Managing menstruation among women and girls with disabilities
“Getting menstrual pads that work for my type of disability remains one of my biggest challenges. I use a wheelchair, and that means that I sit most of the time. When I am menstruating, it’s difficult because I press the pad most of the time, and end up having blood spots on my clothes. To avoid that I use underwear-like pads, and they are very expensive. They are priced at Sh2,000 apiece, and you need at least Sh38,000 for one pack. That is very expensive. Most of us with disabilities come from poor families, and we can’t afford that kind of monthly spending” – Witness, a college student in Tanzania
According to the World Health Organization (WHO), there are more than 2 billion disabled people in the world. The WHO defines a disabled person as anyone who has a problem in body functioning or structure, activity limitation, difficulty in executing an action or task, or with a participation restriction. In Tanzania, there are approximately 3.2 million disabled people, which is about 7.8 percent of the population aged seven and above. Moreover,13.2 percent of Tanzanian homes have at least one member with a disability, according to CCBRT.
People with disabilities are often among the most marginalised and poverty-stricken in the country. Disabilities increase the challenges faced in accessing services, including education and healthcare, as well as acquiring meaningful employment.
It is estimated that at least 300 million women and girls globally menstruate each month, although the experience is different from one woman/girl to another. Menstruation is a natural and normal healthy part of women’s and girls’ lives. Yet, the menstrual experience is steeped in strong taboos that lead to extreme stigmatization. As a result, many women and girls are unable to receive the right information at the right time and cannot speak freely about topics surrounding menstruation.
Furthermore, little space is given within communities to discuss menstrual topics, therefore preventing both men and women from learning, or sharing experiences about healthy menstruation. In addition to stigmatization, menstruating women, and girls face challenges in accessing adequate menstrual services and products. Having a disability adds another layer of difficulty. Women and girls with disabilities often have more negative menstruation experiences compared to non-disabled women and girls. Some experience more pain, heavier periods, and mood swings compared to non-disabled women.
During a Menstrual Hygiene Day event, Ms Blandina Sambu from the women’s wing of the Tanzania Federation of Disabled People’s Organisations (Shivyawata) said women and girls need information to make the right decisions on what product to use and how. However, even when the information is available, it does not include topics relevant to them nor use the language that responds to their specific disability challenges.
According to Ms Sambu, women and girls with disabilities not only face challenges with regard to access or affordability, but also lack the right menstrual information. Most of the programmes on menstrual issues treat women as one group, leaving disabled women invisible.
In most cases, some types of menstrual products might not work for a certain type of disability. For example, it can be challenging for some women with limited hand function to insert and remove a tampon or menstrual cup may. This may not be possible at all for some. In some cases, women with cerebral palsy might use tampons without any problems, but have challenges using menstrual cups because of a lack of muscular strength.
“Other types of disability make menstruation more challenging. For example, if you must exert yourself to walk, that increases the possibility of heavy periods, and that means using more menstrual pads compared to other women and girls. All these are factors that need to be considered when making or designing menstrual pads, particularly for women and girls with disabilities,” said Witness, a college student in Tanzania.
Apart from product use, maintaining hygiene can also be challenging as most infrastructure does not support all disabilities. For instance, washing and changing can be challenging for people with limited physical capabilities.
Therefore, as we advocate access and affordability for menstrual hygiene products, as we advocate for change in policies and strategies, as we advocate against discrimination and wanting menstruation to be a discussable topic, it is important that women and girls with disabilities are actively included. This entails understanding their specific needs and challenges.
Multi-stakeholder approaches should include a wide range of actors and institutions, starting with women with disabilities, youth, the private sector, decision-makers, CSOs working on gender, sexual reproductive health and rights, and other relevant groups to ensure disability needs and concerns are taken care of.
Programmes on menstrual hygiene management must ensure that every girl and woman with disability can manage her periods safely and with dignity. Moreover, all types of disabilities must be considered in the design, implementation, and evaluation of programmes addressing menstruation hygiene. All women and girls have the right to enjoy a healthy and safe menstrual experience, including those with disabilities.
