I had my first period when I was 11 years old. I knew what was happening from science classes at school and I had known to expect it at any time. But I remember a deep sense of shame – one I couldn’t quiet rationalize. I hid it from my mother, using countless amounts of toilet paper until I knew I couldn’t hide it any longer.

About a year later, I was walking from school with a boy who I used to be friends with. He started laughing at me. Not just laughing, but howling. He pointed to the back of my white sports shorts, where I noticed a big red stain. Once again, my overriding emotion was shame.

About two years ago, something similar happened to me in a restaurant. A lady rushed to tell me I’d had an “accident”; she pointed at my white shorts, and there it was again. I just couldn’t look at this mishap as any other, like spilling food or red wine on my dress.

I am a 31-year-old woman and still navigating the shame that menstruation brings. I know this is a reality for many women.

Hushed tones

Growing up in Botswana, the topic of periods was always spoken of in hushed tones. The older women around us would treat it as a secret, something to be spoken about with other women only. Women whisper about it and men distance themselves from it. We called it Aunty Flo or the visitor – anything other than what it actually was. In fact, to hear someone say the word “menstruation” could cause shudders of embarrassment.

Stigma around the subject of periods makes little room for dialogue. And there should be dialogue. Why shouldn’t women’s sanitation be taken just as seriously as any other healthcare issue? Cultural attitudes make it hard to advocate to policy-makers that sanitary pads, for instance, become freely available. How do we argue such a thing when the culture we live in excludes menstruating girls and women from cooking, praying and in some cases going to school? From an early age, girls are exposed to negative messaging about their bodies.

This is not just the case in Africa. In Nepal, 95% of girls in Nepal’s mid- and far-western regions faced some sort of restriction when having their first period, according to a UNICEF report. Of these, 44% observed the traditional practice of chaupadi, which views menstruating women as unclean and requires them to spend their time of the month confined to a shed far away from their families. The study also revealed that 85% of girls have nothing but a cotton cloth to manage their bleeding and don’t have access to commercial sanitary products.

In another study by UNICEF, 48% of girls in Iran and 10% of girls in India believe that menstruation is a disease. In Africa, 1 out of 10 girls will drop out of school because they cannot afford sanitary towels.

Condoms v tampons

In 2015, an online debate erupted as a result of a tweet by a feminist and filmmaker in England who goes by the name @molssimp. When she stated: “If you can afford to give boys free condoms, you can afford to give girls free tampons. Menstruation is a lot harder to refrain from than sex.” This is just one of the questions that women have had to ask. Why is there still a tax on women’s sanitary products?

The hindrance to making menstrual hygiene products freely available to women comes largely from the fact that the topic of menstruation is not freely discussed – and when it is discussed, it is overshadowed by negative cultural beliefs.

To overcome these challenges, we need to move beyond the stigma of menstruation. We need to educate boys and men on the importance of open dialogue on the subject. After all, men make up a larger proportion of government and corporate policy-makers in Africa. It should be accepted that menstrual health is not just a “women’s issue” but everyone’s issue: women cannot drive development in Africa if their menstrual health is not given sue consideration.

Some governments have made notable progress in the area of menstrual hygiene. Kenya dropped its import tax on female sanitary products in 2011, helping to reduce costs by 18%. In 2015, Canada removed tax from feminine hygiene products. In England, a Bristol company has adopted a period policy for women with the justification that “letting women take time off during their menstrual cycle will make workplace more efficient and creative”. Furthermore, the company said: “The purpose of the policy initiative is to create a positive approach to menstruation and the menstrual cycle that empowers women and men and supports the effectiveness and well-being of the organization.”

Despite some progress, there is still much more work to be done. Prioritizing female health in Africa is smart economics for the continent. Every woman and girl should have access to feminine hygiene products in order to fully participate and contribute to national development.

This article is part of our Africa series. You can read more here.

The World Economic Forum on Africa is taking place in Kigali, Rwanda from 11 to 13 May.