The red thread: stakeholder perspectives on menstrual health and hygiene in Ghana

Menstrual hygiene management is a challenge for girls and women in Ghana due to a lack of access to affordable menstrual products; water, sanitation and hygiene (WASH) facilities; inadequate menstrual health education; and social stigma surrounding menstruation. This study aimed to explore the experiences and perspectives of various stakeholders and identify strategies for improving menstrual health and hygiene (MHH) among adolescent girls.

We recruited stakeholders for focus group discussions (FGDs) from basic schools (primary and junior high, grades 1-9) in Hohoe, Volta Region, Ghana. We conducted FGDs with adolescent boys (n=60), parents (n=48) and gatekeepers (n=19). Semi-structured guides were developed and used during FGDs, recorded and supplemented by field notes. Transcripts were thematically analysed using MAXQDA 2024 software.

Adolescent boys demonstrated a willingness to learn and support menstrual health of peers, challenging the assumption that they primarily contribute to stigma. The study also indicated a shift in perceptions and practices related to menstruation among parents; whereas, gatekeepers highlighted government commitments on MHH infrastructure and material provision for schoolgirls. Based on the findings, the following strategies were identified: (1) the need for adequate WASH facilities, (2) the need to address stigma associated with MHH, (3) the need to reduce the cost of sanitary materials and (4) the need for improved menstrual health education.

These results confirm that cultural stigmas, inadequate facilities and financial constraints still exist. These act as key barriers to MHH for schoolgirls in Hohoe, Ghana. To support girls' health, dignity and education, recommendations include inclusive education programmes, improved WASH facilities and affordable and/or sustainable menstrual products.