Menstrual Hygiene Toolkit

Globally, approximately 52% of the female population, or 26% of the total population, is of reproductive age. Most of these women and girls will menstruate each month for between two and seven days.

To manage menstruation hygienically and with dignity, it is essential that women and girls have access to water and sanitation. They need somewhere private to change sanitary cloths or pads; clean water and soap for washing their hands, bodies and reusable cloths; and facilities for safely disposing of used materials or a clean place to dry them if reusable. There is also a need for both men and women to have a greater awareness of good menstrual hygiene practices.

Menstruation is a natural process, but in most parts of the world it is taboo and rarely talked about. It has also been largely neglected by the WASH sector and other sectors focusing on sexual and reproductive health, and education.

As a result, the practical challenges of menstrual hygiene are made even more difficult by socio-cultural factors and millions of women and girls continue to be denied their rights to WASH, health, education, dignity and gender equity.

Young girls often grow up with limited knowledge of menstruation because their mothers and other women shy away from discussing the issues with them. Adult women may themselves not be aware of the biological facts or good hygienic practices, instead passing on cultural taboos and restrictions to be observed. Men and boys typically know even less, but it is important for them to understand menstrual hygiene so they can support their wives, daughters, mothers, students, employees and peers. In the development sector, there is a lack of documentation for sharing best practice on what works.

Impact on social exclusion

Photo: WaterAid

Taboos surrounding menstruation exclude women and girls from many aspects of social and cultural life as well as menstrual hygiene services. Such taboos include not being able to touch animals, water points, or food that others will eat, and exclusion from religious rituals, the family home and sanitation facilities. As a result, women and girls are often denied access to water and sanitation when they need it most.

Well designed and appropriate water, sanitation and hygiene facilities that address menstrual hygiene can make a significant difference to the schooling experience of girls.

Impact on education

Many schools do not support adolescent girls or female teachers in managing menstrual hygiene with dignity. Inadequate water and sanitation facilities, make managing menstruation very difficult, and poor sanitary protection materials can result in blood-stained clothes causing stress and embarrassment.

Teachers (and male members of staff in particular) can be unaware of girls' needs, in some cases refusing to let them visit the latrine. As a result, girls have been reported to miss school during their menstrual periods or even drop out completely.

Impact on health

Why girls miss school in Ethiopia. Photo: WaterAid

Menstruation is a natural process; however, if not properly managed it can result in health problems. The impact of poor menstrual hygiene on the psycho-social wellbeing of women and girls (eg. stress levels, fear and embarrassment, and social exclusion during menstruation) should also be considered.

Impact on sustainability of water and sanitation services and behaviour change

Neglecting menstrual hygiene in water, sanitation and hygiene programmes could also have a negative effect on their sustainability. Failing to provide disposal facilities for used sanitary pads or cloths can result in a significant solid waste issue, with latrines becoming blocked and pits filling quickly. Failure to provide appropriate menstrual hygiene facilities at home or school could also prevent WASH services being used by the intended users all of the time.

The Menstrual Hygiene Modules Toolkit

Drum incinerator for menstrual products in a school in Tanzania.
Photo: WaterAid

Women’s self-help group producing sanitary pads, Rajasthan, India (Photo: UNICEF, India)

Sanitary washing slab for pads in emergencies. Photo: WaterAid

Menstrual hygiene matters (15MB, full download) is an essential resource for improving menstrual hygiene for women and girls in lower and middle-income countries. The document is also available as separate, color downloads: Nine modules and toolkits cover key aspects of menstrual hygiene in different settings, including communities, schools and emergencies.

This comprehensive resource:

- Brings together examples of good menstrual hygiene practice from around the world
- Provides guidance on building competence and confidence to break the silence surrounding the issue
- Encourages increased engagement in advocacy on menstrual hygiene

Downloads

The following modules and toolkits below are low res PDFs. The High res PDFs are good for printing: Download Menstrual hygiene matters - complete report.
Or see each high res module and toolkit on the WaterAid website.