For girls and women who lack access to menstrual products and adequate sanitation, menstruation is a monthly reminder that a normal biological process can become a barrier to education, human dignity, and the pursuit of future opportunities. For Founder and Director of QRATE, academic, and menstrual health activist, Candice Chirwa, ‘period poverty isn’t a fringe issue; it’s a daily reality’. As Chirwa observes, this phenomenon sits ‘at the intersection of education, economic participation, and dignity’ – and should concern every South African. Indeed, period poverty goes beyond the affordability of sanitary pads: It engages a broader set of constitutional rights and raises questions about the state’s obligations, the adequacy of existing policy, and whether further legislative intervention is required.
The constitutional case for menstrual dignity
South Africa’s Constitution does not create an explicit standalone right to menstrual health or an entitlement to sanitary products. It does, however, establish a network of rights that are directly implicated when an individual cannot manage menstruation safely and with dignity and is forced to miss school or work. Indeed, period poverty often interferes with the meaningful enjoyment of several rights expressly protected by the Constitution.
Section 7(2) of the Constitution provides that the state must respect, protect, promote, and fulfil the rights in the Bill of Rights. Accordingly, section 9 guarantees equality and permits measures designed to advance persons disadvantaged by unfair discrimination. Section 10 protects human dignity – a provision that colours the interpretation of every other constitutionally guaranteed right. Section 12 safeguards the right to bodily and psychological integrity, including security in and control over one’s body. Section 27 recognises the right to access healthcare services, including reproductive healthcare, as well as sufficient food and water. Moreover, section 28 provides specific protections for children, while section 29 guarantees the right to a basic education.
Crucially, these constitutional rights operate in tandem. As Chirwa, who is fondly described as the ‘Minister of Menstruation’, puts it: ‘Access to menstrual health is tied to the right to education, the right to dignity, the right to health, and the right to equality, all of which are enshrined in our Constitution.’
Consequently, where inadequate access to menstrual products, sanitation facilities, or menstrual health information prevents girls from meaningfully exercising protected rights, it is plausible to contend that a clear constitutional issue arises.
Gender equality and the right to education
The intersection between menstrual health, gender equality, and education is perhaps the clearest example of how period poverty implicates constitutional rights and broader socio-cultural and economic concerns.
Section 29(1)(a) of the Constitution stipulates that everyone has the right to a basic education. Importantly, the Constitutional Court has held that this right is immediately realisable. In Governing Body of the Juma Musjid Primary School v Essay, the ConCourt distinguished the right to basic education from socio-economic rights that are internally subject to progressive realisation and available resources.
While this does not mean that the Constitution expressly requires the state to provide every learner with free sanitary pads, the conditions which materially prevent girls from accessing and participating in basic education can – and do – have constitutional significance.
Indeed, the educational consequences of period poverty – regularly compounded by a lack of access to running water or functioning toilets at home and school – are substantial and accumulate over time.
‘Missing five to seven school days a month over several years adds up to months, sometimes years, of lost learning time,’ says Chirwa. ‘That gap doesn’t stay contained to menstrual weeks; girls fall behind, struggle to catch up, and some disengage from school altogether.’ In the long run, this results in ‘lower academic performance, higher dropout risk, and reduced access to the qualifications needed for stable employment,’ she notes.
As Chirwa observes, the issue therefore extends beyond menstrual management. Indeed, the consequences of unequal access to menstrual products can begin long before a girl enters the workforce. When girls are more likely to miss school or withdraw from participation because they cannot manage menstruation safely, an existing gender and socio-economic inequality is reinforced from an early age.
Chirwa describes this as ‘a quiet driver of the gender gap in education and, eventually, in the workplace.’ She points out that conversations about closing the gender pay gap or increasing women’s representation in leadership often begin too late. ‘We rarely trace those outcomes back far enough to a twelve-year-old girl who missed a week of maths because she didn’t have a pad.’ For her, ‘menstrual health has to be treated as foundational to education policy, not an afterthought.’
After all, ‘the goals we celebrate for women tomorrow depend on the barriers we remove for girls today,’ she wisely remarks.
Period poverty: A decade of policy intervention
Against this backdrop, South Africa’s response to the crisis of period poverty has developed over more than a decade, although much of it has taken the form of policy and programme interventions rather than dedicated legislation.
For instance, the Integrated School Health Policy, adopted in 2012, provides a broader framework for addressing health-related barriers affecting learners. While it should not be described as a dedicated menstrual health policy, it forms part of the policy environment within which school health and menstrual health management have developed.
The more targeted Sanitary Dignity Implementation Framework was approved by Cabinet in 2017 and revised in 2019. It addresses procurement and distribution of sanitary products, sanitary waste disposal, institutional oversight, training, and health management. When Cabinet approved the revised framework in September 2019, it explicitly stated that its implementation gives effect to the constitutional right to dignity and the right to life of indigent women and girls.
Later, government expanded the Sanitary Dignity Programme. According to a February 2024 report, 4.3 million learners had benefited from the programme between 2019 and 2023, while the 2023/24 budget allocation was R235 million. Critically, that figure should be understood in its historical context. Although it demonstrates substantial reach, this does not mean that universal access has been achieved. Indeed, it is estimated that approximately 7 million girls in South Africa are affected by period poverty each month.
From tax relief to access
Significantly, a welcome tax-related intervention came into effect on 1st April 2019, when qualifying sanitary pads were zero-rated for VAT purposes. SARS confirms that the zero-rating applies to sanitary pads and pantyliners within the relevant tariff provisions. Menstrual products such as tampons and menstrual cups, however, fall outside that particular zero-rated category.
Undoubtedly, the measure has reduced the tax burden on qualifying products, but tax treatment alone cannot resolve period poverty.
‘Period poverty rarely exists in isolation; it’s usually a symptom of broader poverty, unemployment, and inequality,’ Chirwa explains. On this point, she notes that ‘[i]n households where choices are made between food, transport, and menstrual products, pads or tampons often lose.’ Moreover, a learner may benefit from the provision of sanitary pads but lack access to running water or disposal facilities. In that sense, the problem is implicitly tied to ‘geography, infrastructure, and the wider economic conditions families are navigating,’ details Chirwa.
The gap between policy and law
In light of the above, the question now is whether the existing policy framework is sufficient, or whether menstrual health requires clearer statutory protection.
That question moved into sharper focus in April 2026 when Parliament hosted a colloquium on continuing barriers to access to menstrual hygiene products and considered proposals for dedicated menstrual health legislation. Specifically, the feasibility of a Menstrual Health Equity Rights Bill was explored and Parliament recommended that the organisations involved engage the relevant Minister and the Speaker of the National Assembly regarding the introduction of a Menstrual Health Rights/Equity Bill. Notably, Chirwa was directly involved in drafting the proposed legislation and presenting it. She describes the Bill as an important shift towards treating menstrual health as a rights issue rather than simply a ‘distribution problem’.
Absent an existing menstrual health-centred law, the significance of this progress cannot be overstated. The emerging legislative debate raises the possibility of moving beyond policy commitments toward enforceable legal rights and duties delineated in statute.
For Chirwa, that distinction between charity and rights is fundamental: ‘This isn’t a favour we’re doing girls by donating pads; it’s a rights-based obligation.’
Policy implementation remains critical
The issue is not only whether policy exists, but whether it reaches the girls it is intended to support. In March 2026, Parliament’s Portfolio Committee on Women, Youth and Persons with Disabilities received briefings from the departments responsible for the Sanitary Dignity Programme. The committee’s oversight reflects continuing concern about the programme’s implementation and the need for consistent monitoring.
Crucially, the recommendations emerging from Parliament’s 2026 process go beyond product distribution, Chirwa notes. They call for more equitable distribution, comprehensive beneficiary information, regular monitoring, attention to stigma, and stronger menstrual health education. The recommendations also recognise the importance of safe and appropriate facilities and culturally responsive education.
This is consistent with Chirwa‘s view that government action must be broader than the provision of sanitary pads alone. ‘Donations are a short-term relief valve, not a solution,’ she says, pointing to the critical importance of supply chains, functioning toilets and water, private disposal facilities, menstrual health education, better data, and coordination between government departments.
Dignity also means freedom from shame
Importantly, access to menstrual products is only one component of menstrual dignity. The way menstruation is discussed – or not discussed – also negatively affects the well-being and participation of girls.
‘Stigma is often the invisible driver behind period poverty,’ says Chirwa. ‘In many communities, menstruation is still spoken about in whispers or euphemisms, or not at all’ meaning that girls may reach puberty with ‘more shame than information,’ she explains. That silence – underpinned by cultural taboos – can make it difficult to ask parents, teachers, or other trusted adults for help, she notes.
The consequences are particularly acute when girls do not have access to suitable menstrual products and often resort to newspapers, rags, socks, leaves, or other dangerous alternatives. Chirwa details the impact of using these alternatives as extending beyond physical discomfort. On an emotional level, ‘[T]here’s a constant, exhausting anxiety, the fear of leaking, of being seen, of being mocked. That fear alone pulls girls out of classrooms and social situations,’ she observes. Additionally, this teaches girls that ‘their bodies are a source of shame to be hidden and managed alone,’ Chirwa reflects.
Significantly, this gives the crisis a constitutional dimension beyond access to menstrual products alone. Under the Bill of Rights, section 10 protects human dignity, while section 12(2) protects bodily and psychological integrity, including security in and control over one’s body.
Where stigma and material deprivation result in shame, humiliation, or exclusion, they may reasonably impair the meaningful enjoyment of these protected rights. As explored above, the crisis also has a clear equality dimension: When poverty and stigma disproportionately interfere with girls’ ability to participate in education and public life, it reinforces existing gender and socio-economic inequalities.
The role of business and why every donation matters
While government remains responsible for fulfilling its constitutional and policy obligations, the involvement of businesses and the wider private sector can help address gaps through immediate relief, support awareness, and contribute much-needed resources.
It is in this context that STBB’s Women’s Month sanitary pad collection drive forms part of the broader discussion.
During August, our teams have placed collection bins in the reception areas of our 13 offices nationwide. Our target is to collect 1 800 packs of sanitary pads to support 600 girls at various uPhawu-selected schools across the Western Cape and Eastern Cape for three months.
Although Chirwa believes that private-sector participation – coupled with institutional reform – should extend beyond once-off donations, she expressly acknowledges the value of sanitary pad donation drives. ‘Don’t underestimate a single pack of pads for one girl. That’s the difference between attending school that week or staying home in fear and discomfort,’ she reasons.
‘Your donation might mean a girl doesn’t miss a maths test, doesn’t fall behind, doesn’t internalise shame about her own body. A single donation, multiplied by thousands of people making the same choice this Women’s Month, is exactly how real, measurable change happens,’ Chirwa concludes.
Moving the needle
South Africa’s constitutional framework provides a strong foundation for addressing the very real consequences of period poverty. While government has taken steps to formally recognise the multi-faceted nature of the crisis, stronger legislative measures are required. Beyond a monthly expense, period poverty concerns whether girls can attend school, participate fully, and manage their menstrual cycles safely and with dignity – a phenomenon compounded by a lack of infrastructural access and one that impedes future employment opportunities.
Donating one pack of sanitary pads will not end period poverty. But recognising why that pack matters – and understanding menstrual dignity through the lens of constitutional rights and values – moves the conversation toward the realisation of legal rights and state-based accountability.
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The author wishes to thank Candice Chirwa for her collaboration and insights.
