Menstruation without barriers

How a new guide is helping make menstrual health inclusive for girls with disabilities

For millions of girls with disabilities, menstruation is not just a monthly reality. It is a reason to miss school, a source of stigma and in some cases a risk to their safety. While menstrual health remains taboo in many parts of the world, girls with disabilities face an added layer of exclusion.

A new guide, Menstrual Health and Disability, aims to change that. Developed by Liliane Fonds in collaboration with the African Coalition for Menstrual Health (ACMH) and AFRIpads, the guide provides practical tools to help healthcare professionals and organisations design menstruation programmes that include girls with disabilities from the start.

“A healthy menstrual cycle can really make a difference in the life of a girl with a disability,” says Marieke van Gerwen, Sexual and Reproductive Health and Rights Adviser at Liliane Fonds. “Everyone has the right to accurate information, good health and fair opportunities.”

Why menstruation and disability must be considered together

“Being able to take good care of yourself when you menstruate is a right,” says Marieke. “At Liliane Fonds, we ensure that programmes take into account the challenges that people with disabilities face when they menstruate.”

Menstruation is still a taboo in many countries. This is even more so for girls with disabilities. They face double exclusion: because of their disability and because of their menstruation.

“This becomes even more complicated if you have difficulty communicating with those around you,” Marieke explains. “For example, girls with hearing impairments may miss information shared verbally. Others may depend on caregivers or face rejection within their communities. Open conversations can make a real difference.”

When menstruation keeps girls out of school

Globally, there is little attention paid to menstrual health. Similarly, there is little attention paid to the daily barriers faced by people with disabilities. This combination has significant consequences.
“If girls are not supported in managing their menstruation, they are often unable to attend school,” says Marieke. “That immediately affects their chances of becoming financially independent and increases their risk of violence.”

The challenges are practical as well as social. For girls with visual impairments, recognising the start of a menstrual cycle requires different knowledge and skills. “You can’t see when your period is starting,” Marieke explains. “You have to rely on physical signals. If education programmes don’t address that, girls are excluded from essential information.”

For girls with disabilities, school attendance is already fragile. Inaccessible sanitation facilities, stigma from peers and dependence on caregivers often stand in the way. Menstruation adds another barrier. “It becomes one more reason to stay home,” Marieke says.

The impact extends beyond adolescence. Organisations often focus on employment and income generation, which is justified. “Without proper knowledge about menstruation, girls and women are less able to function effectively in these areas too. It is therefore very important that inclusive knowledge about menstruation is also integrated into these organisations.”

What makes this guide different

The Menstrual Health and Disability Guide offers practical guidelines for professionals and organisations working with people with disabilities.

“The document helps experts work more inclusively,” Marieke says. “It also makes other professionals aware of the importance of menstrual health for this target group.”

The guide:

• provides an overview of different types of disabilities
• explains that people with different disabilities benefit from different types of support, as experiences of menstruation can vary
• identifies common challenges, such as double stigma and inaccessible facilities
• describes critical success factors for inclusive programmes
• emphasises the importance of involving people with disabilities from the start of a programme

Collaboration as the key to inclusion

The guide was developed in collaboration with the African Coalition for Menstrual Health (ACMH) and AFRIpads. ACMH is part of the United Nations Population Fund (UNFPA) and consists of a coalition of organisations working in various African countries on menstruation-related issues, such as education and access to clean water. AFRIpads develops reusable menstrual products.

Liliane Fonds contributed expertise on living with disabilities. In addition, Ugandan organisations for people with disabilities (YPDDF, AVSI Foundation, IDIWA and UNAC) were involved in testing the guidelines in daily practice.

What Liliane Fonds wants to achieve

The ambition behind the guide is straightforward: to support as many organisations as possible in working more inclusively.

“We want professionals to feel supported in discussing this topic,” Marieke says. “Ultimately, we want all girls with disabilities to experience a cycle that does not limit their lives.”

Interest from the sector has been strong, she adds, pointing to well-attended webinars organised for the launch of the guide. At the same time, resistance to sexual and reproductive health and rights (SRHR) remains.

“That can be discouraging,” Marieke says, “but it also motivates me, because there is a lot to be gained. After all, healthy menstruation can truly change the life of a girl with a disability.”

For Marieke, the message is clear: “Everyone has the right to accurate information, good health and fair opportunities in life,” she says. “That is what we remain committed to every day.”