A/HRC/33/49 and to clean. Women and girls with disabilities face unique challenges in accessing sanitation facilities. Their ability to properly manage their hygiene may be particularly compromised and, when facilities do not provide for the space and materials they need, they are especially prone to diseases. Service providers must ensure that facilities are designed with the participation of women and girls in order to adapt them to their biological and sociocultural needs. The specific needs of women and girls must be incorporated into the design, implementation, monitoring and evaluation of sanitation facilities. Approaches must go beyond advocacy to address policies, infrastructure, maintenance systems and monitoring in order to ensure that services are adapted to the specific needs of users by, for example, taking into account their bodies, including their physical abilities, and their age. Formal independent regulators, as well as locally based participatory water and sanitation committees, should monitor whether regulations are well interpreted, implemented and effective. 35. Many women and girls risk their health using unhygienic sanitary methods, for example by using dirty rags or newspapers to collect menstrual fluids, as other methods are unaffordable, unavailable or unknown owing to stigma and taboos relating to menstruation. Although women in western countries use, on average, at least 12,000 tampons during their lifetime, there is no extensive and publicly available knowledge on the safety of tampon usage. 39 States are required to enact regulations on the safety of industrially produced menstrual products. Different women prefer different menstrual products, which include cloths and menstrual cups. Information must be provided so women can use the product they feel most comfortable with, with the knowledge and skills to manage their menses hygienically. States must further ensure affordable health care for all women and girls, including for menstrual issues and incontinence. 36. Water, sanitation and hygiene needs are critical to prevent high maternal and newborn mortality rates. In its recently adopted general comment No. 22 (2016) on the right to sexual and reproductive health, the Committee on Economic, Social and Cultural Rights notes that access to safe and potable water and adequate sanitation, as well as access to health-related education and information, are the underlying determinants to that right. Collaboration among sectors makes it possible to exchange information on how to deliver education on culturally taboo topics and to give greater priority to female-specific needs, in a manner that the water, sanitation and hygiene sector alone cannot achieve.40 E. Affordability 37. Affordability is of special concern to women and girls, who often have less access to financial resources than men. Women and girls need toilets for urination, defecation and menstrual hygiene management as well as for assisting younger children. Combined with women’s lower access to financial resources, pay-per-use toilets with the same user fee for men and women are in practice often more expensive for women. Besides, public urinals are often free for men but not for women. To tackle this, the municipal government of Mumbai is currently constructing several toilet blocks the maintenance of which is financed through family passes instead of by charging a fee for each use. Some public toilets can be used free of charge by women and other groups that often lack access to economic resources, such as children and older people. 39 40 Susan Dudley and others, “Tampon safety”, National Center for Health Research (2016). See also http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-//EP//TEXT+WQ+E-2015013116+0+DOC+XML+V0//EN. WaterAid Australia, submission to the Special Rapporteur. 11