Menstrual health during COVID-19: How water, sanitation, and hygiene strategies can improve menstrual health and hygiene and foster gender equality

Abstract

Despite the fact that over 800 million women, girls, transgender, and gender nonbinary persons menstruate, menstrual health and hygiene (MHH) remains a taboo and under-resourced public health subject. Water, sanitation, and hygiene (WASH) insecurity, an issue made worse by the COVID-19 pandemic, plays a significant role in menstruators’ abilities to safely manage their periods. COVID-19 has further revealed how a continued lack of access to WASH resources hinders an individuals’ means to address their menstrual health with dignity. The impacts of COVID-19 have laid bare the many challenges associated with menstruation, intensifying existing inequalities for women, girls, and other menstruators. Mobility limitations and quarantining have created complex obstacles for menstruators while lockdown protocols, border closures, and panic buying have impacted the sanitary pad supply chain. Community and school closures have removed many of the routine ways in which menstruators access sanitary products. Our article seeks to understand how the pandemic and existing WASH systems exacerbated the ongoing challenges associated with MHH, highlighting opportunities for future crisis planning to advance MHH infrastructure, resources, and stigma reduction. A landscape analysis was used to understand how the pandemic affected those who menstruate. Academic, peer-reviewed literature as well as gray literature informed the authors’ understanding of the dynamic nature of COVID-19 and WASH infrastructure on menstruators. From these insights, the authors were able to identify emerging themes and trends that they have highlighted in this article. Water and sanitation programs have the power to improve gender equality and equity, health, and education by investing in menstrual hygiene infrastructure, awareness creation, and stigma reduction. The diversion of resources, and in particular WASH resources, toward pandemic-related hygiene supplies and mobility restrictions, however, have exposed menstruators to sexual exploitation and physical and mental strain. It is critical to understand and address the pandemic’s impacts on menstruators, drawing lessons from and creating opportunities to systematically advance MHH, thereby elevating gender equality.