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  • Ghazala Shahnaz

Menstrual Hygiene in Resource-scarce Settings: Insights from South Sudan

Did you know that more than half of the schoolgirls in South Sudan miss school every month which leads to eventual dropouts? The majority of females are not using menstrual hygiene products, while a proportion of them reported using old clothes or rags. They either buried their menstrual waste or threw it away in floodwaters.


What is MHM? Why does it matter?

Menstrual Hygiene Management (MHM) refers to the practices and measures of hygiene associated with the menstrual process. WHO and UNICEF Joint Monitoring Programme (JMP) for drinking water, sanitation, and hygiene has used the following definition of MHM: ‘Women and adolescent girls are using a clean menstrual management material to absorb or collect menstrual blood, that can be changed in privacy as often as necessary for the duration of a menstrual period, using soap and water for washing the body as required and having access to safe and convenient facilities to dispose of used menstrual management materials. They understand the basic facts linked to the menstrual cycle and how to manage it with dignity and without discomfort or fear.’

The Challenges of MHM in South Sudan:

MHM is a critical yet often overlooked aspect of public health, particularly in regions like South Sudan due to a combination of factors such as cultural taboos, limited resources, inadequate sanitation facilities, limited access to menstrual products, and a lack of comprehensive education on menstrual health. All these factors lead to adverse health outcomes, including increased risk of infections, sexual and reproductive health problems, social exclusion, and gender inequality among menstruating individuals.

A recent study was conducted by ETCH consultancy titled “Process Learning of Christian Aid’s DEC COVID-19 Appeal in South Sudan” in  Ayod and Fangak Counties using a mixed-methods approach. Data from household surveys, Key informed interviews, and FGDs shed light on the challenges faced by the females of South Sudan. It reveals the gaps regarding access to menstrual hygiene products, their disposal as well as awareness of the issue. The study further navigates the taboos and other issues attached to the process of menstruation. 

According to the baseline survey conducted, most girls in South Sudan tend to drop out of school at the age of puberty.  This survey also reveals that, on average, 61.1% of schoolgirls in South Sudan skip school for four to eight days during their menstrual periods, thereby missing out on education every month and eventually leading to dropouts. The reasons cited were a lack of privacy, and proper sanitation and hygiene facilities intertwined with a lack of government support. It not only impacts their education but also leads to poverty and inequality.

Further, the taboo associated with menstruation compounds the problem. According to the data from this study, a staggering 41.39 % of the females answered that they do not talk about periods publicly, 27.79% answered this topic is not addressed in their household, even 10.27% chose not to answer the question, only 20.54% agreed on an open discussion at the community level. 

During interviews, several female respondents stated that they do not use sanitary pads because either it is not available or they are unaware of these products themselves. Some respondents said they chose to ‘let it flow’ or ‘stay away from men’ during those days. Our survey says that nearly 60.1% of the female respondents do not have access to any menstrual hygiene products.While only 17.6% use the materials that are available easily - including old clothes and rags. 

Around 82.42% of females did not attend any educational institutions. They  practise the age-old methods that have passed on them in the disposal of menstrual hygiene products. 40.8% of the females hide them away, 25.7% bury them, 13.2% burn them, 12.8% wash them for reuse, and 1.9% throw them away. 

Strategies for improving MHM in South Sudan

In this study, 23.19% of female respondents suggested that menstrual hygiene awareness provided to their spouses would help them deal with menstrual hygiene in a culturally and respectfully open situation. Additionally, rightful usage and disposal of sanitary pads, and counselling is crucial in managing their menstrual hygiene needs better.

So, as per the insights of this research menstrual hygiene management in South Sudan requires a multi-faceted approach that includes strategies like comprehensive menstrual health education programs, reliable access to affordable and hygienic menstrual products, improving sanitation facilities, and engaging family members and community leaders.

Let’s work together and create a better place for women and girls where menstrual hygiene is viewed with respect and dignity, breaking the stigmas and taboos associated with it. 

This blog is written by Ghazala Shahnaz  MPH, MPT

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