Each day 300 million women and adolescent girls menstruate, and those women and girls have the right to access the products and services to manage their periods safely, hygienically and confidently.

Pacific-focused actors – from governments, donors and civil society organisations to the private sector – need to champion greater investment and commitment to address menstrual health rights as part of the region’s core development priorities.

As WaterAid and Marie Stopes International Australia explored in this blog three years ago, working together across sectors to deliver comprehensive menstrual health outcomes is absolutely critical – no sector can do it alone.

Through the ‘Keeping Girls in School’ program highlighted in that blog, we have drawn together expertise on water, sanitation and hygiene (WASH) and sexual and reproductive health and rights (SRHR) to improve menstrual health outcomes among young people in Timor-Leste and Papua New Guinea (PNG). Supported by the Australian NGO Cooperation Program’s Gender Action Platform, this three-year joint program will end in December 2020 and has provided an innovative programming model, replicated by our respective Federations in other countries. Here we share some tentative programming insights.

Menstrual health is critical to tackling harmful gender norms and social taboos

Mobile family planning outreach clinics were combined with school-based WASH projects to improve family planning access for young people, with different models in each country. In Timor-Leste, innovative ways of attracting young people to family planning services included anaemia testing clinics running alongside menstrual health education sessions. To tackle social taboos in Timor-Leste, the team created a video called MENStruation, targeting men and boys.

Preliminary results from project-funded research and participant feedback sessions indicate improved understanding of reproduction and family planning methods among school-based education participants. Girls also reported feeling safe and confident using upgraded school WASH facilities, communities reported being able to speak more freely about menstruation, and men claimed to have a greater understanding of women’s domestic workload.

Building collaborative partnership with cross-sectoral government teams at different levels can lead to positive outcomes

In Papua New Guinea, the team worked closely with the Ministry of Education and Health to develop a Comprehensive Sexuality Education package, which integrated menstrual hygiene sessions with sexuality education. Teachers were supported to test and deliver the materials. Following this, school administrators in Central Province began stocking sanitary pads in schools, and teachers reported having improved confidence to talk about sexual and reproductive health with young people. School retention among girls also improved according to teacher’s self-reports.

More efforts are needed to establish sustainable and affordable supply of sanitary pads

In Timor-Leste, project partners worked with two women-led businesses to strengthen their business models and improve their supply chain in order to both produce and retail reusable sanitary pads. More than 1,400 reusable sanitary products were sold and a further 500 were used by the government to support women and girls being held in quarantine due to COVID-19. However these businesses are not yet sustainable due to high costs of pad production and low demand from rural women, along with poor supply chains.

A scoping of the Pacific menstrual health ecosystem in 2018 by Pacific RISE and the Criterion Institute found similar challenges – weak supply chains and high price of materials saw women-led enterprises struggling to make a profit. Pacific RISE has responded and are investing in a trade finance model as a tool to strengthen the menstrual health eco-market.

Achieving more together

As we captured in our joint report on integrated approaches to menstrual health in Asia-Pacific, bringing together our two specialist areas achieved more than either organisation would have been able to do alone. Throughout the program, we supported other actors in each country to form communities of practice and host learning events to exchange insights and improve coordination. Last year we leveraged our collaboration to team up with other global SRHR actors to publish A Shared Agenda, a call to action to progress integrated SRHR and WASH programming and advocacy outcomes.

While the Australian Government, countries in our region and development partners move quickly to respond to COVID-19, longer-term women's rights issues such as menstrual health cannot be forgotten. The COVID-19 pandemic has increased difficulties for Pacific women and girls in managing their periods. For example, Mama Laef, a local manufacturer of reusable pads in Vanuatu, reported disruption of supplies from China and New Zealand has led to the halting of pad production, resulting in women staff being stood down and a shortage of sanitary pads available to women and girls during Cyclone Harold relief efforts.

The ‘integrated model of the menstrual experience’, published by leading global academics in 2019, is a reminder of how much more effort is needed to holistically address menstrual health as a core Pacific development priority. With the ‘Keeping Girls in School’ project set to finish in December 2020, WaterAid has begun supporting local rights groups to establish a Pacific Menstrual Health Network to drive a shared advocacy and learning agenda. A recent global menstrual health report outlines emerging grassroots coalitions across the globe are beginning to counter harmful norms. It is critical that Pacific voices as part of this movement. There are deep social taboos surrounding periods that restrict freedom of women and girls in many Pacific cultures due to misinformation, lack of appropriate services, and stigma. As the global menstrual health movement grows, Pacific Island governments, civil society, the private sector and Australia’s aid investments need to come together to address menstrual health, particularly the underlying norms which inhibit women and girls reaching their full potential.


This article was first published on the Devpolicy Blog (devpolicy.org) from the Development Policy Centre at The Australian National University.


Chelsea Huggett is the Technical Lead – Equality and Inclusion at WaterAid Australia. Chelsea focuses on gender equality and social inclusion within water, sanitation and hygiene programs and policy. She has led programming, research and advocacy on menstrual health and hygiene for the past six years.

Michelle Laws is the GAP Regional Programme Manager at Marie Stopes International. Michelle specialises in gender equality and sexual and reproductive health programming in Southeast Asia and the Pacific. Most recently, she has led menstrual health initiatives targeted at improving adolescent access to SRH education and services.