Introduction
I recall numerous conversations where I've passionately communicated the importance of public health addressing menstrual health conditions. The response I often receive, has a recurring theme: "But people are dying from other conditions; so, on the priority scale, the morbidity of menstrual health isn't critical enough."
While it's difficult to digest such views, especially from those who might've personally experienced these challenges, there's a historical context to this perspective. For decades, the yardstick for global health success has often been the metric of the 'number of lives saved'. It's a quantifiable, definitive figure that resonates with stakeholders and, more importantly, donor agencies. And it's precisely this metric that overshadows 'quality of life lived' or morbidity metrics.
While averting death is undeniably paramount, it's equally crucial to ensure that the living are indeed living a life free from pain, prejudice, and economic constraints. The realm of menstrual health perfectly encapsulates this dichotomy. Though menstrual health challenges might not be fatal, they exert a profound toll on the physical, mental, and economic aspects of countless lives. We must ask ourselves: Have we become so laser-focused on the mortality metric that we've become blind to the silent suffering experienced by half the world's population every month?
Mortality vs. Morbidity - The Tug of War in Global Health Priorities
In the annals of global health, an implicit credo often dictates decisions: "If it doesn't kill, it can wait." This mindset finds its roots in history. Visualize a world gasping under the iron grip of the Spanish flu with its staggering death toll in the millions. Or the contemporary struggle against the relentless HIV/AIDS that claims approximately 690,000 lives annually. The tragic numbers from these pandemics have rightly catapulted mortality-centric diseases to the forefront of health interventions. But, lurking in this steadfast approach, are diseases that whisper their torment rather than shout.
Delving into the world of global health funding, one sees a pattern – funding often follows fatalities. Diseases with deathly implications magnetize resources and policy attention. This leaves conditions that impair life's quality, but not necessarily its quantity, scrambling for recognition. It's a phenomenon evident every day, from the headlines that chronicle tragedies to the heart-wrenching stories that catalyze philanthropic donations. Mortality sells, and morbidity? It awaits its moment in the limelight.
The Understated Crisis – Menstrual Health
For millions globally, every month is a dreaded cycle of pain, emotional turmoil, and societal prejudice. This isn't a dystopian tale but a harrowing reality for those battling menstrual health challenges.
It's easy to dismiss menstrual pain as mere 'cramps'. However, for many, it's an excruciating ordeal. Dysmenorrhea isn't just a medical term – for up to 20% of women, it's a debilitating experience that can rival the pain intensity of cardiac events. And then there are conditions like endometriosis and Polycystic Ovarian Syndrome (PCOS). One in ten women wrestle with the former, battling not just pain but potential fertility challenges. Meanwhile, PCOS, with its multifaceted threats ranging from diabetes to mental health issues, looms large for many.
The emotional ramifications of menstrual disorders are as profound as the physical. Consider Pre-menstrual Dysphoric Disorder (PMDD), which goes far beyond typical mood swings. Up to 5% of women in their reproductive age grapple with its tempest, facing episodes of depression and severe irritability. For many, the recurring cycle of menstrual turmoil brews a chronic undercurrent of stress and anxiety. Every calendar mark heralding an impending period becomes a grim reminder of the pain and emotional upheaval awaiting them.
But the cost isn't confined to the personal sphere. Let's talk numbers. According to The World Bank, women stand to lose up to 8 days of work during each menstrual cycle owing to severe symptoms. That translates to nearly a tenth of their working year. Consider the ripple effect on the global economy - diminished productivity, reduced economic output, and stunted growth. Women aren't just shouldering the personal financial burden, which in the U.S. can reach an average of $5000 annually, but economies, especially those already grappling with strained health infrastructures, are bearing the brunt too.
Beyond the tangible costs lies a societal dimension, riddled with taboos and misconceptions. Women facing severe menstrual challenges confront a dual adversary: their physiological turmoil and deep-rooted societal prejudices. This not only compounds their mental strain but also fractures community cohesion and growth, setting the stage for a cycle of stigma and isolation.
Drawing Parallels: From Global Health Priorities to Menstrual Health Realities
Much like the challenges of Non-Communicable Diseases (NCDs), menstrual health disorders present a complex interplay between mortality and morbidity. While they may not directly result in death, the quality of life impairments they inflict mirror those seen in chronic malnutrition or NCDs. The incapacitating pain, emotional turmoil, and subsequent economic losses stemming from menstrual disorders are no less significant than the debilitating effects of chronic diseases. As global health initiatives have recognised the urgent need to address the 'silent pandemic' of NCDs, both in terms of mortality and life-altering morbidity, so too must we extend this dual approach to menstrual health. By paralleling these health priorities, we can draw attention to the less visible but no less profound impact of menstrual health challenges, breaking down the barriers that have long relegated them to the shadows of healthcare policy.
Conclusion
Our world's current fixation on mortality, while not entirely misplaced, has allowed the silent suffering of morbidity to persist unchecked, particularly when it comes to menstrual health. This blind spot in global health strategy isn't just a medical oversight; it's a profound social failure.
The story of menstrual health isn't confined to statistics and medical jargon. It's about human lives, economic vitality, societal integrity, and, indeed, our collective empathy. Every painful cramp, every dollar drained, every societal shackle – they all converge to form a narrative that's been neglected for far too long. As we march forward in our relentless pursuit of a healthier, more equitable world, let's pause and reflect on our priorities. Let's not merely count lives saved but ponder the quality of lives lived. Let's transcend the taboos that constrain conversation and the biases that bind our budgeting.
In championing menstrual health, we're not just addressing a "women's issue." We're embracing a comprehensive vision of well-being that recognizes the interconnectedness of our bodies, minds, economies, and societies. It's not merely a matter of policy change; it's a shift in perspective, a broadening of our collective compassion. It's about recognizing that health isn't just the absence of death but the presence of life – vibrant, fulfilling, and unencumbered.
The time for this change is now. Because menstrual health, like all health, isn't a privilege; it's a right, one that we must prioritize with both our minds and our hearts.
Dr. Achieng' Aling' is an obstetrician gynaecologist and global health professional with a strong focus on health system strengthening and menstrual health. Passionate about advancing global health, she is committed to knowledge sharing to drive positive change in the sphere menstrual health
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