New Resource: Cultural Traditions, Period Poverty and Menstrual Health Resources in Remote Indigenous Communities in North America

Created by Days for Girls with assistance from researchers at New Perimeter, DLA Piper’s nonprofit affiliate focused on global pro bono, this whitepaper explores the community-led revitalization of traditional coming-of-age ceremonies; the unique challenges associated with period poverty in rural communities; the available federal, state, and nonprofit resources in Canada and the United States; and recommendations for closing the remaining policy and investment gaps in menstrual health for Indigenous communities.

Menstruation-Related Rituals, Traditions, and Beliefs of Indigenous Communities

Anthropologists have long known menstruation to be a historically respected and even revered rite of passage among North American Indigenous communities. It is additionally known that colonization negatively impacted the continuation of menstruation-related rituals and coming-of-age ceremonies, with many traditions being forcibly discontinued or subjected to erasure attempts. However, Indigenous community leaders today are investing in the revitalization of traditional ceremonies through the education of youth and the renewed celebration of menarche. The report explores examples of the Kinaaldá celebration of the Navajo, the Ch’ilwa:l ceremony of the Hupa, the berry fast of the Ojibwe, and the moon time reflections of the Métis.

Impacts of Priod Poverty on Indigenous Communities

Rural Indigenous communities experience systemic challenges that disproportionately exacerbate period poverty, or the lack of access to menstrual products, education, and sanitation facilities. Broadly, research across North America has shown that Indigenous individuals are more likely to struggle with access to menstrual products and miss community engagement opportunities such as school or work due to lack of access to menstrual products. In remote communities, significant travel time and associated costs is often necessary for the procurement of menstrual products or the pursuit of menstrual health care. Additionally, infrastructure such as sufficient water access, piped septic services in the home, or accessible waste disposal facilities pose unique challenges.

Menstrual Health Resources for Indigenous Peoples in North America

The United States and Canada have adopted distinct federal systems for menstrual health support among Indigenous communities. In the United States, federal initiatives may provide broader healthcare and educational services, but there is a notable lack of programs specifically addressing menstrual health. In Canada, a more centralized approach has included targeted initiatives to increase access to menstrual products and to scale up menstrual health education programs with a specific focus on Indigenous communities. In both countries, nonprofit organizations regularly fill systemic gaps through the distribution of menstrual products and delivery of co-created menstrual health education together with Indigenous community leaders. 

Recommendations

After over a year of desk research, expert interviews, and site visits, the report concludes with six key recommendations for the systemic investment in menstrual health among remote Indigenous communities in North America:

• Prioritize community-led approaches. Indigenous communities have experienced “one and done” interventions that erode trust. Menstrual health programs should be co-created with community leaders to ensure that they reflect cultural, social, and geographic realities.

• Ensure broad, consistent access to menstrual products. Menstrual health interventions should prioritize dignity of choice by providing a range of quality menstrual products, including both disposable and reusable options, so that individuals can make a decision based on their context and lifestyle.

• Address infrastructure barriers. Infrastructure challenges related to running water, electricity, and waste disposal directly impact menstrual health management. Investment in critical infrastructure is necessary for menstrual health, particularly in remote communities.

• Support community-led, culturally sensitive menstrual health education. When young people receive clear, age-appropriate guidance on the menstrual cycle, hygiene, pain management, and when to seek care, they are better able to safeguard their health and participate fully in school, work, and community life. Educational approaches should emphasize local authority and cultural competence.

• Support the revitalization of traditional ceremonies. There is a vibrant, ongoing revitalization of traditional menstrual ceremonies in many Indigenous communities. Implementers and advocates should educate themselves on the cultural significance of menstruation and support these efforts by elevating local teachings and including menstrual ceremonies in funding programs that address the revitalization of Indigenous heritage.

• Improve data collection and research. Research should examine not only access to menstrual products and sanitation facilities, but also the broader social, economic, and historical factors that contribute to period poverty, including the legacy of colonialism, systemic underfunding, and the disruption of traditional menstrual practices. Addressing this gap in the literature is essential for informing policy, guiding resource allocation, and supporting the design of community-driven solutions.

Days for Girls is grateful for the researchers, editors, and expert interviewees who made the development of this report possible. In a community that has been historically overlooked in the research and delivery of essential services, it is a privilege to shine a light on both the incredible progress and the challenges that remain to be solved in advancing menstrual health for Indigenous peoples.

Read and download the complete report HERE. Learn more about Days for Girls’ ongoing research and distribution programs in partnership with the Navajo Nation HERE.