28 August 2024 by Limpho Sello

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Boitumelo Marake, a young man from Quthing, holds up a pair of black, laced panties, demonstrating how to attach a pad to the gusset.

Marake is giving a public demonstration on the correct use of a pad, an uncommon sight in a country where menstrual education and discussions are traditionally reserved for women.

The public menstrual awareness campaign, led by the United Nations Population Fund (UNFPA) in Mphaki, Quthing district, aims to change traditional beliefs. It also seeks to demonstrate that everyone, including men, should be involved in learning and teaching girls about menstrual health.

“When we arrived in Mphaki, we discovered that many parents, particularly fathers who have undergone initiation schools, felt that discussing menstruation would degrade them,” explained Maseretse Ratia, the UNFPA’s National Program Analyst for Adolescents and Young People.

Ratia believes that this reluctance stems from cultural beliefs that consider menstruation as a topic unfit for men to address.

This sentiment was echoed by an elderly man, Tšoene Molelekoa during the discussions, who stated, “Teaching a girl about menstruation is a woman’s job. It’s a difficult topic for us men, something women understand better.”

In response to such views, Ratia believes that the strong barriers around menstrual health being viewed as a woman’s issue are slowly being broken down through public awareness campaigns. These efforts include a belated celebration of Menstrual Health Day on August 16, 2024.

Originally and globally commemorated on May 28 each year, this year’s celebration was held under the theme #PeriodFriendlyWorld. To promote a menstrual period-friendly world, the UNFPA Lesotho collaborated with the Ministry of Health to observe this day with a three-day community engagement in Mphaki, Quthing. This initiative aimed to foster open conversations about menstrual health and challenge long-standing community stereotypes.

As a result of these efforts, Ratia observed that “after extensive discussions, many parents began to see the importance of having these conversations.”

She added: “By the end of our session, several parents admitted that they had learned the value of talking to their children about menstruation,” Ratia added.

Empowering men

Despite this progress, the challenge of engaging men in menstrual health discussions remains significant. This difficulty is compounded by traditional family dynamics in Mphaki, where children, especially girls, often have closer relationships with their mothers.

Mphaki village health worker, ‘Mamontoeli Montoeli noted, “Children, especially girls, tend to confide more in their mothers, leaving fathers out of the loop on critical issues like menstruation.”

Ratia believes that a cultural gap creates a barrier to open communication. She stressed that cultural beliefs in Lesotho may cause some men to find it embarrassing or shameful to initiate menstrual health conversations with their daughters.

“We need to find ways to help these father figures feel more comfortable discussing menstruation with their daughters,” Ratia said.

Montoeli agrees, suggesting that men can be supported by offering guidance on how to approach these conversations.

“They should understand that they are equally responsible for their daughters’ well-being and should make an effort to befriend their children. This bond will allow for more open conversations on topics that matter,” Montoeli explained.

Ratia of commented during the dialogue that the Importance of such discussions cannot be overstated, particularly in households where only fathers are present.

“In cases where girls are living with their fathers alone, it is crucial for the father to be able to talk about menstruation and other body changes,” Ratia emphasised.

This sentiment was echoed by community representative Thembikose Ntlasana, who, by the end of the dialogue on August 16, acknowledged the importance of communication.

“We understand the importance of talking to our daughters about menstruation, and while it might not be easy, we will try,” Ntlasana committed.

Meanwhile, the UNFPA Lesotho Country Representative, Innocent Modisaotsile, added that menstrual poverty—when young girls cannot afford sanitary pads—remains a significant challenge in Lesotho.

“Without access to sanitary products, many girls miss school during their menstrual periods, which can lead to further educational and social disadvantages,” Modisaotsile said.

Boys as allies

Recognising the broader impact, the dialogue also extended to boys, as over 100 out-of-school youth participated in a session on August 15. This involvement demonstrated that boys can play a crucial role in breaking the cycle of stigma surrounding menstruation.

This is because in many households, traditional norms persist where boys avoid anything associated with menstruation, including touching their sisters’ underwear or assisting with related chores. These attitudes reinforce the notion that menstruation is something shameful or dirty.

One boy, Khabisi Nkhooa, is on a road to transformation. Nkhooa pledged to support girls by not stigmatising them during their periods.

“We need to stand by our sisters and not make them feel ashamed. We should also educate our peers on the importance of supporting girls during their periods,” Nkhooa said.

Building on this, Ratia added that this shift in perspective among boys is essential for fostering a more supportive environment for girls.

“By learning about menstruation and its challenges, boys and men can become allies in the fight against menstrual stigma and poverty,” Ratia said.

A community transformed

The 2024 Menstrual Health campaign in Mphaki went beyond education to include the distribution of dignity kits to both girls and boys. These kits contained a year’s supply of sanitary pads, packs of underwear, and toiletries such as washing powder, soap, toothpaste, and deodorants. A total of 180 girls and boys in Mphaki benefited from these kits, which were financed by UNFPA Lesotho.

‘Mathato Nkuatsana, the Ministry of Health’s Adolescent Health Manager, explained the significance of these kits: “Menstrual health goes hand in hand with cleanliness and hygiene.”

She added: “By providing these dignity kits, we are ensuring that girls can manage their periods with dignity and that boys can also take part in maintaining hygiene.”

Building on this, UNFPA Country Representative Innocent Modisaotsile emphasised the importance of addressing menstrual health on a national level.

“International Menstrual Health Day, celebrated annually on May 28^th, is crucial for raising awareness and fighting stigma,” he said.

He added: “No one should be held back because of menstruation, and we must work together to ensure that menstrual health products are accessible to all.”

A call to action

While this progress is significant, Maseretse Ratia, the UNFPA’s National Program Analyst for Adolescents and Young People, explained that the two-day dialogue in Mphaki highlighted the need for further efforts.

Ratia noted that these sessions revealed a deep-seated need for ongoing education and support, particularly for men and boys, to fully embrace their roles in menstrual health.

“While it was encouraging to see some boys and men publicly demonstrate how to use sanitary pads, it is just the beginning,” Ratia said.

“We need to continue these conversations and ensure that everyone, regardless of gender, feels comfortable and knowledgeable about menstruation.”

The goal is for conversations about menstruation to start changing in households across Mphaki and beyond.

Modisaotsile emphasised that the 2024 Menstrual Health campaign serves as a reminder that true change begins with dialogue and education.

“By working together, we can create a world where menstruation is no longer a barrier to education, dignity, or equality.”

Meanwhile, the 2022 Final Report of the Situational Analysis on Menstrual Health in Lesotho indicates that Quthing ranks lowest in terms of knowledge about menstruation. Some contents of the report reveal that district-level analyses of learners’ knowledge about menstruation show notable variations.

In Thaba-Tseka, 89.9 percent of learners correctly identified menstruation as monthly natural bleeding from the uterus, followed by Mokhotlong at 82.4 percent, Maseru at 57.7 percent, and Quthing at 37.2 percent.

Gender-specific analysis indicates that females generally had a better understanding of menstruation across most districts. However, in Maseru, a higher percentage of males (58.8 percent) correctly understood menstruation compared to females (57.1 percent), although the difference was not statistically significant.

The findings also highlighted misconceptions about menstruation among both learners and the community, often driven by cultural norms dictating girls’ behaviour after their first menstruation.

The report notes that these findings align with a similar study in Kenya, where knowledge of menstruation was limited even among girls and significantly influenced by societal beliefs and culture.

The 2022 Final Report of the Situational Analysis on Menstrual Health quoted Chandra-Mouli and Patel (2020) stating that in low- and middle-income countries, girls had significant knowledge gaps and misconceptions about menstruation. Furthermore, adults around them were often ill-informed and uncomfortable discussing menstruation due to views that it was “dirty, polluting, and shameful.”