Menstrual health & hygiene is a matter of human rights, not a human right
By Mariana de la Roche and Nikki van de Veerdonk
Menstruation is a natural and vital part of the reproductive cycle, experienced by approximately half of the human population. Yet menstruators all over the world are faced with many challenges when it comes to managing their menstruation, often times preventing them from realising their basic human rights, turning the biological fact of menstruation into an obstacle touching various areas of living.
Rather than approaching menstrual health as a separate sector, it is crucial to recognize it a precondition for the achievement of a wide range of affiliated human rights. Menstrual health is a matter of human rights. Making use of the human rights framework is vital when striving to realize universal and inalienable rights for girls, women and those who menstruate.
Menstrual health and human rights: a complex cocktail
According to the United Nations (UN), “human rights are rights inherent to all human beings, regardless of race, sex, nationality, ethnicity, language, religion, or any other status.” In other words, human rights do not address specific issues for a particular type of person. Their primary purpose is to guarantee a minimal array of rights for everyone, everywhere.
In order to define human rights, the UN has established a list of principles that define their qualities. Within this list, emphasis is placed on the universality and inalienability of human rights.
In short, this means that every human being in the world is entitled to human rights everywhere. Further, human rights are interdependent and interrelated: the denial of one right will directly affect the ability to enjoy other rights. To clarify this, the United Nations Population Fund has for instance stated that the fulfilment of the right to health may depend, in certain circumstances, on the realization of the right to development, to education or information.
Therefore, when we talk about human rights, and in particular about the right of health, it is important to keep in mind that this right is fully connected with all other human rights.
As the World Health Organization (WHO) has pointed out, “achieving the right to health is both central to, and dependent upon, the realization of other human rights, to food, housing, work, education, information, and participation.” No one can fully enjoy their rights if they do not have health.
The human right to health creates a legal obligation for countries, “to ensure access to timely, acceptable, and affordable health care of appropriate quality as well as to provide for the underlying determinants of health, such as safe and potable water, sanitation, food, housing, health-related information and education, and gender equality.”
So what is the place of menstrual health within this multiplicity of rights?
Menstruation, and especially menarche, the first period. can be seen as the entry point to female health across the lifecycle: it is connected to sexual and reproductive rights, as well as hormonal health, natal health, breastfeeding, and sexual awareness and wellness, and menopause among others.
Through menstrual health we can also approach topics such as child marriage and female genital mutilation. In line with this, UNICEF’s new 2019 ‘Guidance on Menstrual Health and Hygiene’ underscores the central position that menstrual health has in the bigger scheme of health care:
“Menstrual health and hygiene (MHH) encompass both menstrual hygiene management (MHM) and the broader systemic factors that link menstruation with health, well-being, gender equality, education, equity, empowerment, and rights. These systematic factors have been summarised by UNESCO as accurate and timely knowledge, available, safe, and affordable materials, informed and comfortable professionals, referral and access to health services, sanitation and washing facilities, positive social norms, safe and hygienic disposal, and advocacy and policy.” (UNICEF- Guidance on Menstrual health and hygiene ).
Furthermore, the right to menstrual hygiene cannot be enforced, as hygiene is a personal choice to practice a habit and one cannot claim the right to a habit.
However, MHH can be considered a foundation for the fulfilment of different women’s rights. As mentioned above, MHH is connected to the rights of health, education, gender, dignity, water, and sanitation among others. It requires, taking into consideration the psychological, socio-political, and environmental factors that accompany the menstrual experience.
Women’s rights are, without question, human rights. This does not mean that their rights are different from the rights of men or non-binary individuals. As mentioned above, all humans have an intrinsic and inalienable catalog of rights that they are entitled to, including but not limited to the rights of freedom of expression, health, education, and work. The challenge inherent in enjoying one’s human rights rests in providing equal opportunities to access them. This is particularly of importance when one group of individuals who are entitled to these rights have not been able to enjoy them in the past, like women. Furthermore, menstrual health can be a particular issue for some individuals in particular, such as for those who are not in school, who have disabilities, who are homeless, who are in prison or recently out of prison or transgender males. (United Nations Population Fund).
Applying the human rights framework to menstrual health
According to Inga Winkler, lecturer at the Institute for the Study of Human Rights at Columbia University, applying a human rights’ framework to MHH requires us to “understand and address the lived experiences of all menstruators shaped by marginalization, discrimination, and inequalities, to look beyond access to products and menstrual hygiene to address menstrual stigma; and to address the underlying structural causes of unmet needs”.
This means that we need to consider the lived experiences of women, girls and those who menstruate. There is no such thing as a unique and perfect solution with the power to address all needs in all situations for everyone. It is mandatory to work and develop programs and policies according to the specific realities, needs, and challenges that women, girls and those who menstruate face during their lifetime.
One of the best ways to do this is through participatory approaches and interventions in which there is an active role for the target groups in different phases of the policy process:
- Before the implementation: designing the project and activities with them;
- During the implementation: making them part of the decision making process during the execution of the project, and
- After the implementation: allowing them to provide feedback to support the evaluation of the project.
Furthermore, the distribution of products such as tampons, pads, and cups among the population needs to be connected to research baselines that show which kind of knowledge gaps exist in specific regions, countries or geographical areas. In addition, we also need to generate educational programs that work in parallel with the interventions.
In the case of menstruation, we need to understand that there is no perfect product that can match the needs of every single woman. Solutions are as diverse as the people seeking them.
Thus, the responsibility of organizations and governments working around MHH is on one hand to educate and inform people by using evidence-based information about their choices and on the other hand to create the opportunity for people to access all of those options. These two acts together enable the population to make informed choices about their own bodies and health.
Therefore, we need to work at a structural level to understand which negative beliefs and behaviors we perpetuate in our societies that prevent women from realizing their universal and inalienable rights. In order to see change, we must identify with which stakeholders we need to work and on which level (community, political, etc) so that the policies and interventions are aligned to the realities on the field. This can variate from stressing the importance of menstrual health education and the impact of menstruation on child marriage and female genital mutilation/cutting, to providing access to infrastructure and products to manage menstruation and the option for menstrual leave in the work environment.
Understanding MHM within the context of the human rights that menstruators are entitled to will open the door to more evidence-based interventions and policy regulations. Human rights are negatively impacted when women and girls face challenges when managing their menstruation, but the same human rights are also the solution in eliminating those challenges.
Menstrual health and hygiene can be considered a precondition for the fulfilment of different human rights, so rather than approaching menstrual health as a separate sector, it is crucial to recognize it a precondition for the achievement of a wide range of affiliated human rights.
This makes menstrual health ultimately a matter of human rights, for its intimate connection with the effective enjoyment of a multiplicity of rights such as health, education, work and water and sanitation.
For more information, please get in touch with our Chief Policy Officer, Mariana de la Roche at mariana@mhhub.org
