This article has been published in Enabling Education Review 5
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Tackling taboos to keep girls in school

Mandu Reid

Promoting and supporting girls’ education in low-income countries is a dominant theme in international development. The UN’s Sustainable Development Goals highlight this issue, with specific goals related to achieving universal primary and secondary school education and promoting gender equality. Today, according to the UN, about two-thirds of countries in developing regions have achieved gender parity in primary education, but continued effort, investment, and focus is required to achieve full primary enrollment and then push towards parity at secondary level. Enrollment is only half the battle. Once enrolled, when girls reach puberty the onset of their menstrual cycle can create challenges and obstacles to their attendance and participation in school. In this article, Mandu Reid, Founder of The Cup Effect, explains the innovative approach undertaken by two NGOs (The Cup Effect and Femme International) to keep girls in school.

Many girls face a lack of access to effective, safe, comfortable, and affordable products to manage their period every month (such as disposable pads). Instead they may use traditional or improvised methods such as cloth, mattress stuffing, feathers, animal hide, bark or newspaper, which are unreliable and uncomfortable, and can cause health problems including rashes, irritation, or infections. This, combined with the stigma and taboos associated with menstruation, discourages girls from attending school whilst on their period, or impedes their concentration and confidence when they do attend. Studies show that girls from some of the world’s lowest income communities who are enrolled in school will be absent for up to 20% of the time as a result of their period.

In Kenya, the government has acknowledged this issue and, for the last few years, has operated a national scheme to distribute disposable sanitary towels to some of the most needy schoolgirls. In 2013-14 they spent 200 million Kenyan Shillings on this programme. However, head teachers report that, whilst this intervention does make a difference, the supply of sanitary towels is irregular.

NGO interventions
In this context, it is clear that programmes to distribute more sustainable options for menstrual management could really help girls’ attendance and participation in education. Across the world numerous NGOs have picked up on this, resulting in an increasing number of initiatives that focus on distributing reusable menstrual products, such as reusable cloth pads which typically last up to two years.

Longer-term solutions
The Cup Effect and Femme International are two NGOs working for a more long-term solution. They raise awareness about and distribute menstrual cups, and educate girls and communities about menstrual health, to help erode the harmful taboos and myths about menstruation that compound the difficulties it causes for adolescent girls.

What is a menstrual cup?
A menstrual cup is a small bell-shaped receptacle that is a convenient alternative to pads or tampons. They are made of soft medical-grade silicone and are inserted into the vagina to collect menstrual fluid. After about 8-12 hours or once full, the cup is removed, rinsed, and reinserted. This process is repeated until the end of the period, at which point the cup is boiled in water for 5 minutes to sterilise it, and kept in a clean dry place for use the following month. The key feature of menstrual cups is that they are reusable – each one lasts for up to 10 years, providing the user with long-term, reliable, effective, and dignified menstrual management.

Our programme approach
Typically, The Cup Effect and Femme International work with schools and local community organisations. Our first step is to understand locally specific cultural sensitivities and issues. To enable this, safe spaces are created where girls can have frank and free discussions about menstruation. These initial sessions inform locally relevant adjustments to the teaching module that accompanies each cup distribution.

Information sessions are held with community members, including parents, grandparents, brothers, and other male peers. This helps to demystify menstruation, and break down taboos. In addition, meetings are held with prominent local institutions or individuals, such as faith groups and traditional chiefs who have significant influence over people’s life choices and attitudes.

Cup distributions are carried out in waves. The first cohort to receive cups will usually be a small group of girls or women who already work as peer educators, or those who have a leadership or pastoral role – such as female teachers or community health workers. This group receives the education module as well as a detailed briefing on how to use a cup safely and effectively. These individuals receive ‘train-the-trainer’ training and are equipped to carry out the next distributions to girls who opt in to the scheme.

© Femme International

© Femme International

In addition to training covering reproductive health, the female anatomy, and menstruation, each beneficiary receives an ‘MHM (Menstrual Hygiene Management) Kit’ (or ‘Femme Kit’), which contains a menstrual cup, soap, a small metal bowl in which to boil the cup to sterilise it, and an information booklet that includes information about how to use a cup safely and effectively.

Since 2013, Femme International has directly impacted over 5,000 women and girls in Kenya and Tanzania. Their work has been well received by beneficiaries and community leaders, and teachers have noticed a marked change in the attendance and participation of their female students – as the data gathered from 450 beneficiaries in Kilimanjaro, Tanzania, illustrates:

Before receiving a kit and participating in an education session, 55% of girls reported leaving school early during their period.


  • Only 4% of girls would leave school early;
  • There was a 57% drop in girls feeling financial stress as a result of their menstrual cycle;
  • 78% of girls reported improved academic performance;
  • 83% of girls were better able to concentrate in the classroom;
  • 100% of girls reported feeling more confident.

Bringing the topic of menstruation out of the shadows, and providing cups as an option to address the fact that many girls are needlessly prevented from fulfilling their potential, has huge scope for improving educational outcomes for girls, in both stable and crisis contexts.

Mandu Reid is the founder of The Cup Effect