More than a monthly cycle: Why menstrual health is a human right

That same principle guides CARE’s emergency response far beyond Bangladesh: when disaster or conflict strips away privacy, income, and access to basic services, menstrual health cannot be treated as secondary. It has to be built into response from the start.

Ensuring dignity in emergencies has been central to CARE’s work since the first CARE PACKAGE® deliveries reached families recovering from World War II in 1946. Today, that legacy continues through the CARE PACKAGE® for Emergencies: a portable kit designed to help a family of four through the first critical month after disaster strikes. Each package includes a dedicated dignity kit — with sanitary pads, soap, and undergarments — because menstrual health is not a secondary need. In any emergency, it is a part of survival.

No safe place, no safe period: From Lebanon to Gaza to Cuba

In Lebanon, where conflict has displaced over 1.2 million people, managing one’s menstrual cycle only adds to the strain of daily survival. Displacement disrupts routines, privacy, and access to basic services, and stress can take a physical toll. “Some of us got our period twice in one month due to the stress,” one displaced mother shared. Another added: “We need water, food, and clothes — but we also need to preserve our dignity.”

Lack of menstrual hygiene materials is directly linked to urogenital infections — studies show the risk rises by up to 30%, turning basic hygiene items into an essential part of survival.

In neighboring Gaza, the crisis is even more acute. Nearly 700,000 women and girls lack basic sanitary pads, making it essentially impossible to manage periods safely. Farah, displaced in Gaza, describes the grueling daily toll on physical and emotional well-being: “If you are a woman, you know what it is like to have your period,” she says. “Right now, we have no sanitary supplies. In the shelters, women must sometimes queue for hours to use the bathroom while feeling unwell and unable to dispose of tissues soaked in blood, as they do not have any hygiene pads.”

But period poverty is not limited to conflict or displacement. Environmental disasters and economic collapse can be equally devastating. In Cuba, back-to-back disasters — including Hurricanes Óscar (2024) and Melissa (2025) — combined with soaring inflation have pushed menstrual products off pharmacy shelves, forcing women to find what they need in expensive informal markets.

CARE’s collaboration with the “Copas para Cuba” project offers a more durable alternative: medical-grade, reusable menstrual cups. These products are durable, more affordable over time than traditional menstrual products, and are less dependent on fragile supply chains. According to one survey, a single menstrual cup can last up to ten years — making it one of the most cost-effective and sustainable options for communities with limited resources.

From taboo to transformation: Ethiopia’s school-by-school revolution

In Ethiopia, 70% of women cannot manage their periods in safe and dignified conditions — one of the highest rates of period poverty on the continent. Menstruation is still rarely discussed openly, and that silence has real consequences: girls can miss out on school, families delay buying necessary supplies, and a basic health need is treated as a source of shame.

CARE’s response in Ethiopia works on two fronts: putting menstrual products directly into women’s hands and bringing honest conversations about menstruation into schools, clinics, and communities. In Adama, CARE distributed over 30,000 reusable menstrual kits, with more than half going directly to local schools.

For students, the impact was immediate. “At first, I was unsure, but after trying the reusable pad, I found it healthier and more comfortable. This product should be available to everyone,” says Beza, a high school student.

For Misgana, another student, the difference is even more direct. “I can’t afford disposable pads. The reusable ones let me keep going to school.”

That matters far beyond a single school day. Every additional year of education can increase a girl’s lifetime earnings by up to 10%.

But distributing products without changing attitudes only goes so far. To ensure lasting change, CARE engages entire communities — including men and boys — in practical conversations about menstruation, health, and access.

At a local clinic in Adama, deputy director Ashibir Kita describes a quiet but important act: “We take time to offer 20-minute talks on menstruation, covering topics like premenstrual syndrome, pain relief, the different types of menstrual products, and how to dispose of them. We also challenge taboos.”

In many Ethiopian households, menstruation is still treated as a private shame rather than a health matter, and purchasing menstrual products is seen as women’s business alone. But in communities where many women have little or no independent income, that assumption can leave them without what they need.

“Involving men is essential,” says Rahel, a nurse working with CARE. “Many women have no income of their own, so men must understand and step up to help them access safe menstrual products.”

Further north, in the city of Bahir Dar, CARE is addressing another barrier girls face at school: the lack of a safe, private place to manage their periods during the day. Unique Mebratu, 14, remembers what school used to mean when her period arrived: “Previously, the menstrual health and hygiene room was highly uncomfortable, filled with dust and termites. As a result, I used to miss an average of five classes each month.”

Unique is not alone. Across Bahir Dar’s public schools, missing class during menstruation was common.

CARE’s Abrehot project, funded by Lyreco for Education, has helped change that reality across ten public schools by installing clean, private facilities where girls can wash, rest, and manage their periods safely. For Unique, the difference is practical and profound: “Today, when my period unexpectedly started, I asked my teacher for permission and stepped out of class. In the room, with guidance from my teacher, I was able to use sanitary pads, take a shower, and rest on a bed. After some time, I safely returned to class.”

To help this menstrual health initiative continue independently, CARE equipped each school with electric sewing machines so students can produce their own underwear and reusable pads directly on campus. It may be a small machine in a school room, but it is also much more. It gives girls a tool to build skills and helps create a local, resilient supply chain for menstrual products in times of crisis.

Measuring what matters: How science is backing menstrual health

Ethiopia is not alone in using schools as a setting for change. In Madagascar, the KILONGA project worked with 250 schools to improve menstrual health through clean restrooms, locally produced reusable pads, and training for  “Young Girl Leaders” who can help break down stigma among their peers.

CARE and its local Malagasy partners, SAGE and ATDR, launched the project in 2021. The results caught the attention of the Abdul Latif Jameel Poverty Action Lab (J-PAL), a world-renowned research institute founded by Nobel Prize-winning economists Abhijit Banerjee and Esther Duflo.

Researchers found that the project did more than improve access to menstrual supplies. It helped reduce the daily stress girls experienced around menstruation and supported stronger school outcomes. In the region where the project operates, menstrual stigma and shame push one in two girls out of their grade level upon reaching puberty. But in schools supported by CARE, reported chronic daily stress dropped significantly, and participating girls’ probability of passing their critical end-of-year exams rose from 50% to 60%.

To measure a topic as personal as menstrual stigma, researchers used innovative tools, including heart-rate tracking during peer discussions. The findings helped show what girls already know: when schools provide safe facilities, reliable products, and open conversations, menstruation becomes less of a barrier to learning.

Césaire, a SAGE program coordinator, sees a shift happening not only among girls, but across the school community. “As a man, supporting this change is a responsibility and a source of pride,” he says. “Boys are getting more involved. They understand, respect, and take action.”

From emergency to equality: The work that remains

True change demands more than a single day of awareness. It requires sustained funding for school sanitation, female-led social enterprises, and the removal of economic barriers. One of the most visible is the so-called “pink tax” — in some countries, women pay up to 20% more for menstrual products simply because they are taxed as luxury items, not necessities.

No woman or girl should face these barriers. This is what CARE is working toward — in camps, classrooms, and communities across the world, not just on World Menstrual Hygiene Day, May 28, but every day of every month — because dignity, in any crisis, is never optional.

And when menstrual health is prioritized, something larger unlocks. Girls stay in school. Women stay safe. Families stay intact. And a natural, universal process stops being treated as a source of shame.