1. Menstrual hygiene matters: guidelines for practitioners
A synthesis of best practice in menstrual hygiene management (MHM)
1 The issue 3 Findings 4 Critical gaps
Half of the world’s people menstruate for a • Examples of cross-sectoral collaboration
significant part of their lives, yet this issue has responding to MHM.
been largely neglected by the water, sanitation • Examples of good practice in monitoring
and hygiene (WASH) sector and key decision- and evaluation for MHM. Key indicators
makers. As a result, over a billion women and
girls are denied their rights – to gender equality,
Piecing together the menstrual hygiene management jigsaw and impact assessment.
• Successful approaches to engage men and
WASH, education, health and dignity – and boys in MHM at different levels.
national and international development goals • Successful approaches to MHM for women
will not be achieved. and girls in the most vulnerable situations.
Sidra, 28, "The hygiene class MHM in different socio-cultural and Women and girls in Vulnerable
was really beneficial for all women and girls,
of us, especially the lessons geographic contexts vulnerable situations such as those MHM training
on menstrual hygiene. They with disabilities, for both male
gave us napkins and taught Women and girls face particular challenges in some Dealing with menstrual hygiene when it is incontinence or HIV/ and female
us to use a new one for each socio-cultural and geographic contexts. For example, already difficult to access hygienic water, AIDS, or living in UNHCR staff in
cycle and then to burn them. their usual coping mechanisms for obtaining sanitary sanitation and hygiene facilities poses a extreme poverty, Uganda.
Before, we were using pieces protection materials, bathing with dignity and privacy, double challenge. conflict situations or
of old cut clothes, which we and washing or disposing of their menstrual materials custody, are likely
would wash and use until are disturbed in emergency situations, where they may to face additional
they were too dirty to be of be forced to live in close proximity with male relatives or challenges in
use anymore." strangers. managing their
A hidden issue.
A woman from menstruation.
Chhattisgarh
conceals her
menstrual cloth
at home. MHM is complex and needs to be addressed
holistically and in context as a package of
services that includes:
Photo: CARMDAKSH • A voice and space to talk about the issue, involving women, Photo: Moto Michikata/REDR
Photo: Alixandra Fazzina NOOR for WaterAid
girls, men and boys. Photo: WaterAid/Layton Thompson
• Availability of accurate information on menstruation and
2 The project menstrual hygiene. 5 Next steps
Rationale: There is a lack of systematic • Collaborate with organisations to
• Appropriate and affordable sanitary protection materials
studies analysing best practices in MHM co-publish for broader ownership,
for managing menstrual blood.
and no comprehensive resources to provide dissemination and field testing of MHM
• Facilities for washing, drying and storing or disposing of
guidance on what works in different contexts to guidelines.
used materials.
encourage replication of successful approaches. • Develop an MHM forum to share best
• Privacy and hygienic facilities for changing and washing.
practice and promote advocacy.
Purpose: To improve the lives of girls and • Further work to address gaps in knowledge
women around the world by supporting – especially impacts on health and
opportunities for better MHM practices. education.
Whose responsibility? Sanitary protection - supply, use
Objective: To produce a guideline for The division of responsibility for who takes action on
and disposal
menstrual hygiene management is unclear. Because a
practitioners setting out the key elements of number of sectors have some level of responsibility, there
It is critical to identify:
A cross-sector issue involving:
MHM programmes and how to contextualise • Water, sanitation and hygiene.
is a risk that the issue is overlooked or there is a confusing • User preference.
multiplication of responses. • Disposal options.
them – based on an assessment and synthesis • Reproductive, adolescent and general health. • Affordability.
• Education. A young woman in Bangladesh makes
of existing knowledge and successful • Community development.
• Ability to wash and dry re-usable materials.
cotton sanitary pads which are considered
• Knowledge and ability for hygienic use and disposal.
approaches. • Social protection. by many women to be affordable,
• Private sector. comfortable and hygienic.
Methodology:
Photo: WaterAid/Caroline Irby Photo: ASM Shafiqur Rahman/WaterAid
• Reviewing documentation. Researchers:
• Interviews with MHM practitioners. Thérèse Mahon
• Synthesising the existing literature in MHM Sarah House
guidelines. Sue Cavill
• Cataloguing MHM documentation and
resources. Contact: theresemahon@wateraid.org
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