The Role of Menstrual Health Education in Reducing Period Poverty

Foreword

By: Kirby Moses

Holistic education has the power to bring about true peace and equity. The truth is that misinformation and shame are serious harmful factors to period poverty. This fear of ridicule prevents people from seeking support during their menstrual cycle. This withholding of information and misinformation about menstruation stunts our progress toward more peaceful and equitable Caribbean societies. This learning brief invites us to understand that period poverty is a solvable issue and can be mitigated through community building and menstrual health education. A crucial part of the menstrual equity movement involves teaching communities the art of unlearning myths and stereotypes deeply embedded in our Caribbean culture. When we empower communities this way, they can begin to have more dignified and collective menstrual experiences and a fairer chance to enjoy a liberated lifestyle. This learning brief is a reminder that quality education continues to be the fuel behind equitable, safer, and empowered societies.

Working with Feminitt, I have witnessed the transformative power of menstrual health education as a catalyst for social development and peacebuilding. Menstrual health education workshops/lessons can turn disinterested and "grossed-out" youth into allies and advocates. This knowledge can shift deep shame, misinformation, and embarrassment about their bodies into infectious self-confidence. News of a "care bank" offering free menstrual products launching at their school or community ignites hope and excitement within students.

When given a safe space to have open and honest dialogue, even the youngest among us can grasp the importance of better supporting those who menstruate. If they can shift their perspectives from places of ignorance and helplessness to progression, compassion, and empathy, policymakers can, as well.

Feminitt stands humbly as a trailblazer in ending period poverty and achieving menstrual equity in Trinidad and Tobago. As the Menstrual Equity movement across the region and world continues to build momentum, our commitment to decolonize menstrual health education continues to challenge the oppressive systems that perpetuate menstrual stigma. Menstrual health education is not just an essential branch of Comprehensive Sexuality Education, it is foundational for a peaceful and equitable world. It must continue to extend into our most vulnerable communities, laying the groundwork for cultural transformation and the eradication of period poverty.

Background

On January 24, 2024, Feminitt Caribbean commemorated World Education Day by hosting a virtual panel discussion on menstrual health education. The goal of this panel was to bring together key actors within the menstrual equity field to share impactful stories that highlight the importance of menstrual health education in reducing period poverty.

The event featured Samantha Duncan of Trinidad and Tobago, Founder and Director of People and Innovation of Helping Her Foundation, Tanya Ambrose of Antigua and Barbuda, Founder of Scrub Life Cares, Priya Ramdial of Trinidad and Tobago, Founder of Pretty Tough Project, and Shelly-Ann Weeks of Jamaica, Executive Director of HerFlow Foundation. This session was moderated by Kirby Moses of Trinidad and Tobago, Community Liaison Officer of Safe Cycle by Feminitt.

Central to the responses of each speaker was their commitment to menstrual equity and a world free from stigma and discrimination on the basis of menstruation. Speakers spoke of their advocacy and interventions at various levels. Their openness and methods of storytelling created a brave space for attendees to question, challenge and share their own experiences and knowledge. When panellists were asked about the pushback they have experienced in relation to approaching menstrual health education as part of general comprehensive sexuality education (CSE) programming, the responses varied.

The responses highlighted:

sociocultural differences among various groups of people in Trinidad and Jamaica; a lack of consensus on inclusive approaches to menstruation such as exclusive language and stigmatising language surrounding menstruation, fears that educating boys on menstruation will cause homosexuality and reduced comfort of girls in co-ed teaching sessions; and the belief that menstruation is unclean.

These responses signal the need to:

strategize against misinformation about menstrual health education and CSE

meet communities where they are at with the hope of transforming their beliefs to promote safe spaces for learning dismantle harmful norms and practices around menstruation.

Dunnavant and Roberts (2013) note that religious beliefs among other cultural ideologies can prevent positive understanding of menstruation, further perpetuating myths, stigma, and discrimination. More recently, Rice (2024) notes that a lack of information, access to supplies, ethical and moral considerations act as barriers to comprehensive access to services and education related to reproductive health.

Panellists discussed the need for collaboration between the state and civil society organisations as they are often on the frontlines of human rights discussions and interventions. They highlighted the need for inclusive, ageappropriate, and culturally sensitive CSE that includes menstrual health management and period poverty to be taught in schools. Panellists also placed emphasis on the importance and positive impact of including people assigned male at birth in the conversation around menstruation and period poverty, citing improved gender relationships

Finally, panellists addressed the event’s key question, “what role do you see menstrual health education playing in reducing period poverty?”, by explaining that education is what makes the initiatives to end period poverty sustainable. An emphasis was placed on teaching going hand in hand with learning and understanding people’s circumstances. By educating people on menstruation, it increases people’s options, for example the range of products they are willing to use, and deepens their understanding of bodily functions. In the discussion that ensued about environmental impact of period products, Ms. Weeks pinpointed the cultural factors at play in our Caribbean societies are often the largest barriers to change, while Ms. Duncan added that cultural and religious factors must be manoeuvred and met with respect in the fight for menstrual equity.

Female Reproductive Anatomy Via The

Right Way (Feminitt Caribbean, 2022)

Menstruation is the process of discharging blood and other material from the endometrium – the lining of the uterus. This occurs roughly every 28 days from puberty until menopause, except during pregnancy. Menstruation begins during puberty It includes the follicular phase – when the egg prepares to be released and the uterine lining develops, the ovulation phase – when an egg is released from the ovaries and travels towards the uterus, the luteal phase – when the uterine lining thickens to support a fertilised egg growing during pregnancy, and menstruation – when the uterus lining is shed after the egg is not fertilised. It is a cycle so there is no beginning or end. However, for tracking purposes Day 1 is always the first day of bleeding. The follicular phase happens at the same time as the menstrual phase, ovulation takes place around day 14, and the luteal phase occurs immediately after ovulation.

A ‘Politics of Care’ to

Menstrual Health: What is it and who is it for?

Care is central to ensuring good health and well-being for all The type of care we can receive as human beings determines the quality of our health and how we can enjoy our basic human rights. As feminist activists and advocates, we know that care, particularly, health and health care is political. Bambra (2005) writes that health is political because “power is exercised over it as part of a wider economic, social and political system” (p.187). When considering access to healthcare services and resources, there is a significant disparity between who can comfortably access care and the quality of these healthcare services made available to them.

This brief examines menstrual health and menstrual health education, with the hope of shedding light on the importance of inclusive and critical menstrual health education to reduce period poverty. We know that menstrual health education is one contribution to achieving menstrual equity but we believe that it is a crucial one. To enable a society that sees period poverty as a human rights issue, we must ensure that we understand that experiencing a safe menstrual cycle is something that every human being with the ability to menstruate deserves.

The menstrual cycle spans a 30-day-odd period, variable to each individual. There are four phases of the cycle: menses, follicular, ovulation, and the luteal phase. People who menstruate are always at some point in their cycle, no matter what day or week of the month Therefore, when discussing healthcare, we must also talk about menstrual health, as every aspect of health links to an individual’s menstrual cycle. Access to comprehensive healthcare facilities should include the needed services and resources to ensure a safe menstrual cycle at every phase. According to Hennegan et al., achieving menstrual health is ensuring easy and supported access to information about the menstrual cycle, access to medical treatment and resources, as well as guaranteeing an environment in which caring for your physical and mental well-being is unquestioned and automatic (2021)

Upholding easy and supported access to information means learning about all phases of the menstrual cycle, and this must be implemented at every level of education. Greater emphasis needs to be placed on menstrual health within health education curricula. It should seek to inform young people who menstruate about what is going on with their bodies, the relationship between their menstrual cycles, and its inextricable link to their sexual reproductive health and rights (SRHR).

Supported access to proper medical treatment and resources demands that policies be implemented to facilitate the material conditions that enable access to medical centres, treatment, psychosocial support, and period products from trained and informed practitioners and service providers. More particularly, “supported access” requires that this access be peoplecentred and informed, based on a person's social determinants of health. Therefore, there should not be any form of discrimination regarding the development and implementation of education, prevention, treatment, and care programs and interventions. Such effort must be placed in public education, as well as improving the standard of education for actors delivering menstrual products and care. Policies can only be effective if there are persons who can uphold them and if they are people-centred and evidence-based

Guaranteeing an environment in which care practices are reflexive refers to the required safety in which a person who menstruates can navigate their cycle Hennegen et al (2021) speak of "care practices" in menstrual health, taking into account practical elements such as the use and disposal of (reusable) pads, (biodegradable) tampons, period underwear, menstrual cups/discs, medication, contraception (bearing in mind how the choice of contraception affects the menstrual cycle as well). As well as whatever any person deems necessary to be comfortable, safe, and healthy during their menstrual cycle – not just during their period!

Care practices must be selected and organised according to an individual's choices, but such practices rely heavily on external factors. These link to the environments people who menstruate navigate –– Who are they surrounded by?; What support system do they have?; What water, sanitation, and hygiene (WASH) facilities are accessible to them?; At what cost can they find reusable menstrual period products? Are there unprejudiced, care-intentional medical centres and professionals nearby? How are they getting information relating to their menstrual health?

Advocacy to promote menstrual equity policies should be rooted in care and consideration of the needs and challenges of people who menstruate, inclusive approaches, and aimed at restoring dignity. Consolidating infrastructure around menstrual health must practise a "politics of care" (hooks, 2000). Hennegan et al. speak of "care practices" as how individuals choose to cater to their needs during their menstrual cycles. Choosing means there is the possibility of choice, which demands policy, politics, and infrastructure that allows for this. Among many other lessons, bell hooks teaches us that feminist practice is a practice of solidarity, of community, of love (2000) Achieving menstrual health can only happen through the actions of our communities, with the understanding that safer menstrual health policies for those who menstruate result in safer health and care practices. This is a "politics of care".

A key takeaway from the January 24, 2024, panel is the consensus that being better informed about menstrual health leads to better agency over one’s life and body. A lack of menstrual health education means that people who menstruate are ill-equipped to manage their periods, spot possible irregularities that may require medical attention, and reinforce harmful beliefs about menstruation. Menstrual health education promotes good health and well-being. Additionally, it is critical to include people who do not menstruate in these conversations.

As mentioned in the opening statements of this brief, period poverty and menstrual inequity are a human rights issue: the better informed we all are, including those who do not menstruate, the more responsibly and effectively we can achieve menstrual healthcare. Many people present at the January 24 panel emphasised this need:

“When boys are educated, they are better equipped to challenge myths and stigma about menstruation.”- Priya Ramdial, Pretty Tough Project, Trinidad and Tobago.

This is crucial: people who menstruate are the primary audience for this information, as it directly concerns their bodies and lives. However, fully achieving menstrual health is based on the awareness, respect, and care from all, actively menstruating or not. The findings from the 2021 Safe Cycle report highlight the necessity of including everyone in learning about menstrual health to prevent the spread of often harmful stigma. Following the phrase “Reducing Stigma, Reducing Shame,” it is clear that the stigmatisation of menstruation, menstrual cycles, and periods is toxic to the well-being of those who menstruate and actively prevents fulfilling some of the conditions to achieving menstrual health (Feminitt Caribbean, 2021). Referring to Hennegan et al.'s study, menstrual health cannot be achieved if access to learning, practical, and medical resources is limited, restricted, or prevented (2021). The spread of stigma, particularly with those who, more often than not, gatekeep and control our access to such resources, actively works against the achievement of menstrual health.

Our experiences in healthcare, the case studies, commentaries, and stories gathered for the Safe Cycle report demonstrate that it is necessary to include menstrual health at all stages of education and policy-making. In education, this approach keeps an open, informed conversation going (2021). In policy-making, this provides the infrastructure through which menstrual health, central to satisfying the sexual reproductive and health rights of all, is achieved in such a way that everybody has safe, informed agency over every aspect of their health and well-being

Role of Menstrual Health Education in Reducing Period Poverty

Adequate education menstrual health education can disrupt social and cultural norms that continue to promote stigma around menstruation. A lack of key information about menstrual health can contribute to the persistence of these norms which influence how people who menstruate perceive their bodies, and in turn discourages people from seeking assistance when problems arise regarding their menstrual health (UNESCO, 2018)

In a study done by Plan International United Kingdom (U.K.) (2017), 1000 girls in the U.K. between the ages of 14-21 were surveyed about their menstrual experiences. The main findings of the study showed that three-quarters of girls admitted that they were made to feel embarrassed buying sanitary products while 82% admitted they hid or concealed sanitary products. Additionally, less than a quarter of them felt comfortable discussing their periods and under a third reported feeling comfortable discussing their bodies with their fathers. For this reason, menstrual health education should also be extended to other audiences, especially men and boys in order to equip them with the empathy and knowledge needed to support women, girls and people who menstruate. Simply put, period stigma exacerbates period poverty through shame and discomfort that prevents people from asking for resources when they need them.

In addition to empowering people to advocate for themselves by asking for help, education also encourages people to advocate for change at the policy level. Approximately 500 million girls will experience period poverty in their lives (Alugnoa et al., 2022) as a result of lack of access to education, menstrual products, hygiene facilities and waste management (Cardoso et al., 2021) This number is likely to have increased during and after the height of the COVID-19 pandemic.

Period poverty is a serious concern for gender equality, especially in lowincome and resource-scarce communities. For instance, in Kenya, young girls miss approximately 35 million learning days a month due to the lack of access to menstrual products and adequate sanitation (Secor-Turner et al., 2016), also making this phenomenon part of a larger education crisis for girls. Despite the gravity of this phenomenon, there is a glaring lack of research on it, with most of the literature being concentrated within the U.S. and U.K. Research can play an important role in educating and influencing policymakers to enforce legislation that can contribute to period poverty relief.

In a study that utilised data from 504 women between the ages of 18-48 in urban areas of Trinidad and Tobago, researchers found evidence that supports the existence of period poverty in the country (Rambocas et al., 2023). The main findings were as follows:

76% reported that they did not believe sanitary products were affordable.

51% reported they struggled to obtain sanitary products.

55% indicated that they had to borrow or change the current brand of period product they were using.

51% reported that they had to improvise or use alternative materials instead of menstrual products such as toilet paper.

A large number of participants reported that their workplace or school did not provide menstrual products.

99% reported they believed that schools and workplaces should provide these products.

This study presents significant findings for legislative decisions that can address this issue and complement the efforts of NGOs and activists in the country and wider Caribbean region. The findings also contribute to filling the gap in period poverty literature within the region. The researchers note that a potential limitation of the study is due to no standardised measure for researching period poverty, which suggests a need for additional research on the topic

Another way in which menstrual health education can alleviate period poverty is by informing people about alternative, more accessible, and more sustainable menstrual products that they may not be aware of. However, if people cannot access proper resources and sanitation facilities, sustainable menstrual products may not be best suited. Thus, cooperation with national institutions is critical for implementing interventions for relief by providing proper access to sanitation, in addition to efforts such as free or subsidised menstrual products In the interim, the work of NGOs and activists across the Caribbean continues to provide aid in the form of education and menstrual products such as Feminitt Caribbean (Trinidad and Tobago), Scrub Life Cares (Antigua), and HerFlow (Jamaica).

What’s Sustainability Got To Do With It?

MENSTRUAL HEALTH EDUCATION, PERIOD POVERTY AND REUSABLE PERIOD PRODUCTS

The use of reusable products requires regular care that can only be done with clean running water and access to menstrual health education that explores a range of menstrual health management plans. As such, in many communities across the globe, there are substantial barriers to using reusable products, as there is a lack of basic sanitation services particularly in low to middle-income countries. A UNICEF report found that around 2.3 billion people across the world lack access to these basic services, like clean running water and soap (UNICEF, 2018). This must primarily be addressed to make the shift to a more green menstrual health management plan that can both benefit people and the planet. Coupled with this, a cultural shift is required to reduce stigma and taboo related to "purity" and blood.

Reusable period products have also proven to be cost-effective and environmentally sustainable in the long term. Although they can have a steep upfront cost, they last longer than disposable products. Harrison and Tyson (2022) -- note that it takes about 500 to 800 years for disposable period products to decompose, emphasising that they are not biodegradable. These statistics demonstrate the linkage between menstrual equity and climate and environmental justice. “...human and planetary sustainability are one and the same thing” (The Common Worlds Research Collective, 2020, p.2). As a feminist organisation, our goal is not to place the onus on individuals to change the trajectory of the climate crisis, but to understand the connections while advocating policymakers and state officials to transform systems that allow for the integration of comprehensive menstrual health education, gender-responsive climate policies and improved WASH facilities for all.

Case Studies Across The Anglophone Caribbean: Who is Who?

Helping Her Foundation (HHF)

HHF is a registered NGO based and operating in Trinidad and Tobago for the past nine years Founded by Samantha Duncan, HHF provides free menstrual health products and menstrual health education to citizens of Trinidad and Tobago. Its main target audience ranges from school students, residents of state homes, and working professionals in the public and private sectors.

HHF delivers menstrual health education sessions in secondary schools across Trinidad and Tobago, corporate companies, and state homes, exploring topics such as menstrual health management, period poverty, myths and stigma, and the role of the state in ensuring menstrual equity for all.

Pretty Tough Project (PTP)

PTP is a registered NPO based and operating in Trinidad and Tobago for the past two years Founded by Priya Ramdial, PTP conducts workshops and sessions for students, especially younger women in primary and secondary schools in Trinidad and Tobago covering topics such as self-love, menstrual and mental health.

PTP also works alongside other organisations within the private sector to gather resources to support young people who menstruate in accessing the needed period products and healthcare.

Scrub Life Cares

Scrub Life Cares is a nonprofit organisation serving women and youths in underserved communities by promoting Health Education. The organisation believes that every person who menstruates should have access to these basic essential items to manage during their cycle. Scrub Life Cares addresses the critical issue of menstrual health among girls and women in underserved communities. Through targeted educational programs, such as their Community-Based Grow with The Flo program, they focus on menstrual hygiene geared toward educating menstruators about their periods, the significance of having a Period, removing the stigma, and having open conversations about periods and hygiene. They strive to remove the barriers that prevent women and girls from receiving the supplies and education needed to remain healthy during their menstruation and throughout their daily lives.

In addition to the focus on menstrual health, Scrub Life Cares is committed to providing comprehensive sexuality education to individuals in underserved communities. They recognize the interconnectedness of menstrual and reproductive health and understand the importance of equipping individuals with the knowledge and skills necessary to make informed decisions about their sexual and reproductive well-being. Their program covers a wide range of topics, including contraception, STI prevention, good touch, bad touch, consent, and healthy relationships, empowering individuals to navigate these aspects of their lives confidently and responsibly. Through this holistic approach, they aim to promote a culture of respect, understanding, and autonomy surrounding sexual and reproductive health

HerFlow Jamaica

HerFlow, founded by author and activist Shelly-Ann Weeks, is an awardwinning social enterprise in Jamaica. The organisation addresses period poverty, period stigma, and shame and provides information and support for female reproductive health. Described as the foremost authority on period poverty in Jamaica, HerFlow delivers menstrual health education programmes for in and out-of-school youth, partnering with other NGOs to advance menstrual equity. More than 7 million menstrual products have been donated to Jamaican public schools, government homes, correctional facilities, and community organisations as of January 2024.

HerFlow organises a period awareness week in October that brings together local advocacy to end period poverty while providing educational resources and support for women and girls. As the lead of HerFlow, Weeks works to link menstruation to nutrition and other lifestyle choices, centering a holistic approach to ensuring safe menstrual cycles.

Panellists Insights

When young people are better informed about menstrual health, they can have greater control over their lives and contribute to decisionmaking.

1. Having the practical knowledge, such as information about hygiene, nutrition, and self care, equipped people who menstruate to make more informed decisions, alleviate discomfort, assert bodily autonomy, and build confidence that applies to other parts of life.

With more knowledge, your decisions are not based on myths and misconceptions and people who menstruate are also able to know their body better and seek medical attention when necessary.

Eg: A UK study found that 62% of women (aged 16-54) would put off going to a doctor with symptoms of endometriosis because they don’t think it’s serious enough to bother a doctor with and they would be embarrassed, or dont think they would be taken seriously (Endometriosis-UK, 2021).

2. There needs to be deliberate inclusion of boys and men in the conversation.

When boys in school are educated about periods, the dynamics between them and girls witness a remarkable enhancement. This results in a shift in behaviours where boys refrain joking about menstraution and menstrual products –– normalising puberty.

Boys and men also go through puberty and body changes - this can help normalise their own understanding of themselves as growing people, and to help feel confident and sure in their bodies throughout all its changes. i.

3. “Reducing Stigma, Reducing Shame”: Menstrual stigma is largely invisible but extremely harmful.

Stigmatising beliefs can have harmful effects:

i.

Common period taboos include the idea that women are impure, dirty, or sinful while they’re menstruating. Some women are discouraged from touching or washing their genitals during their periods to eliminate the possibility that they might contaminate the water of a communal bathing area (UNFPA, n.d).

ii.

Reinforces misogynist beliefs: Research shows that women who signalled their menstrual status by dropping a tampon in front of others were ranked less competent and less likeable than someone who dropped an object perceived as neutral, such as a hair pin” (Roberts et al, 2002)

Recommendations

Develop and implement a curriculum for boys and men to learn about menstrual health:

Schools should be a source of life-changing education that supports the development of learners as they navigate the world around them. However, topics related to sexual and reproductive health, particularly menstrual health education is left out of the general school curriculum as it is not an examinable topic. However, significant effort has been made in the Caribbean region to deliver non-formal menstrual health education which can work as a positive alternative. Teachers and facilitators should be engaged in consistent training with adequate compensation to learn how they can navigate diverse classrooms in a way that fosters safety, comfort and openness for all learners. Though existing teaching and learning practices on topics of menstruation in the Caribbean encourages sex-seggregated classrooms, there is benefit in joint classrooms as menstrual equity is a whole-society issue. However, teachers and facilitators should be trained to determine what is needed to ensure the safety and comfort of students.

Equip school bathrooms and classrooms with menstrual products:

Though pink tax was removed from menstrual products in some Caribbean countries, some families are still unable to afford them Global studies show that some students often miss school due to period poverty. Schools can play a critical role in ensuring that all students can learn by providing free menstrual products for them to access with ease. When schools provide menstrual products, students are more likely to attend school (Citron Hygiene, 2023).

Continued collection of information from local communities across the Caribbean region to determine barriers to menstrual education, menstrual health care services and menstrual products.

Addressing period poverty requires constant interrogation of the issue and responsive interventions that seek to ensure that people who menstruate are able to do so with dignity and safely. As the world faces various impacts to regional economies, there is significant job loss that impacts household income. Understanding the needs and the range of barriers that exist to menstrual equity, allows for movement actors to tailor their responses accurately and effectively to the benefit of those most affected.

“Period poverty is a project because it is something that we can end.” - Shelly-Ann Weeks, HerFlow, Jamaica.

1. Periods and Neurodivergent Children by the University of Edinburgh: https://www.ed.ac.uk/sites/default/files/atoms/files/periods and neurodi vergent children .pdf

3.

The Cost of Menstrual Shame: TedTalk by Kayla-Leah Rich : https://www.youtube.com/watch?v=S y6CJLMuiw

2. Policy and Standards for Water, Sanitation & Hygiene (WaSH) in Schools 2018-2023 by the Ministry of Education, Papa New Guinea: https://www.education.gov.pg/admin/images/products/046b4b4c8e205 37b88adecaab2c918d2.pdf

4.

Period Poverty: A Neglected Public Health Issue: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372806/

5. Period Stigma: https://wwwippforg/blogs/period-stigma-how-it-holdsback-girls-and-women

Safe Cycle Report- Ensuring a Safe Menstrual Cycle and Menstrual Equity: https://issuu.com/feminittcaribbean/docs/safe cycleensuring a safe menstrual cycle and me

6 Puberty and Menstruation- What to expect: https://amaze.org/video/puberty-menstruation-what-to-expect/

7. Five Things You Can Do to End Period Poverty: https://planuk.org/blogs/five-things-you-can-do-to-end-period-poverty

8. Why boys and men need to be included in menstrual health and hygiene resources: Why boys and men need to be included in menstrual health and hygiene discussions - AFRIpads.

10.

9. Talking about Periods beyond Gender: Talking about periods beyond gender

References

Citron Hygiene “The Benefits of Tampon and Sanitary Napkin Dispensers in Public Restrooms.” 2023.

Common Worlds Research Collective. “Learning to Become with the World: Education for Future Survival.” UNESCO, Futures of Education Initiative, 2020.

Dunnavant, NC, Roberts, TA Restriction and Renewal, Pollution and Power, Constraint and Community: The Paradoxes of Religious Women’s Experiences of Menstruation Sex Roles 68, 121–131 (2013). https://doi.org/10.1007/s11199-012-0132-8

Feminitt Caribbean. 2021. Safe Cycle Report: Ensuring a Safe Menstrual Cycle and Menstrual Equity. Trinidad and Tobago: Feminitt Caribbean.

Feminitt Caribbean (2022), The Right Way Toolkit: Understanding, Exploring and Reimagining Sexual and Reproductive Health and Rights

Garg S, Anand T. Menstruation related myths in India: strategies for combating it. J Family Med Prim Care. 2015;4(2):184-186. doi:10.4103/2249-4863.15462.

Harrison, Megan E, and Nichole Tyson. "Menstruation: Environmental impact and need for global health equity." International Journal of Gynecology & Obstetrics 160, no. 2 (2023): 378-382.

Hennegen J, Winkler J.T, Bobel C, Keiser D, Hampton J, Larsson G, Chandra-Mouli V, Plesons M, Mahon T 2021, Menstrual Health: A Definition for Policy, Practice and Research, Sex Reproductive Health Matters 29(1) , Menstrual Health: a definition for policy, practice and research

Rambocas, Nadira, Yasphal Kissoon, Jade Marie Kennedy, Kabirah Mohammed, Danae Khan, M. Shastri Motilal, and Anu Bissessar. "Assessing period poverty in Trinidad and Tobago: An exploratory approach" Medical Science and Discovery 10, no 1 (2023): 25-30

Rice M. Sociocultural Factors Affecting Reproductive Health in Latin America and the Caribbean. International Quarterly of Community Health Education. 1991;12(1):69-80. doi:10.2190/T30Y-NUMU-VE57-T649

Roberts, T.-A., Goldenberg, J. L., Power, C., & Pyszczynski, T. (2002). “Feminine Protection”: The Effects of Menstruation on Attitudes Towards Women Psychology of Women Quarterly, 26(2), 131-139 https://doiorg/101111/1471-640200051