The absence of comprehensive national menstrual hygiene policies, the persistence of menstrual stigma and misconceptions, and the prohibitive costs of sanitary pads are significant obstacles that hinder progress in menstrual hygiene management in countries like Rwanda, activists say.

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People mostly from vulnerable backgrounds, especially young women in schools still find it hard to access sanitary pads and often face stigma from their community, making their lives difficult.

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Speaking to The New Times, Dr. Julius Kamwesiga, the Medical Director at AIDS Healthcare Foundation (AHF) Rwanda, noted that despite the government’s move to waive VAT on sanitary products, they are still not quite affordable to a large number of women.

"Sanitary pads cost around one dollar (slightly over Rwf1,000). Not everyone can afford this month-in, month-out. We are grateful that the country has waived VAT on such products, but something more can be done in terms of waiving taxes on the raw materials used to manufacture them. This will enhance the in-country capacity for manufacturing such products and will improve their accessibility,” he said.

Kamwesiga cited issues in the community’s understanding of menstrual hygiene, noting that there are some people with myths and wrong perceptions about menstruation, and with these, they stigmatize women.

"For example, some people think that the blood that comes during the menstrual period is contaminated and can cause problems to plants or that women are not clean enough during periods. Such myths create stigma around women and can lead to consequences like missing school or eventually dropping out,” he said.

Trevor Emojel, the Country Youth Coordinator at AHF Care Uganda, said his country faces almost similar challenges.

"The context is almost the same in Uganda. Menstrual hygiene challenges are strong enough to keep a girl out of school and we have seen this happen in Uganda, especially in vulnerable communities,” he said.

As noted, AHF put effort into promoting menstrual hygiene in various countries. It operates in 45 countries including Uganda and Rwanda.

The organization’s work in this context is mainly under the "Girls Act program,” a girl-led initiative that fosters leadership and confidence for girls and young women to support each other, strengthen fundamental life skills, and develop community activism.

In Rwanda, the initiative reaches out to girls between the ages of 10 to 24, in schools and out of school, about their health rights. The beneficiaries are equipped with knowledge of sexual and reproductive health, and provided with free sanitary pads, and school fees. Some are given seed funding and business skills to start their own income-generating activities.

Grace Uwicyeza, the leader of Girls Act Rwanda, says the knowledge shared with the girls under the initiative is very important because a number of them rarely get it from their parents.

"We make them understand the process and how to manage it. We have clubs in four schools in Kigali and Musanze where we do our activities, but we also do outreach activities at local health centers where we meet more women who need support,” she said.

Established two and a half years ago, Girls Act Rwanda has so far reached out to 900 girls.

According to Dr. Kamwesiga, AHF provides 10,000 free sanitary pads to girls and women every year, but he says this is just a drop in the ocean in comparison to the need.

He suggested ways of continuing to make sanitary pads more accessible, for example through investing in innovation for making reusable sanitary products. He also called upon the community to prioritize menstrual health because it is a significant need that cannot be taken for granted.

"Communities need to understand that it is a normal need that should be prioritized. So, as families make their budgets, they should not forget that their girl children need sanitary pads. In addition, parents should talk to their children about menstrual hygiene and the changes that occur to the body as children grow up,” he said.

These pressing issues not only undermine women’s and girls’ health and well-being but also perpetuate inequalities and hinder societal advancement, the experts noted.

As noted, addressing these challenges requires collective efforts from governments, NGOs, and communities to ensure that every woman and girl can manage their menstruation with dignity, access affordable and quality menstrual products, and receive adequate support and education to overcome the barriers associated with menstruation.