Written by: Sophie B. (IMHER Research Assistant)

Edited by: Jennifer W. (IMHER Research Assistant)


When considering the process of policy-making on menstrual hygiene management (MHM) issues, the roles of politicians, journalists, lobbyists, and interest groups tend to be the focus.  Less often considered is the role of the wives of politicians, both national and local, as change-makers for female-focused policy, including issues pertaining to menstrual health.  Here, we review the instrumental role of the wives of leaders, or “first ladies,” of several countries in keeping menstrual health on the political and media forefront.


Classic Routes to Political Change

As women’s health—and more specifically, women’s menstrual health—comes to be recognized as a critical component of development, organizations focused on menstrual health and hygiene are looking for ways to bring the issue to the forefront of their countries’ national agendas.

Standard ways to influence policy tend to include actions such as lobbying legislators or parliamentarians to consider MHM issues in policymaking (while encouraging supporters to do the same), coordinating women’s marches, attracting media coverage of MH subjects, and attending speeches by politicians to ask questions pertaining to menstrual health.

Building connections with women officeholders tends to be a core focus for organizations working on MH policy.  However, given the gender imbalance of legislators – the majority of whom are male in most countries around the world – it can sometimes be difficult to find vocal champions of these issues within legislatures. 

Beyond influencing politicians directly, one potential way for organizations and citizens to influence policy involves engaging the wives of politicians as champions of issues pertaining to women.


First Ladies: A Unique Position of Influence

The “First Lady” of a country – a term commonly used for the wife of a democratically-elected president or prime minister – holds a unique political role that often allows her to be a formal or informal leader, especially on issues pertaining to women or children. 

In some countries, first ladies are expected to develop a portfolio of issues that they will focus on after her husband takes office.  However, even in places where that is not a formalized part of the role of a first lady, she often has some degree of power to informally influence political dialogue and educate the public about an issue of concern to her. 


Auxillia Mnangagwa of Zimbabwe
Auxillia Mnangagwa of Zimbabwe
(Photo credit: https://www.263chat.com/auxillia-mnangagwa-steps-mp/)

With a severe financial crisis, the cost of commercial sanitary pads in Zimbabwe has increased dramatically in recent years (a packet of pads that would have cost the equivalent of $1 USD in 2015 was up to $5 by 2018 due to currency challenges and associated supply issues.)  In response, First Lady Auxillia Mnangagwa – the wife of Zimbabwe President Emmerson Mnangagwa – has worked to distribute free sanitary pads to menstruators in need. 

Some suggest that focusing on these issues might have the potential to help the electoral prospects of President Mnangagwa to some degree.  As one example, a blog post for One.org quotes a 17-year-old schoolgirl Maria Chaodza as saying in 2018, “If we vote for the right person to lead our country, I’m sure things will get better for us, as poor women, facing difficulties (getting) sanitary wear.”

First Lady Auxillia Mnangagwa’s work in the MHM sphere has not only helped to facilitate access to sanitary products, but also has helped to amplify progress made within Zimbabwe on other issues related to menstrual hygiene, including moves to eliminate taxes on menstrual products.

More generally, the activism by the First Lady – as well as for all of the wives of the leaders mentioned below – has helped to legitimize and encourage vocal discussion of this issue by other organizations and by girls and women around the country.


Sia Nyama Koroma of Sierra Leone
Sia Nyama Koroma of Sierra Leone
(Photo credit: http://unga-reception.org/sia-nyama-koroma/)

Sia Nyama Koroma, wife of President Ernest Bai Koroma, was the first lady of Sierra Leone from September of 2007 until April of 2018.  As part of her work in that role, Koroma provided leadership and support to the National Girls’ Camp in Sierra Leone, the purpose of which was to encourage girls to build confidence and make smart decisions surrounding reproductive health.

She also worked with groups such as Speak Up Africa, who set up classes at the camp to provide girls with menstrual health education. By incorporating MH curricula into her programming, Koroma worked to reduce the stigma surrounding MH within the cultural and political atmospheres in Sierra Leone.


Gertrude Mutharika of Malawi
First Lady Gertrude Maseko of Malawi
(Photo credit: https://en.wikipedia.org/wiki/Gertrude_Maseko)

As a member of Malawi’s National Assembly from 2009 to 2014 herself, prior to her 2014 marriage to President Mutharika – and as a nurse by training – Gertrude Maseko Mutharika brought a special combination of skills to her role as First Lady of Malawi. In the past several years, she has founded the Beautify Malawi (BEAM) Trust to focus on the educational and personal success of women and girls in Malawi, with programming about reducing  stigma surrounding menstruation.


Meghan Markle of the British Royal Family
Duchess of Sussex, Meghan Markle
(Photo credit: https://commons.wikimedia.org/wiki/File:Meghan_Markle_-_2018_(cropped).jpg)

While not technically a first lady, the Duchess of Sussex Meghan Markle (the wife of Prince Harry, a member of the British Royal Family), penned an article about the importance of menstrual health for TIME magazine in 2017 which raised awareness and highlighted projects that have been working on MHM issues in various countries.

In addition, Markle and Prince Harry requested that in lieu of wedding gifts, guests should donate to at least one of seven charities. One of the charities named by the couple was the Myna Mahila Foundation, a MHM-focused organization based in Mumbai, India that produces low-cost sanitary pads and provides women with menstrual health education.

Ms. Markle has previously promoted Myna Mahila’s work, visiting their headquarters in 2015, as a friend of the organization’s founder, Suhani Jalota. her choice garnered substantial positive media attention for her, while also publicizing menstrual health as an issue in India and elsewhere.


Engaging the Wives of Local Leaders in Kenya

While relatively few people tend to have direct access to the first lady of a country, there tend to be more opportunities to talk to the wives of lower-level political leaders, including the wives of legislators/parliamentarians, governors, mayors, or village chiefs.  While some do not get involved in politics at all, some do so on occasion as part of their expected roles, while still others will do so when they are sufficiently convinced about the importance of an issue.

In Kenya, MHM programs and policies vary to some extent between its 47 counties, but most now include some degree of provision of sanitary products, education efforts in schools to reduce the stigma around menstruation such as sensitization programs, and participation in a national menstruation day (for a report on the outline of the challenges faced in Kenya as of 2016, prior to these more recent changes, see this report by the consulting firm FSG.)

Through new initiatives, organizations and groups have worked to engage influential policymakers on MHM issues with an advocacy strategy that focuses on county-level first ladies to promote changes at the local level.  For a useful description of this process, see this conference paper for a detailed description about how the WSSCC (the Water, Supply, and Sanitation Collaborative Council) worked with county-level first ladies to champion Kenyan MHM initiatives.


Building Relationships

There is no clear “how to” approach that can help individuals build alliances with politicians’ wives.  Much of the success of this approach will depend upon the cultural context, personal connections in your own country, and the receptivity of the individual in question, along with some degree of luck on political timing.

Even without personal connections, it can still sometimes be possible to build or strengthen policy bridges through first ladies.  In many cultural contexts, it will not hurt – and may help – to reach out by letter, email, or phone, to arrange for a meeting to discuss MH issues. The success rate with a “cold call” approach is not likely to be high; however, given that any new champion for MH has the potential to make a difference, it may still be worthwhile.  Moreover, as all working within MHM know, menstrual health is an issue that tends to bring many women together.  Many are open to learning about this topic, and some become quite passionate once they learn about all of the exciting work being done to promote MH access. 

In approaching first ladies about MH issues, do not forget that involvement may be to their benefit as well.  Support for menstrual health can often break down standard political alliances, allowing partnerships between factions that usually disagree; as such, menstrual health tends to be a politically “safe” issue.  Press coverage of a first ladies’ role in promoting MH issues is more likely to help an administration than hurt it, while promoting a sense that the government is paying attention to the needs of its people.  For first ladies themselves, taking on a role in promoting the interests of girls and women may help them to feel empowered, providing them with a “passion project” to discuss in the kinds of social networking situations common to life as a political wife.

Regardless of whether they ultimately incorporate the issue into personal agendas, it tends to be all to the good to familiarize those in power with the work MH organizations are doing. 


HELP TO BUILD KNOWLEDGE: Do you know of other activism on MHM income and access issues by political wives and first ladies other than those noted above?  If so, please share your knowledge about it with others in the field with a comment below.