual cramps, in some cases, they might even be discouraged to do so as it would somehow make them less of a woman if they wouldn’t withstand the pain. Thus for several days of the month, they are willing or unwilling compelled to stay away from their school, which has terrible implications on their academic learning and success.
Due to unhygienic practices of reusing dirty rags as alternatives to disposable products like pads or tampons leads to many vaginal infections in many girls and women. Urinary Tract Infections (UTIs) can also be considered one of the common causes of infertility in many young women. If left untreated it can also lead to acute renal failure due to the body experiencing septic shock and resulting in death. As a result of common misconceptions regarding menstruation, many girls also avoid taking bath during their days due to the fear of infertility, worsening their hygiene. Many girls also suffer from iron deficiencies and undiagnosed anemia15, which can cause weakness and lethargy during their periods when they experience excessive flow. These issues can easily be cured with proper diagnosis and supplements.
Measures to be undertaken
Awareness campaigns can play a very important role in ensuring that stigmas and misinformation around menstruation are eliminated and menstrual issues rather than being snubbed and dismissed become a part of public discourse. UNICEF WASH, a program that ensures universal and affordable access to water, sanitation and hygiene and Ureport, a social messaging tool and data collection system designed by UNICEF are actively working towards spreading awareness and knowledge through online live chat sessions where both men and women are encouraged to ask questions and share their experiences regarding menstruation.16 According to a study carried out by U-report in Pakistan, 49%17 young girls had no knowledge about menstruation prior to their first period. The inclusion of menstrual issues and hygiene should be made a compulsory part of the curriculum for young girls and boys in schools and colleges. Instead of stigmatizing issues related to reproduction, sexual health and fertility, governments should encourage that these issues should be taught and talked about for the betterment of the society. And for this matter community leaders, especially religious leaders, can also be sought so that they can effectively engage with the people in their communities to promote healthy conversations regarding the issue.
Products like pads and tampons remain beyond the reach of many women due to financial constraints. These women mostly rely on using and reusing rags, towels or cheap cotton sheets which are friendlier on their pockets but remain a large concern in terms of hygiene. According to a study carried out by WaterAid, an international NGO working towards water and sanitation in Pakistan about 82% of girls interviewed used cotton cloth. In comparison, only 15% of the girls surveyed reported using sanitary pads.18 Educating women about hygienic measures that they can take in order to properly dispose off, sanitize and disinfect their choice of items can prove to be beneficial for them. Menstrual cups, despite being a cheaper and more environmentally sustainable option, are not welcomed by many due to myths and taboos around them. Myths around them can only be dispelled through proper engagement with women. Through these engagements, they can be made aware of its use and its practicality while also having their religious and cultural concerns being addressed.
Elimination of Tampon tax
Over the years feminine movements around the world are pushing towards tax exemptions for menstrual hygiene products. New Zealand recently passed a legislation that ensures access to free sanitary products around the country meanwhile in places like the United Kingdom and India tax reforms to eliminate tax on sanitary products were introduced to fight period poverty. The charity Bloody Good Period estimates the average lifetime cost of having a period amounts to £4,80019 (Rs. 1118673.29) in the UK. For a developing country like Pakistan the costs can easily double up since most sanitary napkins in the market are imported and also subjected to multiple taxes. The government of Pakistan can abolish all taxes on sanitary products to bring the prices down for if not all then some consumers.
Subsidised quality products
Access to quality menstrual hygiene products should be treated as a basic necessity for all women and not as a luxury that only a handful of the women population could afford. Supporting local manufacturing companies and ensuring the availability of menstrual products in all public buildings, schools and universities could make the lives of countless women and girls better.
Period poverty is a prevalent yet an often neglected issue around the world. As of 2020, Pakistan’s population is estimated to be around 220,892,33120, with women constituting 48.5%21 of this estimate. With an ever-growing population Pakistan has done very little in terms of addressing female health and hygiene issues surrounding menstruation. With the ongoing pandemic, the financial situation of many households has worsened, with many people having been laid off from their jobs. In today’s age, women and men need to contribute equally towards the well-being of their households and the community at large. Women still remain a largely untapped resource in terms of Pakistan’s workforce. Period poverty affects women from both a financial and a societal point of view. While mitigating period poverty might not undo all the obstacles and problems women face but it can surely help in empowering them to gain a certain autonomy in their lives. To curb the issue, the conversation around periods needs to become part of the public discourse, only then could it be ensured that women in Pakistan have access to adequate information about MHM and menstrual products. By utilizing technology and framing progressive policies, government and citizens alike, can work toward eradicating period poverty in Pakistan.
About the Author
Neesa Abbas is co-editor of Student’s Quarterly and is currently a student of MPhil Public Policy at CPPG. Her research interests include identity politics, social activism, institutional reforms, and women & minority rights.
Ali, Tazeen S. & Syeda Naghma Rizvi. “Menstrual knowledge and practices of female adolescents in urban Karachi, Pakistan.”, Journal of Adolescence 33(4), 0–541. (2010) https://www.sciencedirect.com/ science/article/abs/pii/S014019710900075X Hafeez-Ur- Rehman, Hira. “U-Report Encourages Menstrual Health In Pakistan”, UNICEF. (2017) www.unicef.org/innovation/U-Report/ menstrual-hygiene-innovation-challenge-pakistan Hanifen, Katharine. “5 Facts About Menstrual Hygiene In South Asia.”, The Borgen Project. (2019) https://borgenproject.org/5-factsabout-menstrual-hygiene-in-south-asia/ Laborderie, Cécile & Deepa Shakia & Rehana Shaikh. “Ensuring girls’ rights through school-based WASH and improved menstrual hygiene management (MHM) in Nepal and Pakistan.”, WaterAid. (2018) https://www.wateraid.org/pk/sites/g/files/jkxoof326/files/endreview-report–pakistanpdf.pdf Period Poverty: What Is It & How Can We Help? https://yoppie.com/ period-poverty Somani, Anushka. “Combating Period Poverty In Pakistan.”, The Borgen Project. (2021) borgenproject.org/period-poverty-in-pakistan/ Total Population, Pakistan. The World Bank. (2021) data.worldbank. org/indicator/SP.POP.TOTL?locations=PK