Period Poverty Is Not a Hygiene Problem — It Is a Justice Problem

Ubuntu Village · Public Health · East Harlem & East Africa

A girl who cannot afford menstrual products cannot go to school. Cannot go to work. Cannot be well.

Period poverty — the inadequate access to menstrual products, sanitation, and education that girls and women in low-income communities face every month — is consistently misframed as a hygiene problem. It is not. It is a structural justice problem, with consequences that compound across generations: in East Harlem, where Ubuntu Village is rooted, and in Kenya, Uganda, and Nigeria, where our programs work alongside communities building their own futures. This post names what period poverty costs girls’ education and futures, what our ancestors understood about menstrual health that colonialism tried to erase, and what justice — not charity — requires.

The Language We Choose Is a Political Act

Period poverty is defined as the inadequate access to menstrual products alongside the inadequate access to toilets, handwashing facilities, and menstrual health education that compounds their absence. The word “poverty” is doing important work in that phrase. It names the material condition. But when public conversation defaults to calling this a “hygiene issue,” something shifts: the burden is placed on the girl’s body. The problem becomes about cleanliness — about individual maintenance — rather than about the structural conditions that make maintenance impossible.

In the United States, menstrual products are not covered by SNAP. Not covered by WIC. Not covered by most Medicaid plans as a direct benefit. For years, menstrual products were classified as “luxury items” by the IRS — a designation corrected only in 2020 — making them ineligible for tax-free purchasing through Flexible Spending Accounts. As of this writing, more than twenty states still apply sales tax to menstrual products under state law. The people most harmed by these tax structures are the same people with the least margin for error: women and girls in low-income communities, which in East Harlem means largely Black and Latina families already navigating the compounding arithmetic of poverty.

The average person who menstruates spends an estimated thirteen to seventeen dollars per month on menstrual products — a small number that becomes significant when the budget is already broken. In a household spending the majority of its income on rent and food, thirteen dollars can be the difference between buying products and going without. The PERIOD Organization has documented that approximately one in five girls in America has struggled to afford period products. That statistic lives in East Harlem. It lives in every neighborhood where poverty concentrates and basic needs remain unmet by the systems designed to meet them. And the direct connection between period poverty and girls’ education — in school attendance records, in dropout data, in the research across East Africa and the United States alike — makes clear that this is not a personal management problem. It is a structural one.

The framing matters because the solution follows the frame. If period poverty is a hygiene problem, the solution is education — teach girls to manage their bodies better. If it is a justice problem, the solution is structural: change the tax code, expand Medicaid coverage, fund free products in schools and shelters, and center menstrual health in every public health conversation that claims to care about girls. Ubuntu Village holds the second frame. Communities are not the problem. Structures are. And structures can be changed.

What Our Grandmothers Knew: Menstrual Traditions Across the African Diaspora

Before the pharmaceutical industry packaged menstrual management as a product line. Before the word “hygiene” was deployed to sell disposables. Before girls were taught to hide their periods under clinical shame — our grandmothers held menstruation as a threshold event, a rite of passage worthy of ceremony, not concealment. Across the African continent and its diaspora, the onset of menstruation was often met with celebration and community preparation: the Xhosa tradition of intonjane in South Africa, a period of intentional seclusion and teaching in which elder women prepared a girl for womanhood; the Kikuyu traditions of central Kenya, in which a girl’s transition into womanhood was marked with community gathering, song, and instruction from elder women about her body, her power, and her responsibilities. In many Yoruba communities, elder women held the knowledge of womanhood — including the management of the body through each season of life — and the transmission of that knowledge was itself a sacred act.

Alongside ceremony was plant medicine. Ginger root — used across West Africa, East Africa, and the African diaspora — has documented anti-inflammatory and antispasmodic properties that make it effective for menstrual cramping, a finding that modern clinical research has confirmed. Moringa leaves, rich in iron and used across Nigeria, Kenya, and Uganda, address the anemia that heavy menstrual flow can cause, particularly in adolescent girls whose bodies are still developing. Baobab fruit, dense with vitamin C, supports iron absorption — a critical nutritional pairing with moringa. These practices were not superstition. They were pharmacopeias — developed through generations of careful, communal observation of what kept women well across the full arc of their reproductive lives.

Colonization disrupted this knowledge in multiple registers simultaneously. Christian missionaries framed menstruation as impure — sin-adjacent, something to be ashamed of and concealed — replacing ancestral teachings of transition and power with teachings of contamination and secrecy. At the same time, colonial land economies restructured communities’ relationships with the plants that carried this medicine. And market economies introduced disposable products that created dependency while simultaneously stigmatizing the reusable cloth that African grandmothers had always understood as dignified, effective, and communally maintained.

What remains is a complicated inheritance: girls who have been taught to hide their periods from the very communities that once held them in ceremony; communities that have been stripped of both the ancestral knowledge and the material resources to manage menstrual health with dignity. Ubuntu Village’s work holds both of these losses — and insists that the path forward is neither a return to the past nor an uncritical adoption of the market’s solutions. It is a reclamation: of plant knowledge, of communal support, of the simple insistence that every girl’s body deserves care, and that the structures preventing that care are the problem to be solved.

The Numbers That Name the Crisis — East Harlem and East Africa

In East Harlem — one of New York City’s most economically stressed neighborhoods — the poverty rate runs more than twice the citywide average. Median household income sits significantly below the city median. These are not abstract statistics: they are the conditions inside which families make daily decisions about what to buy and what to skip. For a girl from a family with very little margin, a monthly purchase of thirteen dollars for menstrual products competes directly with food, transportation, and school supplies. The PERIOD Organization has documented that approximately one in five girls in the United States has struggled to afford period products. In a neighborhood like East Harlem, that national average is not a distant data point. It is the block.

In Kenya, Uganda, and Nigeria — where Ubuntu Village works alongside communities building their own futures — the relationship between period poverty and girls’ education is direct and well-documented. WHO and UNICEF data document that across sub-Saharan Africa, between one in five and one in ten school-age girls misses school during her period because she lacks access to menstrual products and adequate sanitation. In Uganda, research estimates that girls lose as many as two to three months of school per year because of period poverty. In Nigeria, studies in rural and peri-urban areas have found that the majority of girls in low-income settings use unsafe alternatives — cloth, mattress stuffing, newspaper — when they cannot afford products, with the associated infection risks those materials carry. These are not isolated exceptions. They are patterns — structural patterns with structural causes.

Kenya’s tradition of harambee — the communal pulling-together to meet each other’s needs — has long meant that neighbors fill the gaps that markets and governments leave behind. But harambee cannot substitute indefinitely for structural investment. When a community must pool resources every month to cover the cost of products that should be accessible as a basic right, the community is bearing a burden the system designed for them, not with them.

In both East Harlem and East Africa, period poverty maps directly onto other forms of structural exclusion: inadequate sanitation infrastructure in underfunded schools, healthcare systems that exclude menstrual health from primary care conversations, and economic policies that treat menstrual management as a discretionary expense rather than a health necessity. The data does not surprise the communities living inside it. They already know what the numbers are measuring. What the numbers can do is make legible to the wider world what those communities have always been navigating.

What Period Poverty Costs Girls’ Education — and Why Counting It That Way Matters

A girl who misses school because she cannot manage her period is not making a lifestyle choice. She is responding rationally to a situation in which she has no good options: attend school without menstrual products and risk humiliation, or stay home and fall behind. In communities where school attendance is already strained by poverty, transportation barriers, and chronically underfunded schools, the additional burden of monthly period-related absences compounds existing disadvantage in ways that attendance data rarely makes visible. The cause goes unnamed. The girl gets counted as absent.

Girls who miss two or three days of school each month during their period miss — over the course of an academic year — weeks of instruction. In Uganda and Kenya, where researchers have directly tracked this connection, the girls most likely to drop out are often the same girls whose absences began with menstruation. Dropout and period poverty are not separate phenomena. The body carries the cost of structural failure — in lost education, in chronic stress, in futures foreclosed before they opened. Each dropout becomes a data point in a different dataset; the systemic cause goes unexamined in either.

The health costs of unsafe alternatives are not theoretical. When girls use cloth that is not properly cleaned, newspaper, mattress stuffing, or leaves — each documented in research across East Africa and in some U.S. settings — the risk of bacterial and reproductive tract infection is real and compounding. These infections, left untreated due to the same lack of healthcare access that allowed the period poverty to go unaddressed, become chronic. When the formal health system fails a community, that community finds other ways — but improvisation should never be the permanent plan.

For adult women, the cost extends into the workplace. A woman who cannot afford menstrual products cannot reliably attend work during her period. This matters most in hourly, service-sector, and informal-economy jobs — disproportionately held by Black and Brown women — where missing work means missing pay, and where flexibility is rarely available. Economic empowerment cannot be separated from bodily autonomy — and bodily autonomy, for women, includes the ability to manage their bodies without choosing between their period and their paycheck.

Tax Policy, Community Power, and the World’s Most Overlooked Model

In 2004, Kenya became the first country in the world to eliminate the value-added tax on menstrual products — making sanitary pads exempt from VAT, reducing their cost at market, and signaling in policy terms that menstrual products are a health necessity rather than a luxury. Uganda followed in 2016. These were not accidents of government generosity. They were the result of sustained advocacy by women’s organizations, by health equity researchers, and by the girls and women who had long been naming what the tax cost them. The Global South — often positioned in Western development discourse as the recipient of solutions invented elsewhere — was leading on this one. The United States has not yet enacted a national exemption.

The movement to eliminate the “tampon tax” in the United States has made real but uneven progress. By 2026, more than half of U.S. states have eliminated state sales taxes on menstrual products, including New York, which did so in 2016. But in states that maintain the tax, it falls hardest on the people with the least. The PERIOD Act — federal legislation that would require Medicaid to cover menstrual products — has been introduced in multiple Congressional sessions. It has not yet passed. That gap between introduction and passage is not an oversight. It is a set of choices made by people who do not personally pay the price of those choices.

In the absence of structural solutions, communities have always organized their own. In East Harlem, local organizations, mutual aid networks, and schools have run period product drives and distribution programs for years. In Kenya and Uganda, women’s groups have organized communal purchasing cooperatives — bulk-buying products at lower cost and distributing them among members — a direct expression of the harambee tradition of pooling collective resources to meet collective needs. These are not charity programs. They are community organizing. They are what solidarity looks like when the state has not yet caught up to what is right. But they should not have to be permanent substitutes for policy.

New York City took a step in 2016 that should be universal: requiring free menstrual products in public school restrooms, homeless shelters, and correctional facilities — making New York one of the first cities in the country to institutionalize this access as a baseline right rather than a program that could be defunded. The implementation has been imperfect and inconsistently enforced. But the mandate represents the right framework: menstrual products as infrastructure, not charity. As access, not gift. What New York codified in policy, communities in East Harlem have always practiced in spirit — because they did not wait for the state to value what they already knew to be necessary.

What Menstrual Justice Looks Like

Free menstrual products in every school — universally, not selectively. Every school, public and charter, in every district that claims to care about girls’ education should provide menstrual products in restrooms as a basic operational expense — the same way it provides toilet paper and soap. This is not a significant budget line. It is a decision about whether girls’ bodies matter enough to fund as infrastructure.

Federal Medicaid and SNAP coverage for menstrual products. The PERIOD Act represents the minimum structural change the federal government should make: categorize menstrual products as medical necessities, allow SNAP benefits to cover them, and ensure that the most economically vulnerable women in this country are not choosing between products and food. This is not a radical ask. It is the baseline of recognizing menstrual management as healthcare.

Eliminate the tampon tax in every state that still levies it. Period products are health necessities. The states that still tax them are making a policy choice to extract revenue from a basic bodily function. Kenya made the correct decision in 2004. Uganda made it in 2016. Every U.S. state should follow.

Center menstrual health in community health worker training. Community health workers in East Harlem and in Ubuntu Village’s East African programs are positioned to carry menstrual health education — including ancestral plant medicine knowledge alongside contemporary product access and information — into homes, churches, and community centers. This is not about replacing clinical care. It is about extending dignified, culturally grounded menstrual health support through the trusted relationships that already exist.

Reclaim ancestral menstrual wisdom. The plant knowledge our grandmothers carried — ginger for pain, moringa for iron, the communal practices that held girls in ceremony rather than shame — is not superstition. It is health infrastructure. Ubuntu Village holds it as part of the same healing framework as modern medicine, not in opposition to it. Reclaiming that knowledge is not nostalgia. It is insisting that our communities’ accumulated wisdom about bodies and healing is as legitimate as any other source of knowledge — and that girls deserve access to all of it.

---

A girl who cannot afford menstrual products cannot go to school. Cannot go to work. Cannot be well. That is not a problem of personal hygiene. It is a problem of collective will — embedded in tax codes and Medicaid rules and school supply budgets — to treat her body’s needs as optional. Ubuntu Village refuses that framing. We hold menstrual health as a community health issue, a justice issue, and an ancestral issue — one that our grandmothers named in ceremony and our communities are naming now in policy, in organizing, and in the daily work of holding each other.

I Am Because We Are. And Together, We Heal.

References

PERIOD: The Menstrual Movement. Period Poverty: Data and Impact. PERIOD.org, 2024. (2 in 5 adults and nearly 1 in 4 students struggle to afford period products in the United States.)

UNICEF. Menstrual Health and Hygiene. UNICEF WASH Programme, 2023. (Global data on girls’ school attendance and menstrual product access.)

World Health Organization. Menstrual Health. WHO Fact Sheet, June 2026. (An estimated 500 million people globally lack access to menstrual materials and WASH facilities; two in five schools worldwide provide menstrual health education.)

Alliance for Period Supplies. Policy + Legislation: Menstrual Equity for All Act. Alliance for Period Supplies, 2025. (Documents federal legislation requiring Medicaid to cover period supplies and eliminate the tampon tax.)

PERIOD Organization. Global Period Poverty and Advocacy. PERIOD.org, 2024. (Documents global menstrual product access and policy advocacy, including tax exemption history in Kenya, Uganda, and the United States.)

Sumpter C, Torondel B. “A Systematic Review of the Health and Social Effects of Menstrual Hygiene Management.” PLOS ONE. 2013;8(4):e62004.

Ozgoli G, Goli M, Moattar F. “Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea.” Journal of Alternative and Complementary Medicine. 2009 Feb;15(2):129-32. DOI: 10.1089/acm.2008.0311.

---

Related Reading at Ubuntu Village

What Kenyan Harambee Can Teach American Mutual Aid Movements

Epigenetics and Ancestral Memory: What Your Body Remembers

When the Church Is the Clinic: Faith-Based Health Advocacy in African and Diaspora Communities

Solidarity Economic Empowerment and the African Diaspora

Michele Mitchell is the Founder, President & CEO of Ubuntu Village Inc., a 501(c)(3) nonprofit rooted in East Harlem, New York, with programs in Kenya, Uganda, and Nigeria. A writer, advocate, and community strategist working at the intersection of ancestral wisdom, public health, and community power, Michele leads Ubuntu Village’s work to center communities as the protagonists of their own healing. She writes from the conviction that science and spirit are complementary, that healing is relational, and that community is the medicine.