Uganda: The Hidden Menstrual Hygiene Crisis Among Middle-Class Women

When menstrual hygiene is talked about, most times, it’s framed as an issue exclusive to underserved or rural communities. However, even middle-class girls and women who may not struggle with access or affordability face significant challenges, particularly when it comes to safe and dignified disposal of menstrual products.

The absence of appropriate menstrual product disposal facilities in public toilets and workplaces forces many women to carry used sanitary pads in their bags until they find a suitable place to discard them. But is this hygienic?

The challenge is even more pronounced for women living in apartment buildings, where waste collection trucks often follow bi-weekly schedules. By the time the garbage is picked up, the used pads may have already started to emit foul odors, posing not only a hygiene concern but also a significant loss of dignity

Addressing menstrual hygiene for middle-class women is not about convenience; it’s about rights, dignity, and inclusion. It’s time we stopped assuming who needs support and started building systems that recognize the diversity of menstruators. The law is on our side. Now, implementation must follow.

A UNICEF and WHO report “Progress on drinking water, sanitation, and hygiene in schools 2000-2023: special focus on menstrual health” highlights that globally, access to proper menstrual waste disposal in schools remains alarmingly low, as less than one in three schools worldwide — just 31 percent — have bins for menstrual waste in girls’ toilets.

The situation is even more concerning in the least developed countries, where only one in five schools (17 percent) provide such facilities.

In sub-Saharan Africa, the numbers are worst of all, with just one in ten schools–only 11 percent–offering bins for girls to safely dispose of used sanitary pads.

Uganda, as a signatory to the Sustainable Development Goals and the Maputo Protocol, must translate these global commitments into localized actions starting with dignified menstrual waste disposal systems for all. Some of these global commitments include SDG 6 (Clean Water and Sanitation), especially the target to achieve equitable sanitation and hygiene for all, including menstrual hygiene.

Studies in many countries have found that inadequate disposal options often lead girls and women to either carry used pads with them or dispose of them unsafely–through flushing them down the toilet or open dumping.

Menstrual dignity should not be a privilege of the few. Whether one lives in a rural village or an urban apartment, the right to dispose of menstrual products safely and privately is a basic human right. Menstrual waste management is a justice issue

To improve menstrual hygiene management in schools and public places, the UNICEF and WHO report recommends several key interventions, but most importantly, and perhaps the most affordable and quick, is the provision of menstrual waste bins.

Uganda has committed to improving menstrual health through the Menstrual Hygiene Management Charter and WASH in schools guidelines. However, without enforcement mechanisms or accountability structures, these remain under-implemented.

The lack of disposal bins in both public and private institutions highlights a gap between policy and practice. It is essential for all girls’ toilets in schools to be equipped with covered disposal bins to allow for the safe and hygienic disposal of used menstrual products.

This issue is not limited to rural or low-resource settings–it also applies to urban areas, including even five-star hotels, which are not exempt from the challenges of menstrual hygiene management. These establishments must be more considerate of women’s needs by incorporating appropriate menstrual hygiene facilities into their sanitation infrastructure.

Providing adequate and conveniently placed disposal bins significantly reduces the chances of improper disposal methods, such as flushing pads down toilets or discarding them in open spaces. Such practices pose serious health risks and environmental hazards, which can be mitigated through proper waste management solutions.

Uganda’s National Menstrual Hygiene Management Charter (2015), is a policy that calls for all institutions, especially schools and workplaces, to provide menstrual hygiene-friendly infrastructure, including disposal bins and private wash areas.

The Water and Environment Sector Development Plan (2015-2020) acknowledges the need for safe sanitation services, including menstrual hygiene management.

The Education Sector Policy of the Ministry of Education and Sports has guidelines for WASH in schools, which recommend gender-sensitive sanitation facilities including bins in girls’ toilets.

Equally important for sustained progress, policy development and implementation at the national level are necessary. Governments must create and enforce policies that institutionalize menstrual health management in schools, ensuring that the necessary infrastructure, funding, and oversight are in place.

We call upon the Ministry of Health and Ministry of Education to integrate menstrual waste management into national health and school sanitation audits, ensuring no institution is left behind.

By Independent (Kampala).