For Poka Health App – the preferred period tracker and women’s health app for African Women, with funding from Standard Chartered Bank through the Ghana Climate Innovation Centre.
For many women and girls in Ghana, menstruation is still accompanied by discomfort, stigma, and uncertainty. Although access to disposable sanitary pads has improved in recent years, issues like skin irritation, leaks, and shame during menstruation remain common. But menstrual health isn’t just about managing bleeding—it affects women’s education, their personal dignity, reproductive and sexual wellbeing and even safety.
This article draws on a wide-ranging review of research from 2019 to 2025, along with new findings from a recent survey by Poka Health App, to shed light on the challenges and realities of menstrual hygiene in Ghana today.
A Global and Regional Perspective
Recent studies from Asia, Europe, and the Americas have underscored similar themes: disposable pads dominate the marketplace, and women who lack reliable menstrual products or safe disposal options face higher risks of infections, school absenteeism, and social stigma.
In Europe and North America, concerns have emerged about chemical residues and rare but serious conditions like Toxic Shock Syndrome—though incidence remains low.
Meanwhile, in many low-and middle-income settings, girls and women still use rags, leaves, or old cloth to manage heavy flow, driving rates of bacterial vaginosis, urinary tract infections, and—even more troubling—school dropouts.
Within Africa, these challenges are especially pronounced. Landmark trials in Kenya show that girls provided with menstrual cups or sanitary pads not only experienced fewer infections but also had lower rates of sexually transmitted infections (STIs) over time.
In Ethiopia and Nigeria, where three-quarters of women lack consistent access to clean pads and private facilities, girls regularly miss classes or resort to transactional sex to afford menstrual products. South Africa has taken steps—distributing free pads in some schools—but shortages and stigma persist, particularly in rural townships.
And here in Ghana? According to a 2024 multi-country analysis of Performance Monitoring for Action (PMA) data, 34.2% of Ghanaian women still report unmet menstrual hygiene needs—significantly lower than Burkina Faso (74.8%) or Ethiopia (69.9%), but still a sizable portion.
Swathes of rural girls, especially outside Accra and Kumasi, lack the means or knowledge to manage their periods safely. A 2024 cross-sectional study of senior secondary girls in the Eastern Region found that nearly all respondents used disposable pads, yet 43% still practiced poor hygiene—rarely changing their pads, drying used menstrual cloths in hidden locations, or incorrectly disposing of used products.
Poka Health App Survey: Listening to Ghanaian Women
In May and June 2025, Poka Health App, a period tracker and women’s health app designed for African women—surveyed over 50 Ghanaian women, most of whom were aged 32–38, held tertiary degrees, and lived in Greater Accra or abroad. Here are the key takeaways from their responses:
1. Disposable Pads Reign Supreme
○ Nearly every respondent has used disposable sanitary pads. Other materials—tampons, reusable cloth pads, cotton wool, even toilet tissue—appear, but only as occasional or temporary back-ups.
○ Today, almost all women still report disposable pads as their go-to product. Only a handful regularly use tampons or menstrual cups.
2. Why Women Stick with Pads
○ Comfort: Many respondents find pads more familiar and easier to manage than menstrual cups.
○ Affordability and Accessibility: Pads are widely sold in pharmacies and convenience stores—even in smaller towns—often on a pay-as-you-go basis.
○ Health Concerns: The women shared that pads help to reduce direct vaginal irritation and eliminate the discomfort or fear associated with inserting products like menstrual cups and tampons into the vagina.
3. Health Effects from Overuse
○ Over half of survey respondents reported at least one negative experience while using pads or tampons—mainly itching, skin irritation, and painful rashes. Some spoke of urinary tract infections or “bad odours” when pads were left on for too long, especially in the humidity.
○ A few women mentioned vaginal dryness or unusual discharge linked to either pads or tampons. One respondent reported lower back pain during heavy flow months, attributing it to the physical restrictions and discomfort sometimes associated with pad use..
4. Seeking Medical Help—or Not
○ Despite the reported discomfort, only a small minority sought professional medical advice. Those who did were often prescribed antibiotics or topical creams, with mixed success. Many simply switched brands or changed pads more frequently.
○ This gap in care highlights two realities: first, low menstrual health literacy, and second, lingering stigma around discussing period-related problems with doctors.
5. Alternatives Remain Untried
○ Nearly everyone has heard of menstrual cups, reusable cloth pads, or menstrual discs—but few have tried them.
○ Barriers: Fear of insertion, doubts about hygiene, limited accessibility to organic, reusable menstrual products, and minimal instruction on proper use.
○ A handful of women living abroad (USA, Canada, UK) reported trying cups but ultimately returning to pads, usually due to initial discomfort or difficulty finding the right size.
6. Talking About Periods: A Mixed Picture
○ Poka Health App’s data show most women feel comfortable discussing menstruation with other women—friends, sisters, or female health workers—especially when experiencing pain or irregular cycles.
○ However, many still shy away from talking about periods with male family members, partners, or colleagues. As one respondent in Accra put it, “if a man sees my pad brand, he’ll tease me; it’s better to keep it private.”
○ Others noted that social media and peer-led platforms such as the Poka Health App Community Group – We are Pokadolls– have made sharing menstrual experiences easier, gradually chipping away at shame.
7. Where Did We Learn About Menstrual Products?
○ Most women first encountered formal menstrual education in junior high or senior high—a single biology lesson, usually focusing on “female anatomy” and “changing pads.”
○ Non-formal sources—friends, online articles, or health-centre pamphlets—played a larger role in shaping knowledge of different products.
○ Very few reported receiving detailed guidance—how to sterilize a cup, how often to change reusable pads, or how to recognize early signs of infections.
8. Voices from the Ground: Women’s Suggestions
○ Start Early, Include Boys: Almost every respondent recommended introducing menstrual hygiene sessions in primary schools—educating both girls and boys to foster empathy and reduce teasing.
○ Subsidize or Distribute Free Pads: Several pointed to April 2025’s national free-pad program for school girls as a step in the right direction but cautioned about sustainability. They urged the government and NGOs to consider “menstrual funds” or “pad banks” at community health posts.
○ Use Local Languages and Visual Aids: Women stressed educational materials in Twi, Ga, Ewe, and other local dialects—complete with diagrams or short videos showing how to clean, dry, and store reusable cloth pads.
○ Leverage Faith and Community Groups: Churches, mosques, and women’s guilds could host monthly “Period Chats,” pairing health professionals with local women to answer questions and demonstrate product options.
○ Diversify Supply Chains: Stocking menstrual cups, reusable pads, and period panties at rural chemical shops, not only in pharmacies, would expand choices beyond the dominant pad brands.
Connecting Literature to Local Realities
Poka Health App findings align closely with broader African research:
● Infection Risks & “Hidden Costs”: Kenyan randomized trials (2016, 2023) showed that girls provided with clean menstrual cups had lower rates of bacterial vaginosis and STIs. While Poka’s Ghanaian data do not measure STI rates directly, many women described recurring urinary tract infections or persistent vaginal itching—suggesting that subsidized access to safer, reusable products could reduce health burdens.
● School Absenteeism & Economic Pressures: Studies from Tanzania, Ethiopia, and Nigeria estimate that up to 30% of girls miss school during their periods. Though Poka did not survey school-aged girls directly, adult respondents frequently recalled skipping classes in their youth due to lack of pads. One respondent from Volta Region shared how she missed up to three days of school each month as a secondary school girl.
● Stigma & Cultural Barriers: Across Africa, menstruation is often cloaked in taboo. In Ghana, a recent University of Ghana study (2024) found that 83% of adolescent girls in rural communities engaged in transactional sex to afford pads. Poka’s survey, focusing on adult women, confirms that menstrual shame still influences product choice and communication, even among educated, urban professionals.
Ghana’s April 2025 rollout of free sanitary pads for schoolgirls aims to end many of these hardships. Early feedback suggests improved attendance in pilot regions; yet Poka’s respondents emphasized that policy alone is not enough. Without proper education on safe use and disposal, free pads risk being used sub optimally—left unchanging for long hours, or discarded in unsanitary ways, perpetuating health risks.
Bridging the Gaps: Practical Recommendations
Based on the literature review and Poka Health App’s on-the-ground insights, several action points emerge for policymakers, NGOs, and community leaders:
1. Integrated Menstrual Health Curriculum
○ Move beyond one-time biology lessons. Develop a curriculum that, starting in primary four, teaches anatomy, hygiene practices, and introduction to a range of products (pads, tampons, cups). Include interactive demonstrations and take-home visual resources in local languages.
2. Community-Level “Menstrual Health Champions”
○ Train midwives, community health nurses, and respected women’s group leaders as “Menstrual Health Champions.” These champions can host regular workshops for mothers and daughters, provide one-on-one counseling, and distribute product samples.
3. Sustainable Pad Distribution + “Reviews”
○ Build on the current free-pad program by instituting a tracking system: chemical sellers and school health offices can survey girls quarterly about pad quality, fit, and skin reactions. This feedback informs contract renewals for pad suppliers.
4. Introduce Subsidized Reusable Options
○ Work with local women’s cooperatives to manufacture and test Ghanaian cloth pads, using moisture-wicking, skin-friendly fabrics. Offer these at a subsidized rate, alongside training on washing, drying, and storage. Pilot partnerships between rural health centers and community tailors to ensure affordability.
5. Menstrual Health in Public Campaigns
○ Capitalize on social media’s growing reach: partner with influencers and local radio programs to demystify period myths. Short videos demonstrating safe cup insertion—and stories from Ghanaian women who’ve switched—can break down fears. Encourage “Menstrual Mondays” segments on morning TV shows, where doctors and community figures answer questions live.
6. Male Engagement Initiatives
○ Pilot “Period Literacy for Men” sessions at workplaces and church groups—teaching male partners, fathers, and brothers why menstrual hygiene matters. Breaking the silence among men can reduce teasing in schools and at home.
7. Robust Monitoring & Research
○ Establish longitudinal studies—tracking a cohort of girls from late primary school into senior high—to measure health outcomes (infections, school attendance, STI incidence) tied to specific product access. Poka Health App can collaborate with universities to use app-based surveys for real-time data gathering.
Conclusion: Menstrual Hygiene as a Human Right!
For Ghanaian women, the transition from cloth or improvised materials to disposable pads has brought clear benefits.
Yet, as both global literature and Poka’s survey show, reliance on a single product category has created new challenges—health complications from prolonged pad use, persistent stigma, and financial burdens for many families.
Transforming menstrual health in Ghana demands a multi-pronged approach: education, affordable product diversity, community engagement, and ongoing research.
By listening to women’s voices—through Poka’s app-based surveys and grassroots conversations—we can tailor interventions that respect cultural contexts and meet real needs. In doing so, we affirm that menstrual hygiene is not simply a women’s issue, but a matter of public health, gender equality, and human dignity.
After all, a Ghana where every girl and woman can manage her period safely, comfortably, and without shame is not just an ideal—it is a policy imperative. Let’s keep the conversation going, one pad (or cup) at a time.
Ready to take charge of your reproductive health? Download Poka Health App on the App Store or Google Play Store today— www.pokaapp.com.
By Dr. Abena K. Karikari – Medical Anthropologist
