By: Joyce Kantam Kolamong
This article contains some disturbing images
It usually starts by girls staying at home during the menstrual cycle and then slowly the time spent at home becomes extended for a mixture of intersecting reasons such as financial constraints at home, distance from school and menstrual cramps among others.
Self-reporting by girls suggests that inadequate menstrual hygiene management like clean toilets and washrooms, access to water and poor access to materials for menstrual health are associated with failing classes, absenteeism and high drop-out rates.
In many basic schools in Ghana, urinals and toilets are the only primary sanitation facilities where girls in their periods utilize but often in poor sanitary conditions.
Privacy during menstruation at school is crucial for girls’ dignity, confidence and comfort. As the country observes Menstrual Hygiene day, it is imperative to deepen calls for the government to prioritize the provision of changing rooms as well as hygienic urinals and toilets for girls especially in the Northern region.
Period At School
Juliana’s face tightened with frustration and held her nose as she stepped into the school’s urinal to change her pad. She navigated her way through traces of fecal matter, urine, drops of blood, pure water sachets and other materials to find a perfect spot. The lack of proper changing rooms for girls like her is a constant struggle as she has to deal with cramped and unhygienic spaces which she wished she never had to experience.
“It is so frustrating and embarrassing to enter the unhygienic urinal to change. There are times my shoe touches the pad in the course of wearing my pant and the sad aspect is that if you are not lucky and the pad falls down while you are trying to fix it, you just have to pick it like that, use tissue or sanitizer to clean it before wearing. This is very dangerous because you can easily get infection”, She explained.
“And after changing the pad too, there is no dustbin to drop it, you have to put it into a polythene bag or sometimes hide it in your uniform, look for a place to dispose it off” she added.
Juliana, a form two student from one of the basic schools in Tamale, said sometimes when the urinal is busy, she has to go to the school’s toilet to change and dispose the pad in the toilet. “The toilet is even dirtier than the urinal, the feaces, urine and maggots are all over and it is sad changing there. The sad aspect is that in the course of changing, your fingers can touch the blood and you need to wash but there is no access to water, so you either use sanitizer to clean your hands or buy sachet water to wash”, she indicated.
Juliana said sometimes she envisages a school where girls like her could manage their periods with dignity and where facilities are cleaned, private and accessible. She also wished that menstrual health and hygiene would be taken seriously at the basic level to make girls feel safer and at peace during their periods.
Menstrual Hygiene Management
One key catalyst making girls feel comfortable while in their periods is the prioritization of Menstrual Hygiene and health Management. Menstrual Hygiene Management is defined by the World Health Organization and the UNICEF Joint Monitoring Programme as people who menstruate using “a clean menstrual management material to absorb or collect menstrual blood, that can be changed in privacy as often as necessary for the duration of a menstrual period, using soap and water for washing the body as required, and having access to safe and convenient facilities to dispose of used menstrual management materials. They understand the basic facts linked to the menstrual cycle and how to manage it with dignity and without discomfort or fear.”
UNESCO summarizes Menstrual Health and Hygiene as access to menstrual education, access to health services, hand washing facilities and period products, the social norms surrounding periods, access to safe and hygienic disposal, and period advocacy and policy.
Menstrual hygiene management (MHM) challenges during changing and disposal of menstrual items are important, where schools lack sufficient water and sanitation. Changing menstrual items in poorly maintained latrines may expose girls’ to excrement and infection. Imagine attending a school without any toilets or drinking water. Imagine attending a school with a single latrine for all the students. Imagine that the latrine is smelly, with no toilet paper and the door no longer closes. Imagine trying to attend classes in these schools while you have your menstrual period. Imagine your menstrual period is extremely painful. Imagine your reuse-able pad is soaked through but there is no running water to clean it, or that there is no trash bin for disposing your used pad. Imagine having your pad soaked through to your pants so you have to hide the stain with your book or bag. And do not forget that this happens every month. Sadly, adolescent girls in the developing world have to face one or more of these challenges at one point in time or the other.
When girls attend and remain in school, individuals, households, and countries benefit. While there has been progress globally in keeping girls in school, menstruation often restricts girls and women from fully participating in social, educational, and professional activities. Menstruation is a frequently neglected yet critical aspect of girls’ reproductive health. Limited access to adequate menstrual hygiene products due to unavailability and unaffordability means girls and women often use non-durable and/or unhygienic materials like cotton, cloth, or toilet paper to manage their periods. Fear of blood leaking onto school uniforms and lack of knowledge of the menstrual cycle, in addition to stigma surrounding menstruation and related teasing from boys, can prevent girls from attending or actively engaging in school, which can have long-term consequences on girls’ education outcomes, confidence, and independence. A baseline study in schools conducted by Global Communities, a WASH NGO, with technical support from Be Girl, found that 47% of girls reported that they had difficulties going to school during menstruation; while 29% reported that they had been absent due to their menses. Additionally, 81% of boys reported that they are uncomfortable around girls during their period.
Private Changing Room That Never Was
Private changing room for girls to bath and change has been assessed as a catalyst that can help girls feel more comfortable attending school and participating in lessons. Changing facilities with water supplies offer girls a place to change, wash and dry menstrual supplies during the school hours. Some changing rooms may also provide students with free menstrual supplies, which is essential for impoverished girls who lack access to these products outside of school. Without private changing rooms, female students may feel embarrassed to come to school during their periods, especially in cultural settings where people stigmatize menstruation. In cultures that stigmatize menstruation, some girls pretend to be ill or come up with other excuses to avoid attending school during their periods due to shame or embarrassment.
Menstruation is a biological process, whereas, menstrual health and hygiene are the social, political and economic factors that allow them to safely manage this biological process so that is has as little impact on their life as possible.
However, in a world where education is the key to the future, the state of school toilets and urinary pits tell a story far beyond cleanliness, directly affecting the health, education, and future prospects of millions of students globally particularly girls.
The Coalition of Non-governmental Organisations in Water and Sanitation, CONIWAS, in a referenced report by the Ghana Education Service (GES) in 2017, indicated that about 7,332 out of the 20,738 public basic schools in the country do not have toilet facilities, while 6,922 do not have urinal facilities. Regretfully, the state of the few toilet facilities in Ghana’s public schools presents a dismal image.
Students’ and pupils’ well-being and educational experience are greatly impacted by inadequate, unclean, and frequently non-functional facilities, which expose girls to a variety of health risks and discomforts during their periods. More worrying is the fact that there are no changing rooms in almost all schools be it basic or senior levels. Girls in their periods are compelled to change their pads at urinals and toilets depending on which one is convenient. Many schools particularly public schools in the Northern region do not have good water, sanitation and hygiene facilities.
A walk-in visit by GBCNews to some basic schools in the Tamale metropolis and Sagnarigu municipality revealed a very poor, unhygienic condition of some of the school’s urinals and toilets. Traces of feacal matter and urine, bloodstained tissues, water sachets and other materials were competing with each other for space. Also, the heat and stench that emanated from the urinals and toilets was very strong.
Girls’ Situation and Frustration
Some girls worry about having their period when they are at school. Students at Bishops R/C Junior High School shared their frustrations
“Every day when I go to school, I take an extra pad with me and because there is no changing room, during my period, I go to the urinal and I do not find it easy changing, sometimes you see drops of blood and used pads and the sight is unbearable. Sometimes in the course of removing or putting back your pant, your shoes can touch the pant and this is not good at all”, one of the students remarked.
“Times that I stain myself, I have to cover it with a book or my bag and then I rush to get water to clean it”, another girl added
During an interaction with a section of school girls at Choggu Demonstration Junior high school, they revealed how having their periods in school make them feel uneasy.
“ Madam, me, when I am menstruating, I do not go to school because of the dirty bathrooms and also when I have my period at school, I go home and change and sometimes I do not go back”, a form 3 student indicated.
“There are times after changing, we put the used pads in our bags and dispose it off at home because there is no proper place to dispose it”, another form 3 student said.
One striking aspect of my interaction with the girls was their consistent search for water to wash their hands after changing their pads. The lack of hand washing facilities poses a significant challenge to practicing good menstrual hygiene and health. Ensuring access to clean water and hand washing facilities cannot be overemphasized in maintaining proper hygiene and preventing infections.
Sustainable Development Goals
Improved WASH in schools is included in the Sustainable Development Goals (SDGs). Goal 6 refers to universal access to clean water and sanitation, encompassing all settings including schools while goal 4 refers to safe and effective learning environments for all school children including providing all schools with access to basic drinking water, single-sex basic sanitation facilities, and basic hand washing facilities. Many girls stay home during their periods without safe spaces to change and dispose of used pads. In Ghana, about 60 percent of basic schools lack usable single sex toilets, including urban schools like all basic schools including Bishop R/C and Choggu Demonstration junior high schools.
Finding Solutions
On 25 April, 2025, the government officially launched the Free Sanitary Pad Initiative, a program to distribute sanitary pads to schoolgirls nationwide to support their health and education. The initiative, according to the President, is more than just a policy, but a movement aimed at protecting the future of Ghana’s girls. He said his administration along with stakeholder collaboration would ensure that girls in Ghana can continue their education without fear of missing school due to menstruation.
While the free sanitary pad policy for girls is a commendable initiative to promote education, its impact may be limited without infrastructure. Many schools lack access to water, proper bathroom and toilet facilities, including changing rooms with hand washing facilities, which are essential for menstrual hygiene management. To create a supportive environment, the government should prioritize constructing and renovating school toilets with changing rooms for girls, clean water and soap for hand washing, and sanitary disposal bins.
Children spend around one-third of their day in school, which is why the school administration must ensure that students have access to clean and hygienic urinals and toilets. Unfortunately, many schools pay little to no attention to the cleanliness of school toilets, which negatively impacts students’ health and learning ability. This underscores the need for a targeted intervention and hence the provision of changing rooms at schools for girls is paramount.
The Inspectorate Divisions of the Ministry of Education and Ghana Education Service should ensure that these basic requirements are in the schools during routine monitoring, to provide a safe environment for girls so that girls are not advantaged when it comes to access to quality education
A WASH Specialist, Martha Atia-Adjei said there are disparities among the urban rural and the public and private schools.
“If you look at most of the private schools, they have adequate sanitary facilities, very decent washrooms where girls can easily access during menstruation but same cannot be said for public schools in Ghana”.
She emphasized the need for decent changing room for girls at school. “There is a clarion call that when they are going to construct schools, schools must make sure that they have adequate sanitary facilities, changing room in the girl’s washrooms”.
Mrs. Atia-Adjei commended the government for launching the free sanitary pad initiative.
“On this particular day, I want to wish all girls happy menstrual day, menstruation is a beautiful thing and as activists within the WASH and Menstrual Hygiene sector, we want to commend the government for finally agreeing to support girls in school with sanitary pads. We hope that this will go a long way to improve and put confidence in our girls to become the best in future”.
