Breaking Silence on Menstrual Hygiene

Amplifying youth voices to tackle myths and taboos surrounding menstrual hygiene

Gloria Lihemo and Hira Hafeez-Ur-Rehman
Aneesa, 12 years old, studies in SCD child protection center for adolescent girls in Quetta, Baluchistan province, Pakistan.
UNICEF/Pakistan/Asad Zaidi
17 April 2017

“When I first got my period I didn’t tell anyone for several days because I was ashamed, it took me two months to open up to mother.”  An 18-year old girl in Pakistan describes her experience through a U-Report poll on menstrual hygiene management (MHM) conducted on the 16th of February, 2017.


Prevailing social norms surrounding menstruation

Adolescent girls in Pakistan are often unaware or unprepared for the onset of menstruation (menarche) – mostly due to a culture of silence surrounding women’s reproductive health issues of which menstruation is a part. This lack of preparation, knowledge and poor hygienic practices during menstruation presents negative impacts on girls’ self-esteem and personal development. It also affects their education – they often miss school because of shame or lack of adequate facilities to manage their menstrual period. In addition to schools lacking proper hygiene facilities, teachers are often not prepared to respond to girls’ inquiries about menstruation.

Adolescent girls in Pakistan
U-Report Pakistan
Adolescent girls in Pakistan

Poll reveals girls lack knowledge of menstrual hygiene

To better understand this need, UNICEF launched an SMS poll on the 9th of March 2017 targeting 3,800 females aged between 10 and 35 via the U-Report platform. U-Report is a social messaging tool empowering anyone, especially the youth in any community globally, to respond to polls, and report issues that affect them.

The poll sent positive messages regarding the proper management of menstrual hygiene and invited young girls and women from all over the country to respond to questions relating to menstrual hygiene, free of charge. 710 of these young girls and women responded and shared their perspective on it.

The results indicated that 49% had no knowledge of menstruation prior to their first period. Also, mothers and teachers (53% and 27% respectively) were the primary sources of information on menstruation for girls. 0.9% of the respondents also rated the Internet including YouTube as sources for information. The poll further revealed that 44% of the girls do not have access to basic menstrual hygiene facilities at home, their workplace or school. 28 % of respondents said they missed school or work while on their period mainly because they were ashamed of getting red spots on their clothes/uniform, that boys would find out, or due to pain related to their period.

Respondents also cited helplines via their phones, information tools such as leaflets, social media, and doctors as ideal sources of information on menstruation.

5 questions polled on Menstrual hygiene management using the U-Report platform
U-Report Pakistan
5 questions polled on Menstrual hygiene management using the U-Report platform.

Girls’ voices echo the importance of breaking the silence around menarche

I wish every girl has proper knowledge and guidance so that when a girl reaches her puberty for the first time, she is confident and not panicked,” said a young female poll respondent.

“When I purchase sanitary napkins from a local store, they always wrap it in a newspaper or a paper bag so that no boys or men can see what I’m purchasing, why is buying sanitary napkins such a shame? I want every girl to talk about menstruation without feeling ashamed” says a 25- year old U-Reporter. Respondents cited examples of solutions needed to improve menstrual hygiene including access to affordable pads and proper sanitation facilities such as private and clean bathrooms.


Social media outreach offers girls a platform to ask questions

In addition to sending a poll, UNICEF also hosted a 3-hour live chat on the U-Report platform – targeting all 25,000 registered U-Reporters in Pakistan. UNICEF responded to over 500 of the 2,500 questions sent by girls and boys across the country via SMS messages (free of charge).A list of frequently asked questions and answers were also created and shared with all U-Reporters.

An invitation to a live chat discussion wherein you can ask questions sent via SMS (free of charge) around Menstrual Hygiene.
U-Report Pakistan
An invitation to a live chat discussion wherein you can ask questions sent via SMS (free of charge) around Menstrual Hygiene.


Below is a sample of questions raised:

“They say you should not take bath during first 3 days of periods, is it true?”

“I know about menstruation, but what are the ways I can ensure hygiene during periods?”

“Is it harmful to use sanitary napkin up to 10 hours?”

“What sort of hygiene should be adopted during periods?”

“If someone has menstruation, should she go to school or not”

“I feel a lot of pain during periods, why is that and what should I do”


Pakistan’s growing youth population is increasingly dependent on social media as a viable source of information. Platforms such as U-Report are leading the way by offering creative interactive methods to engage youth on issues that affect their development such as menstrual hygiene.

“Thanks to U-Report PakAvaz team for discussing topics like menstruation, it’s much needed,” said a U-Reporter from Sindh province. Excellent initiative, we need a platform to discuss important topics like this openly’ added a U-Reporter from Khyber Pakhtunkhwa province.

Feedback received from the menstrual hygiene poll and live chat has offered UNICEF vital insights to inform its work on social and behavior change communication for menstrual hygiene. U-Report is now partnering with UNICEF to create a network of champions to advocate for menstrual hygiene within their communities. Additionally, UNICEF and U-Report are launching an innovation challenge calling for youth to submit innovative tools and models that will allow girls and women to manage their menstruation with dignity.

Read the analysis of the menstrual hygiene poll and highlights from the live chat

The original story was published in U-Report Pakistan on 29 March 2017. View original story here.


About U-Report
U-Report is a social messaging tool allowing anyone from any community, anywhere in the world to respond to polls, report issues, support child rights and work as positive agents of change on behalf of people in their country. Members join the programme by sending a free SMS “join” to a short-code 8623 or U-Report twitter handle @PakAvaz or on Facebook at U-Report PakAvaz

Find out more here: U-Report PakAvaz & U-Report Global.

About UNICEF Global Innovation Centre
UNICEF’s Global Innovation Centre is working across the globe with country offices and partners to help unlock the big ideas like this that could benefit millions of people and has provided both the training and platform development to make this kind of activation possible.

Find out more about the UNICEF Global Innovation Centre here:

UNICEF promotes the rights and wellbeing of every child, in everything we do. Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere.

Find out more here: UNICEF & UNICEF Pakistan