Menstrual Hygiene Management (MHM) is not merely a matter of personal health-it is a keystone in the arch of gender equality and educational equity. In Bangladesh, we stand at a critical juncture where the need to address MHM is not only urgent but imperative for the socio-economic upliftment of our society.

The Overlooked Crisis of MHM

Defined by WHO/UNICEF as the practice of using clean menstrual management materials to collect menstrual blood, ensuring privacy, and using soap and water for washing the body as required, MHM is a public health issue with far-reaching consequences. Poor MHM is linked to cervical and urinary tract infections and can significantly impact reproductive health (The Lancet Public Health, 2020). Moreover, the issue of menstruation is inextricably linked to educational attainment and gender equality. UNESCO reports that girls missing school due to menstruation contribute to gender disparities in education. Yet, in Bangladesh, a staggering 89% of girls use cloth, often reused, for menstrual management (Water Aid Bangladesh), and only 36% of adolescent girls are aware of menstruation before their first period.

The Cultural and Educational Landscape

The current landscape of MHM in Bangladesh is characterized by deep-rooted cultural taboos, inadequate facilities, and a lack of comprehensive education. These cultural beliefs often lead to menstruating women being considered impure and facing various restrictions (BMC Women's Health, 2018). The practical implications are grave-only 6% of schools in Bangladesh have a menstrual waste disposal mechanism (BRAC, 2016), and there is a lack of comprehensive menstrual health education in schools (UNICEF Bangladesh). As a result, adolescent girls in Bangladesh miss an average of 6 days of school per month due to menstruation (UNESCO), a disturbing statistic that speaks volumes about the silent epidemic affecting our future generations.

The Path Forward

As a representative of World Vision Bangladesh, we call upon all stakeholders-government, civil society, educators, and the healthcare community-to unite in transforming our approach to MHM. We need to develop and implement comprehensive strategies that incorporate evidence-based practices and are sensitive to the cultural context of our communities.

Firstly, we must increase the accessibility and affordability of sanitary products. The recent MHM roundtable discussions hosted by World Vision Bangladesh revealed the need for adaptable programs, particularly for marginalized groups such as girls and women with disabilities. We must also dismantle the taboos through targeted education and awareness programs that involve both genders, respecting and navigating cultural norms sensitively.

Secondly, policy changes at the national and local levels are essential. We need to strengthen monitoring systems in schools and disaster shelters and develop a line ministry/inter-departmental coordination mechanism with an appropriate budget allocation to support MHM initiatives.

Lastly, we must build advocacy campaigns that include the voices of those most affected by MHM challenges. This includes increasing family dialogue, engaging males in discussions, and leveraging media platforms for impactful storytelling.

A Collective Journey toward Inclusivity

The challenge of MHM is not one to be faced in silence. It is a collective journey toward inclusivity and understanding. Through strategic advocacy, policy reform, and community engagement, we can ensure that no girl in Bangladesh has to compromise her health, education, or dignity because of menstruation. Let us pledge to bridge the gap in MHM and herald a future where menstrual health is not a barrier but a gateway to opportunities for all girls and women in Bangladesh.

World Vision Bangladesh works with more than 150,000 adolescent girls improving their access to menstrual hygiene.

Dr. Rahul Mathew is the Deputy Director - Resource Development, World Vision Bangladesh.

Rahul can be reached by email: dr.rahulmathew@gmail.com