Beyond Shame & Shortage: Building Menstrual Health Systems in Climate-Resilient Communities
- Merihene Ben said
- Aug 28
- 7 min read
This blog was generated by analyzing reports and materials available on global-waters.org.
For millions of girls, menstruation still means shame, silence, and missed opportunities. Across rural Africa and parts of Asia, a lack of safe toilets, running water, or affordable supplies means girls miss school days monthly — falling behind or dropping out entirely.
At FLUSH, we believe that menstrual hygiene management (MHM) isn’t just about products — it’s about dignity, access, climate resilience, gender equality, and sustainable systems. Two landscape assessments — in Fiji and Bangladesh — highlight just how interconnected these values are, and what we can learn as a global community working toward menstrual equity.
The Common Thread: Shared Struggles in Two Very Different Places
Though Fiji and Bangladesh are worlds apart—Fiji is a Pacific Island country, while Bangladesh sits at the heart of South Asia—both face strikingly similar challenges around MHM. Fiji’s hundreds of islands are vulnerable to climate shocks like cyclones and flooding, often making water and sanitation access difficult, especially in rural communities.
Bangladesh, meanwhile, is one of the world’s most densely populated countries, struggling with rapid urbanization, frequent flooding, and a large number of people living in poverty. Despite these different landscapes, both societies confront powerful stigma, limited product access, and ongoing infrastructure barriers when it comes to MHM.
Stigma and social norms
In both Fiji and Bangladesh, menstruation is often hidden due to cultural taboos and social expectations. In Fiji, girls face teasing at school and are taught to keep their periods secret from male family members, fostering shame. In Bangladesh, menstruation is considered “unclean” and is rarely discussed at home, leading to silence and exclusion. These norms limit access to vital information and support — many girls lack timely and accurate education about menstruation because mothers, teachers, and community members feel embarrassed or ill-equipped to discuss it openly.
For example, in Bangladesh, teachers sometimes skip menstrual topics in co-educational classes or ask students to study them independently, missing critical biological understanding before menarche (the first occurrence of menstruation). According to the 2018 National Hygiene Survey by the Bangladesh Bureau of Statistics, only 30 to 36 percent of women had heard about menstruation before puberty. Without accessible, clear information, menstruators often do not learn how to manage pain, hygiene, or product use safely, nor when or how to seek medical or emotional support.
Gaps in products and services
Limited affordability and availability of menstrual products persist in rural and urban poor communities alike. Many Fijians in remote islands resort to cloths because disposable or reusable pads simply aren’t accessible. In Bangladesh, 50% of adolescents and nearly 65% of women also use old cloth, often unhygienically. This means these cloths are frequently washed without adequate soap or clean water, dried indoors or in damp places away from sunlight, and reused without proper sterilization.
Such practices increase the risk of infections, including urinary tract infections and reproductive tract infections, which can impact menstrual health and overall well-being. Education is also crucial for the distribution of reusable menstrual products. In Fiji, recipients often do not recognize cloth pads as menstrual items. One informant shared that some recipients, due to limited awareness and the low visibility of reusable menstrual products in the country, sometimes used the pads for cleaning windows instead.
Water, sanitation, and waste
Good MHM depends on reliable water, sanitation, and hygiene services; however, rapid urban growth, climate shocks, and underinvestment leave many without adequate support. In both Fiji and Bangladesh, disposal and waste management of menstrual pads remain significant unresolved challenges. In Fiji, limited waste infrastructure means that many people burn used sanitary pads or discard them in rivers, bushes, or the ocean, leading to environmental pollution and public health risks, particularly in rural and island communities.
Urban areas also struggle with waste segregation and disposal capacity, which is further complicated by the impacts of climate change, including rising sea levels and reduced landfill space. In Bangladesh, improvised methods of storing menstrual waste—such as keeping used pads in grocery bags for several days—pose significant hygiene risks and highlight the absence of adequate waste management systems.
Why do we care about menstruation?
Menstrual health is not just a biological issue—it is a matter of human rights, dignity, and equity that affects half the world’s population. In Bangladesh, a key informant shared, “Poor MHH is both a symptom and a cause of gender inequality. When a girl feels like she’s committing a crime five or six days out of a month, every month, she feels like a lesser person.” When stigma, lack of infrastructure, and unaffordable products prevent people from managing their periods safely, the impacts ripple beyond individuals to affect education, economic participation, and community well-being.
The experiences in Fiji and Bangladesh show that these challenges are complex and deeply rooted in social, economic, and environmental conditions. To achieve true menstrual equity, we must recognize the diverse realities of menstruators—including those marginalized by geography, identity, or circumstance—and commit to inclusive, multi-sectoral solutions that uphold everyone’s right to dignity and health.
Those That Get Left Behind
Both assessments underline that a “one-size-fits-all” approach won’t work. Out-of-school adolescents, working women, gender-diverse people who menstruate, and those living in fragile or disaster-prone areas often fall through the cracks of existing programs and policies. For example, rapid urbanization and climate-related shocks in Fiji, such as frequent cyclones and flooding, strain already limited water and sanitation infrastructure, making it difficult for communities—especially in remote and informal settlements—to access clean water and private, safe facilities for MHM during emergencies.
These conditions worsen during disasters when water supply may be disrupted, and evacuation centers often lack adequate gender-segregated toilets, washing areas, and disposal systems, placing menstruators at risk of poor hygiene and compromised dignity. On the other hand, working women in Bangladesh’s ready-made garment sector have benefited from workplace health programs. However, informal workers and gender-diverse menstruators still lack tailored support.
What Can We Do Differently?
Insights from the Fiji and Bangladesh landscape assessments point to three core priorities for advancing MHM—each directly tied to challenges documented earlier.
Strengthen local supply chains and product access
Reliable, affordable menstrual products are still out of reach for many, especially in rural and low-income communities. Both countries need support for local manufacturing and new ways to get products to consumers, such as women-led distribution and online sales. In Bangladesh, social enterprises like Ella Pad, Shaathi, and Safepad are piloting reusable pads made from local materials, sometimes partnering with factories or NGOs. But their reach remains small, mainly because they rely on donor funding, struggle to access investment, and lack robust marketing and distribution networks.
Most locally made products are distributed by NGOs rather than on store shelves—so they remain unavailable to many who need them. To move from pilots to real impact, these local businesses need investment, business training, and support to build broad, reliable supply and sales channels.
Integrate menstrual health across sectors
Menstrual health extends beyond water, sanitation, and hygiene (WASH); it intersects with education, workplace policies, public health, and climate resilience. The Fiji and Bangladesh assessments emphasize that addressing menstrual health in isolation limits impact, while cross-sector integration improves outcomes and sustainability.
Embedding menstrual health into school curricula and teacher training normalizes menstruation and reduces stigma, encouraging girls to stay in school. Workplaces, both formal and informal, need supportive policies ensuring access to products, sanitation, and menstrual health awareness. Health services should integrate menstrual care as part of sexual and reproductive health, providing respectful, tailored support.
Climate shocks exacerbate menstrual health challenges by disrupting facilities and supplies, making inclusive disaster preparedness vital. Menstrual waste management remains critical: investing in safe disposal infrastructure, promoting reusable or biodegradable products, and increasing community awareness protects health and the environment. Integrating these aspects across sectors ensures comprehensive, context-sensitive support for all menstruators.
Shift social norms
Stigma and silence around menstruation fuel exclusion and prevent access to education, products, and support in both Fiji and Bangladesh. That’s why both reports call for programs that create safe conversations for all genders about menstruation. Changing attitudes requires teacher training, sessions for boys and men, and open community dialogue, so that menstruators no longer face shame or embarrassment over a normal bodily process.
Menstrual Equity is Everyone’s Business
Globally, approximately 500 million people lack the resources to manage menstruation safely and with dignity. In many low-income countries, up to 80% of girls reach menarche without sufficient information, contributing to inadequate hygiene and missed education.
This reality demands that menstrual health be elevated to a central development priority. Governments must embed MHM in national policies and budgets, donors should fund innovation and partnerships, and NGOs can drive community-led, inclusive programs.
The experiences of Fiji and Bangladesh offer a blueprint: invest in resilient supply chains, embed menstrual health across sectors, challenge societal norms, and prioritize marginalized groups.
How will you contribute? Whether advocating for policy change, supporting local menstrual product initiatives, or fostering open conversations, your action is vital to advancing menstrual equity.
Want to learn more? Explore the full reports at global-waters.org:
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