When Emma McHugh was in high school, Celeste Mergens, the founder of an organization called Days for Girls, spoke to her church. Mergens shared about visiting an orphanage in Kenya where some of the girls were sequestered in small rooms where they had to sit on cardboard squares and be passed food from under the door for several days. They weren’t being punished for bad behavior. They were simply menstruating.
Although menstruation is a natural part of the female reproductive cycle, with around 1.8 billion people menstruating each month, many find talking about periods to be uncomfortable or even shameful. Unfortunately, the stigma surrounding menstruation has made it difficult to address problems that disproportionately affect women living in poverty such as lack of access to menstrual supplies, dignity, and education.
This lack of access is known as “period poverty” or “menstrual inequity,” and it’s a global issue.
Despite the prevalence of menstrual inequity, the issue has not received the attention and research it deserves. However, some of the needed research is currently being undertaken by PLNU faculty, staff, and students. It all started when McHugh decided she wanted to do an honors project connected to what she had heard at church from Mergens.
McHugh, who is originally from Colorado, studied international development and sustainability at PLNU. When it came time to plan her honors project, McHugh knew she wanted to focus on an issue that was important to her.
“I cared about poverty alleviation and women – as two separate areas,” she said. She had previously done projects related to human trafficking as part of her major, but McHugh hadn’t engaged in serious research before. That’s why after doing informational interviews on the topic of period poverty with people from several organizations, including The Pad Project, she planned to have her honors project combine advocacy with art rather than with original research.
“For the Honors Scholars Program, I wanted to compare and contrast the menstrual experiences of individuals living in the Global South based on the research that I assumed already existed,” she explained. “I thought I would do an art exhibit on the experiences of seven girls in seven different countries such as Kenya, Peru, and the Philippines. But, I couldn’t find a lot of peer reviewed work.”
When McHugh shared her ideas with Dr. Mark Mann, the Honors Scholars Program director suggested she consider doing the research herself and talk to Dr. Rob Gailey, professor of business and director of PLNU’s Center for International Development (CID), about honing her ideas. The CID ultimately provided much of the funding and support for the project with an additional contribution from the honors program.
Gailey reached out to some of his contacts, including Nell Sweeden at Nazarene Compassionate Ministries (NCM) and Rod Reed, provost of Africa Nazarene University at the time, on McHugh’s behalf. As a result, Maureen Ocholah with the organization Nazarene for She welcomed McHugh to interview women in Kawangware, an economically disadvantaged settlement in Nairobi, Kenya, where Ocholah lives.
In November, McHugh headed to Kenya for nine days and met with 156 women not only in Kawangware but also in Kibera and Rongai, which are also among the poorest urban areas of Nairobi. She also met with students at Africa Nazarene University, thus including women with different socioeconomic backgrounds and educational opportunities.
Many girls did not know about menstruation at all before their first period, and common materials used were mattress filling, old clothes, rags, and toilet paper
“Going in, I was expecting to hear different materials girls were using [to deal with their periods] and what levels of understanding they had about what their period was,” McHugh said. She did find answers to these questions — many girls did not know about menstruation at all before their first period, and common materials used were mattress filling, old clothes, rags, and toilet paper as well as pads that might be used for a girl’s entire period or even shared with others. However, she also was shocked to learn of another serious issue she hadn’t anticipated.
“They told me, ‘You can ask the boda boda men [moped taxi drivers, some of whom have been associated with criminal activity and violence against women in Kenya]. They will give you one pad in exchange for sex. They said it was very common; it happens all the time. One woman said, ‘If the government and world really cared about STDs, AIDs, and pregnancies, they would give us pads instead of condoms.’ Some girls wouldn’t talk about themselves but talked about their friends. In all, 94.6% said they knew someone who had participated in transactional sex for pads.”
“94.6% said they knew someone who had participated in transactional sex for pads.”
McHugh felt shattered by what she heard and contacted Gailey. “I texted, ‘Why wasn’t I prepared for this?’” He replied that economic poverty leaves many people with only hard and unfair decisions to make for survival, but that he had never heard of this particular tragic circumstance that her research had uncovered. “I said, ‘I am a 20-year- old undergrad. I can’t be the one figuring this out,” said McHugh. “I also asked the wife at the missionary housing where I was staying, ‘Why didn’t you prepare me for this? My heart is breaking. This is so hard for me to hear.’ She told me she had no idea, and she had lived there for 20 years.”
Gailey said: “Maureen’s courageous and regular work in very poor neighborhoods in Nairobi and Emma’s willingness to go into these areas to interview and talk with women about their experiences has brought to light an uncomfortable truth: Economic poverty additionally and significantly impacts girls and women with difficult decisions to make when faced with a monthly biological occurrence. And, more of the world should be made aware of this injustice in order to mobilize to help address it.”
Although McHugh was interested in everything she learned from the women in Kenya, the shocking discovery of the common practice of transactional sex for period products is what really propelled the continuation of research among PLNU students in the Honors Scholars Program and additional funding from the CID. A second honors student, Lydia Umhau, returned to Kenya the following year to do more research in additional areas with support from McHugh, Gailey, and Mann. An additional 287 women were interviewed. Between them and the original 156 women, 87.2% said they knew someone who had traded sex for pads. A new finding was that some Maasai women reported sitting over holes for more than 12 hours a day while menstruating and using animal skins at night. On this trip, the team was able to bring 200 menstrual cups, a sustainable period product, to give to women they interviewed. The cups were purchased with funds McHugh’s art installation raised. Then in summer 2024, two more honors students traveled to Eswatini and Malawi, expanding the research from East Africa to Southern Africa. McHugh, Gailey, and Mann were also there, and Maureen Ocholah of Nazarene for She helped oversee the research. Most recently through the CID, research was conducted in Oaxaca, Mexico, in March 2025. The ongoing research is part of the CID initiative “Akinyi,” a word from the Luo tribe in Kenya that means “girl born in the morning.”
“We still ask questions about what it is like to be on your period and how it affects your life as a whole [where you live] to better understand the realities of menstruation across different communities and cultures,” McHugh said. “We are learning about the other parts like not knowing about your period [before you experience it], what products are accessible, and not being able to go to school or work or participate in [community] life. On top of that, sex [in exchange] for menstrual products probably happens in other places. We want to learn about that, especially if there is a correlation to pregnancy and STDs, making it part of a larger global health crisis.”
The ongoing research is part of the CID initiative “Akinyi,” a word from the Luo tribe in Kenya that means “girl born in the morning.
As more people have been brought into the Akinyi project, McHugh is still a driving force behind it. Her first step after returning from her initial Kenya trip was to host the art installation she had planned. “I processed a lot through that part of it,” she said. “I learned that I love conducting research, but the most important thing to me is to elevate stories. Getting to print out beautiful portraits that I took of women and write their stories below them felt like I was dignifying their stories.” She then went on to share her research and findings at the annual PLNU Honors Conference. Many of those in attendance were moved by her work and several, including men, wanted to find ways to help. “It was one of the most moving — if not the most moving — presentation I have ever seen,” Mann said. “Here was a young woman talking about her own menstruation as a stepping stone to talking about the problems in the world, specifically in the slums of Nairobi.”
“After hearing her presentation at the Honors Scholars conference, I approached her and asked if she wanted to continue the project, and if so, that I’d help her however I could,” Mann said. “My proposal was that we try to find another Honors Scholar to continue the project the next year, and she would go with the student to continue and oversee the research.”
They set up a meeting with Gailey to discuss this further and just days later they found their answer when Umhau approached Mann about doing research on period poverty as an honors project her senior year. Mann sent her immediately to Gailey and McHugh and by the end of the week, a second year of the project had fallen into place. That next fall, under the direction of Gailey, McHugh returned to Nairobi with Umhau, this time to extend the research into rural areas.
Then, in 2024, Arwen Martin and Aliya Mccord joined the research group, each focusing their own honors project on period poverty. The research project is now multi-disciplinary as Martin and Mccord both graduated in May 2025 with degrees in biology. Mccord led the work in Eswatini [formerly known as Swaziland]. Her goal, inspired by her honors research experience, is to work in public health. Martin, who is heading to medical school with plans to become an OB-GYN, led the research in Malawi. Martin and Mccord traveled to Africa together with McHugh, Gailey, and Ocholah. They spent some of their time together and some in their respective countries of research focus.
Because of several generous donors, when the team went to Eswatini and Malawi, they were able to bring 500 menstrual cups to offer to the women they interviewed. Although many of the women were unfamiliar with the cups, once they learned how sustainable and sanitary they were, many were excited by all they could do while wearing them (leave the house, swim, even dance!).
In both countries, support from local Nazarene churches and nonprofits was invaluable. Gailey had connections in Eswatini because he grew up there while his parents were missionaries. Also in Eswatini, a nonprofit called Women Unlimited helped Mccord formulate her questions, especially since menstruation was a sensitive topic that was seen by some as culturally and religiously taboo.
“The hardest part was learning how to interview with cross cultural and language barriers and working with the translators,” Mccord said. “But it was amazing to see women open up and be more comfortable.”
In Eswatini, Mccord found that menstrual products were available but often not accessible. Many women resorted to using cloth or tissue instead and had to stay at home during their periods due to inadequate supplies.
Martin experienced similar challenges in Malawi, but, again, the Nazarene church connections there were very helpful to her. She found that 94% of the women and girls she interviewed didn’t know about menstruation before they had their first period. Many were terrified when they started, fearing they were dying and not knowing what to do. She also learned that in Malawi, it is often the grandmother rather than the mother who instructs young women about menstruation.
As in Kenya and Eswatini, many women in Malawi used cloth during their periods instead of pads or other store- bought products. However, they shared that the cloths were often hard to clean (access to soap was often mentioned as their greatest need) and evoked fear of smelling unclean.
Martin shared: “The number one thing we really took away was the need for education about menstruation and reproduction: knowing how to deal with periods, how to use products, how to dispose of them, how to be clean and comfortable. That’s so important to be able to go to school and work. Also, men need to care [about menstrual equity], too.”
In March 2025, McHugh and honors student Ceci Corona expanded the Akinyi research to North America for the first time, by beginning work in Oaxaca, Mexico. Overall, McHugh said they found “much happier stories in Oaxaca.”
“Period products are much cheaper in Mexico than even in Malawi,” she shared. “Still, there were some sad stories to do with negative beliefs about periods and blood. If girls started young, parents sometimes thought it was due to a loss of virginity. Some parents married their daughters off as young as age 8 to make sure they hadn’t started menstruating since blood could bring their virginity into question. Overall, though, there was more education and acceptance in Oaxaca than elsewhere.”
They were also able to bring 200 menstrual cups donated by a company called Saalt to Oaxaca. After reassuring some of the young women that the cups couldn’t affect their virginity, McHugh found a lot of acceptance of the products there as well.
The hope is for the CID to find additional donors or larger grants in order for the CID to commit to not only researching the issue of period poverty but helping to find solutions.
An exciting part of McHugh’s trip to Oaxaca was that it was the first time she traveled as a full-time PLNU staff member. She began working with the CID as a research associate part-time in October 2024, and in spring 2025, the CID was able to hire her full time. Part of her salary is currently being funded by a grant from Nazarene Compassionate Ministries (NCM).
The hope is for the CID to find additional donors or larger grants in order for the CID to commit to not only researching the issue of period poverty but helping to find solutions.
“The long-term plan is not just to do research,” said Gailey. “We want to know how we can address this as a justice issue, using both the Nazarene and international development spaces. The CID is connected to our business school and international development program. We want to learn how we can create businesses to make safe and affordable products that can be locally sourced and therefore be sustainable. The menstrual cups are part of it. It would be great to have local production. Could we also create businesses in the Global South to make things more affordable, accessible, safer, and sustainable? We want to continue to engage students, our business school, and the university. ”
McHugh and Gailey say their goal is to expand their work to new areas such as South America and Southeast Asia. They are also hoping to expand Akinyi beyond the Honors Scholars Program in order to include more students and partnerships.“It’s extremely gratifying to witness how a student research project has taken on a life of its own, addressing such important issues and seeking solutions that can have a real impact on real people’s lives,” Mann said. “I hope that it inspires more of our students to envision how their own passions, talents, and skills can likewise be used in service to Christ and the benefit of others [and that more alumni will catch a vision to support this kind of work].”
More information about Akinyi and opportunities to engage and support its work can be found through the CID’s website.
