Every May 28, Menstrual Hygiene Day (MH Day) raises awareness and combats taboos associated with menstrual hygiene with the goal of enabling women and girls to achieve their full potential. The theme of Menstrual Hygiene Day 2019—It's Time for Action—not only emphasizes the urgency of this public health issue, but also highlights the transformative power of improved menstrual hygiene to unlock economic and educational opportunities for women and girls.
Empowering women and girls and promoting gender equality are core operating principles of the U.S. Government Global Water Strategy and USAID Water and Development Plan. To alleviate a major constraint to women’s and girls’ participation in education and public life, USAID seeks to integrate menstrual hygiene management (MHM) interventions where practical and improve MHM in key settings, including schools.
As a contribution to MH Day 2019, this issue contains links to recent studies on “period poverty,” MHM and its impact on schooling/education, MHM in humanitarian situations, and other MHM–related topics.
Menstrual Hygiene Day 2019 – This global advocacy platform for MH Day brings together the voices and actions of nonprofits, government agencies, individuals, the private sector, and the media to promote MHM for all women and girls. This website contains campaign materials for this year’s theme—It’s Time for Action—and a list of events and resources.
WASH Innovation Challenge on Menstrual Hygiene Management (MHM) and Incontinence – Elrha’s Humanitarian Innovation Fund is launching a challenge May 23, 2019, and will be seeking innovative projects exploring how to design safe and dignified MHM spaces in emergency camp settings and how to better engage with and understand the needs of people with incontinence in emergencies. Additional information will soon be posted on the Elrha’s website.
What Is the Point of a Period? Scientific American, May 2019. Age-old taboos against menstruation have led to a lack of research on how women's menstrual cycles work, with serious consequences for their health.
Period Poverty Impact on the Economic Empowerment of Women. Knowledge, Learning and Evidence for Knowledge, January 2019. Period poverty refers to a lack of access to sanitary products due to financial constraints. The problem exists in high as well as low- and middle-income countries.
Menstrual Hygiene Management Virtual Conference 2018 – This conference, held on October 30, 2018, as part of the Water and Health Conference at the University of North Carolina at Chapel Hill, included 11 web-based presentations and a short ﬁlm. The presentations provided a broad range of perspectives from around the world, such as the unique challenges of girls in Mongolia during cold winter months when water is not available in schools, or the lack of adequate MHM guidance and facilities in schools in Indonesia, Nigeria, and the Solomon Islands.
Globalwaters.org/Menstrual Hygiene Management – This knowledge-sharing hub from the USAID Water Office includes a resource collection on MHM.
MHM Country/Regional Studies
Menstruation Hygiene Management and Work Attendance in a Developing Country. University of Göttingen, 2019. The authors of this study provide, for the first time, evidence of a strong causal impact of advanced MHM on work attendance. Access to advanced MHM materials reduced work absenteeism of women by about 21 percent in Burkina Faso.
A Rite of Passage: A Mixed Methodology Study about Knowledge, Perceptions and Practices of Menstrual Hygiene Management in Rural Gambia. BMC Public Health, March 2019. Strategies to encourage positive social norms toward menstruation in rural Gambia would help to promote more open discussions about it at the family, community, and national level, in turn supporting improvements in MHM in this and similar communities.
Menstrual Cup Interventions Follow-Up Study Report. WoMena Uganda, March 2019. This study discusses the results of a menstrual cup intervention in three rural districts of Uganda.
Menstrual Health Management in East and Southern Africa: A Review Paper. United Nations Population Fund (UNFPA), June 2018. This literature review forms the basis for a situational analysis of the current state of MHM in eastern and southern Africa to guide UNFPA in the development of a strategic and holistic approach to MHM.
MHM and Education/Schooling
Effect of Menstruation on Girls and Their Schooling, and Facilitators of Menstrual Hygiene Management in Schools: Surveys in Government Schools in Three States in India, 2015. Journal of Global Health, June 2019. The survey showed an association between access to pain medication in school and use of disposable pads with lower absenteeism, and inadequate sanitary facilities with higher absenteeism during menstruation.
Pupil Absenteeism, Measurement, and Menstruation: Evidence from Western Kenya. Columbia University School of International and Public Affairs, March 2019. Researchers conducted a trial that provided sanitary products to schoolgirls to reduce absenteeism, concluding that access to sanitary pads reduces absenteeism by 5.4 percent.
Menstrual Hygiene Management of Adolescent School Girls and Nuns: A Knowledge, Attitude, and Practices Study in Bhutan. UNICEF, 2018. This report highlights the findings of a study of MHM knowledge, attitudes, and practices among adolescent schoolgirls and nuns in Bhutan as of 2017. The study is the first of its kind.
Menstrual Hygiene Management and School Absenteeism Among Adolescent Students in Indonesia: Evidence from a Cross-Sectional School-Based Survey. Tropical Medicine and International Health, December 2018. High prevalence of poor MHM and considerable school absenteeism due to menstruation among Indonesian girls highlight the need for improved interventions that reach girls at a young age and address knowledge, shame and secrecy, acceptability of WASH infrastructure, and menstrual pain management.
MHM and Humanitarian Situations
Pilot Study Findings on the Provision of Hygiene Kits with Reusable Sanitary Pads. United Nations Refugee Agency (UNHCR), December 2018. In collaboration with AFRIpads, UNHCR Sub-Office Mbarara implemented a three-month pilot intervention to test the acceptability of introducing reusable sanitary pads to schoolgirls in the refugee context.
Periods Don’t Stop in Emergencies: Addressing the Menstrual Hygiene Needs of Women and Girls. Humanitarian Innovation Fund, August 2018. This article discusses the challenges that women and girls face around menstrual hygiene in emergencies.
Exploring Menstrual Practices and Potential Acceptability of Reusable Menstrual Underwear among a Middle Eastern Population Living in a Refugee Setting.International Journal of Women’s Health, July 2018. Primary data analysis of narratives around the beliefs, behaviors, and practices of menstrual hygiene in this population revealed key themes related to the physical environment; the social environment; cleanliness, comfort, and health; and adaptation and coping.
Pilot Testing and Evaluation of a Toolkit for Menstrual Hygiene Management in Emergencies in Three Refugee Camps in Northwest Tanzania. Journal for International Humanitarian Action, June 2018. This paper describes the development and pilot testing of the Menstrual Hygiene Management in Emergencies Toolkit in three camps hosting Burundian and Congolese refugees in northwest Tanzania.
Improving Menstrual Hygiene Management in Emergency Contexts: Literature Review of Current Perspectives. International Journal of Women’s Health, April 2018. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts to understand the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations’ menstrual needs.
Menstrual Hygiene Management in Emergencies Toolkit. Columbia University Mailman School of Public Health; International Rescue Committee, 2017. The toolkit provides streamlined guidance to support organizations and agencies seeking to rapidly integrate MHM into existing programming across sectors and phases.
MHM and Waste Disposal
Menstrual Hygiene Management and Waste Disposal in Low and Middle Income Countries—A Review of the Literature. International Journal of Environmental Research and Public Health, November 2018. A literature review showed that MHM and sanitation value chains often neglect the disposal of menstrual waste, leading to improper disposal and negative impacts on users, sanitation systems, and the environment.
Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries. Journal of Environmental and Public Health, February 2018. At home, women dispose of menstrual products with other domestic waste. Outside of the home, they often flush them in public toilets without knowing the consequences of choking sewer pipelines.
Menstrual Waste Management: A Simple Guide. Ministry of Drinking Water and Sanitation, Government of India, 2019. This guide discusses composting and small-scale incineration of disposed menstrual hygiene products.
Systematic Review of Menstrual Hygiene Management Requirements, Its Barriers and Strategies for Disabled People. PLoS One, February 2019. Researchers identified little evidence on the requirements of disabled people and their ability to manage menstruation. They identified only one intervention, along with a range of barriers. The consequences of failing to meet MHM needs of disabled people include shame, social isolation, and even sterilization.
Sanitation Secrets and Menstrual Hygiene Management: What Can Perimenopausal Women Tell Us? 41st International WEDC Conference, July 2018. The WASH sector has focused on the MHM needs of adolescent girls, while ignoring the MHM needs of a growing population of perimenopausal women, who commonly experience changes and irregularities in their menstruation.