The Red Thread: Stakeholder Perspectives on Menstrual Health and Hygiene in Ghana
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Background
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.
Methods
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 analyzed using MAXQDA 2024 software (1).
Results
The themes identified were menstrual health management, perceptions and understanding of menstruation, social and cultural practices, and education and awareness. 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.
Conclusion
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 programs, improved WASH facilities, and affordable and/or sustainable menstrual products.
What is already known on this topic?
Menstrual hygiene remains a significant issue in Ghana, with challenges such as a lack of affordable menstrual products, inadequate water, sanitation, and hygiene (WASH) facilities, limited menstrual health education, and pervasive stigma.
What this study adds
This study uniquely incorporates perspectives from multiple stakeholders, including adolescent boys, parents, and gatekeepers (teachers, school health coordinators, and school community leaders), to provide an all-inclusive understanding of MHH barriers and strategies to address them. The study reveals a shift in cultural practices, with modernization eroding some traditions but perpetuating stigma through religious and social norms, which continue to isolate menstruating girls and women.
How this study might affect research, practice, or policy
The findings support policy recommendations to reduce financial barriers to menstrual products, including tax elimination or subsidies, and to invest in school infrastructure upgrades. Future research and interventions can build on this study’s insights to develop context-specific, gendersensitive, and sustainable approaches to improving MHH.
