Menstrual health policy in Southeast Asia and Taiwan are emerging discourses in the region’s policy sector. Increased literature and scholarship on menstrual movements within the region allowed for research-driven policymaking. This blog aims to highlight menstrual health advancement efforts and current region-specific bodies of literature in the field in parallel with implemented policies across the region.
The movements to advance menstrual health in Southeast Asia and Taiwan have gained positive policy momentum in recent years but often gain global attention. Menstrual Health in East Asia and the Pacific (2023) provided an overview of the policy progress landscape. It confirmed the acknowledgement of menstrual health as multifaceted in the emerging policy and program initiatives. Incorporating aspects of menstrual health into more extensive procedures and programmes such as sexual and reproductive health and rights (SRHR), education and WASH (Water, Sanitation & Hygiene) can be recognised as an “entry point to policy recognition. Regionally, sources that survey respondents across Asia look to for menstruation-related information reportedly ranged from mothers and sisters to teachers and schools. Only.
Paid period leave for working women who menstruate is recognised by the Indonesian government; embarrassment and shame during the menarche were reportedly 30% in Indonesia, according to Davis et al. (2018). Wherein certain social norms or restrictions may limit behaviours deemed appropriate during menstruation. Furthermore, limited family and community support access due to shame and distress and intergenerational stigma may also play a role in the restriction. A study by Morrison et al. (2018) and colleagues 2018 described the factors influencing menstrual management, including education, socioeconomic background, occupation, and geographical area. McCarthy and Lahiri-Dutt (2021) also posited that, in turn, these factors influence the attitude of women, adolescent girls, and people who menstruate toward daily life and activities. Those bring to light the cross-cutting, multifaceted nature of menstruation. Therefore, context-specific policy analysis and understanding of appropriate interventions are pertinent in driving menstrual health advocacy movements.
Since 2020, female employees in Viet Nam can get a 30-minute paid break each day, at least three days a month, during menstruation. Female employees are granted bonus pay when they decide not to take menstrual leave and if they are approved to work by employers according to the decree detailing and guiding the implementation of the Labor Code. Indonesia is among the few to include menstrual health in many policies. In Indonesia, menstrual leave of up to 24 days annually is also included in the Labor Law, while aspects of menstrual health, including menstrual hygiene management, are integrated into WASH in schools’ policies and guidelines, National School Health Strategy (2014), Menstrual Hygiene Management Guideline for Teachers and Parents (2017), Guidelines on Sexual Reproductive Health (2021), and Menstrual Hygiene Management Communication Strategy (2018).
Progress has been documented in the Philippines and Timor-Leste. Menstrual hygiene is included in WASH in schools’ policies in The Philippines Basic Education Development Plan and Gender Responsive Basic Education Policy supported by the Policy Guidelines on Implementing Comprehensive Sexuality Education. Timor-Leste WASH in schools’ guidelines and Community Action Plan for Sanitation and Hygiene (PAKSI) Guideline commit to addressing menstrual health requirements.
Menstrual health is incorporated in national guidelines for WASH in Cambodia, Lao PDR and Myanmar. Cambodia includes menstrual health in National School Health Policy (2019), National Action Plan (2021-2030) and Standard Procedures on school health (2022). Besides WASH policies, Lao PDR’s Education and Sports Sector Development Plan 2021-2025 Comprehensive Sexuality Education and National Strategy and Action Plan for Integrated Services on Reproductive, Maternal, Newborn and Child Health (2016–2025) cover menstrual health.
A study of reproductive health strategies across countries in Asia revealed that Thailand had referenced the education sector. Menstrual Hygiene Management was also found to be incorporated into the Thai curriculum in the Thai language, which consisted of the ‘Guideline on Sexuality Education’s Learning Activity’ for primary and secondary education as published by the Child Protection Center (CPC) and the Office of the Basic Education Commission (OBEC) in 2015 disseminated to 30,000 schools in Thailand. Menstrual Hygiene Management is integrated into Sexuality Education under the Learning Area of Health and Physical Education as part of the Basic Core Curriculum 2008. The current Health and Physical Education maintains information on menstruation in Grades 1, Grade 4, Grade 5, and Grade 6 as part of primary education, which caters to students of 7 to 12 years of age on average, and Grade 7 as part of secondary education. Topics about Menstrual Hygiene Management taught in these subjects also include what should be done if one is teased about menstruation.
Taiwan has had a paid menstrual leave policy in place since 2013. By law, people who menstruate can take up to twelve days of menstrual leave a year – one day a month, with three of them being half-paid, in addition to their regular sick leave. A study on the menstrual experiences of people who live in Taiwan revealed that 54.22% of menstruators experience disruption in their work or study due to menstrual discomforts (With Red, 2021). However, cultural barriers and societal stigma often deter people from using such leaves. According to interviews done by With Red, a Taiwanese NGO at the forefront of promoting period equity in Taiwan and Asia, and research from the government, although the situation of menstrual stigma has improved drastically in the past few years, many people who menstruate still fear discrimination or are uncomfortable asking for menstrual leave, lest they be perceived as using their period as an excuse to skip work.
Education and menstrual needs in public places have also been the focus of the menstrual movement, which drives policy changes in Taiwan. According to With Red’s research (2021), more than 90% of menstruate people have experienced being without period products while outside. To counter this inconvenience to ensure menstruation no longer restricts women, girls, and menstruators’ mobility, With Red initiated a few projects focusing on building a period-friendly environment since 2019. More than 20 local and national policies have changed to address menstrual needs in public places and to emphasise the necessity of comprehensive and inclusive period education. In August 2023, Taiwan officially became the first country in Asia to provide free menstrual products on campuses, including primary and secondary schools. The Ministry of Education Taiwan also promised that education, including curriculum, teaching materials and training, would be their next focus in policy change.
Although policies alone cannot address and solve menstruation stigmas and multifaceted menstrual health issues, they play an integral part in interacting with communities and challenging misconceptions and stigmas, therefore leading to changing behaviours, as well as building the enabling environments for promoting menstrual health by holistic and right-based approaches.
Though menstrual health has been recognised as a multifaceted issue, low prioritisation is one of the barriers resulting in under-resourced allocation and investment. To address the problems, there is an urgent need for national and regional collective efforts, including governmental coordination, investment and stakeholders’ involvement, which will pave the way for addressing menstruation stigmas and generating evidence to inform policies and interventions, especially context-specific data and systematic monitoring, evaluation and learning from policy implementation.
Within Southeast Asia and Taiwan, current menstrual health-related policies mainly focus on the menstruation of students in schools and employees in formal sectors, which has left out the most marginalised populations regarding menstrual health. Ongoing and future efforts need to seek the inclusion of marginalised groups, including gender-diverse and sexuality-diverse people, people who menstruate out-of-school contexts, people with disabilities, and migrants in menstruation narratives, research, interventions and policy development with intersectionality and gender-transformative lenses; especially in relevant laws and policies to promote menstrual products accessibility as well as in humanitarian and special conditions, where menstrual health has been overlooked.
Moreover, while ensuring access to menstrual products is essential, period equity is more complex and intersectional than providing products alone. Areas yet to be done include the intersectionality of period stigma and the effective implementation of menstrual leave; the importance of comprehensive and inclusive menstrual education curriculums and the access to complementary training and resources for educators and carers; long-term research and evaluation on the impact of policies, etc.
These policy changes across Southeast Asia and Taiwan exemplified the emerging progress in the region and are critical milestones that we should celebrate and recognise. However, critical voices from researchers and activists highlighting the multifaceted nature of menstrual health should also be considered when moving towards the following steps – this is the only way to march towards a menstrual justice world together.
