Stories From the Field

Empowering Kenyan women and girls with disabilities in managing menstrual health

Anne leads a program on sexuality for girls with disabilities, which includes menstrual hygiene management. © This-Ability Trust

NAIROBI, Kenya – Anne found out she had gotten her first period when a classmate told her she had stained her dress. No one had ever explained menstruation to her. She didn’t understand why she was bleeding or why she was in pain. The then-14-year-old had a congenital mobility disability and hearing impairment. “I didn’t even know how to wear a sanitary pad,” she said. One of Anne’s teachers explained that periods were normal. They gave her underwear and pads, showed her to use them, and then checked on her every day.  

Now 29, Anne runs a group for persons with disabilities that includes a program on sexuality for girls. Many girls with disabilities never receive critical sexuality education as their families and caregivers are often uncomfortable discussing menstrual health. “Because of a lack of sexuality education, many girls with disabilities turn to their friends for information, which can sometimes be misleading and dangerous,” she said. “Some have been told that to manage their periods, they needed to have sex, and they end up with early and unwanted pregnancies.”  

Changing the narrative 

UNFPA partnered with This-Ability Trust, an organization that advances disability rights and inclusion by working with groups like Anne’s. They aim to improve access to sexual and reproductive health information and services for women and girls with disabilities. The partnership has reached 12,000 people in eight counties and educates both recipients and caregivers on menstrual health management. Part of this work is distributing dignity kits that contain washable sanitary pads. 

“There is a misguided narrative that portrays women and girls with disabilities as asexual,” said Maria Rosa Cevallos, a project manager with This-Ability Trust. “The consequence of this is that they are not provided with adequate information about their reproductive health, including menstruation.” 

According to the 2019 census, more women (2.5 percent) than men (1.9 percent) live with a disability. Girls with disabilities – especially mobility, visual impairment, and cognitive disabilities – are often denied the right to make decisions for themselves. When it comes to reproductive and sexual health, this leads to greater risks of sexual violence, unplanned pregnancy, and sexually transmitted infection

A need to close gaps

A recent study in Kenya showed gaps in the provision of reproductive healthcare services for women and girls with disabilities.

“Many healthcare workers were of the opinion that 15 years is the appropriate age for women and girls with disabilities to receive sexual and reproductive health information,” explained Cevallos. “This might be too late for adolescent girls who experience their first period much earlier.”  

Girls with disabilities are also at risk for period poverty. The cost of sanitary pads and tampons is 300 Kenyan shillings (about $3) a month. However, about one in three people in Kenya live below the international poverty line of $1.90 per day. Depending on the type of disability, some women and girls may require more expensive menstrual products such as period underwear. Managing menstrual hygiene can be further complicated by the need to rely on others for changing sanitary pads and bathing or for access to water and other sanitation amenities.

Which is why awareness and education are so important. “We need to reduce period stigma so that women and girls with disabilities feel comfortable to talk about the challenges they face managing their menstrual health,” said Anne. “That way, we can ensure more inclusive menstrual health strategies that take our needs into account.” originally published a version of this story.

Dana Kirkegaard
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