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UNESCO HIV and Health Education Clearinghouse

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  1. Mapping the knowledge and understanding of menarche, menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries

    This paper maps the knowledge, attitudes, beliefs and practices surrounding menarche, menstrual hygiene and menstrual health among adolescent girls in low and middle income countries in order to inform the future design of relevant policies and programming. The study of over 80 journal articles from a number of low and middle income countries confirmed that: (1) Many adolescent girls start their periods uninformed and unprepared. (2) Mothers are the primary source of information, but they inform girls too-little and too-late and often communicate their own misconceptions. …

  2. Menstrual hygiene management. National guidelines

    The Menstrual Hygiene Management Guideline is issued by the Ministry of Drinking Water and Sanitation to support all adolescent girls and women. It outlines what needs to be done by state governments, district administrations, engineers and technical experts in line departments; and school head teachers and teachers. This guideline is organised as follows: Part 1: About the guideline; Part 2: Who needs to know what, why and how; Part 3: Providing adolescent girls with menstrual hygiene management choices; Part 4: MHM infrastructure in schools and the safe disposal of menstrual waste.

  3. Menstrual hygiene management impacts girls’ school experience in the Bolivian Amazon

    The purpose of this study on menstrual hygiene management (MHM) in the Beni department of Bolivia was to better understand the challenges girls face due to menstruation; describe factors which influence girls’ experiences during menstruation; and present recommendations to create a supportive school environment for adolescent girls in Bolivia. This study complements the findings of the first MHM study undertaken in Cochabamba, Bolivia in 2012, by providing information specific to the Amazonian population of the eastern lowlands of Bolivia. …

  4. WASH in schools empowers girls’ education in rural Cochabamba, Bolivia: an assessment of menstrual hygiene management in schools

    The experiences girls face at school in Bolivia during menstruation had never been formally researched before this project. Data collection in Bolivia was part of a multi-country assessment of the challenges girls face in schools that included the Philippines, Rwanda and Sierra Leone. The overarching aim of this collaboration was to understand the range of challenges faced by schoolgirls during menstruation, as well as the determinants of those challenges, and to provide recommendations for stakeholders. …

  5. A comparison of the menstruation and education experiences of girls in Tanzania, Ghana, Cambodia and Ethiopia

    The barriers to menstrual hygiene management faced by adolescent schoolgirls in low-income countries are gaining interest at practice and policy levels. The challenges include inadequate water, sanitation and disposal facilities for the management of menses with privacy and dignity, and insufficient guidance to help girls feel confident in attending school during menses. The studies described here aimed to examine how menarche impacts the lives of schoolgirls in three low-income countries (Ghana, Cambodia and Ethiopia). …

  6. WASH in schools empowers girls' education in Freetown, Sierra Leone: An assessment of menstrual hygiene management in schools

    From June through July 2012, Emory University and UNICEF collaborated in research aimed to understand the range of challenges faced by girls during menstruation in urban Freetown, as well as the determinants of those challenges. This report presents the methods, findings and key programmatic recommendations to address menstruation-related challenges among girls. More than 100 participants were engaged in eight schools and two communities, including teachers and girls, both in school and out of school.

  7. WASH in schools empowers girls’ education. Proceedings of the Menstrual Hygiene Management in Schools Virtual Conference 2012

    WASH in Schools (WinS) fosters social inclusion and individual self-respect. By offering an alternative to the stigma and marginalization associated with hygiene issues, it empowers all students – and especially encourages girls and female teachers. In recognition of the positive impact on girls’ school attendance and achievement, initiatives around the world are addressing adolescent girls’ menstrual hygiene management (MHM) needs through WinS programming. …

  8. A systematic review of the health and social effects of menstrual hygiene management

    Background: Differing approaches to menstrual hygiene management (MHM) have been associated with a wide range of health and psycho-social outcomes in lower income settings. This paper systematically collates, summarizes and critically appraises the available evidence. Methods: Following the PRISMA guidelines a structured search strategy was used to identify articles investigating the effects of MHM on health and psycho-social outcomes. The search was conducted in May 2012 and had no date limit. Data was extracted and quality of methodology was independently assessed by two researchers. …

  9. Study on menstrual management in Uganda

    This pilot research study on the impact of menstrual hygiene on girls in school is primarily aimed at the Ministry of Education and Sports and the National Sanitation Working Group. Within the context of Uganda, the results of this study will be used to provide evidence-based advocacy on the role of upper primary girls, from the ages of 13-18, whom have started menstruating, with a specific emphasis placed on the issues and challenges that they face at school. …

  10. We keep it secret so no one should know - A qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural western Kenya

    Background: Keeping girls in school offers them protection against early marriage, teen pregnancy, and sexual harms, and enhances social and economic equity. Studies report menstruation exacerbates school-drop out and poor attendance, although evidence is sparse. This study qualitatively examines the menstrual experiences of young adolescent schoolgirls. Methods and Findings: The study was conducted in Siaya County in rural western Kenya. A sample of 120 girls aged 14–16 years took part in 11 focus group discussions, which were analysed thematically. …

  11. Growing up at school. A guide to menstrual management for school girls

    This booklet has been written to help school girls manage the critical period when they enter adolescence between the ages of 10 and 14. Adolescence is the time during which boys and girls grow from childhood into adulthood and changes take place in their bodies. During this period, known as puberty, menstruation starts in girls.

  12. Sanitary pad interventions for girls' education in Ghana. A pilot study

    Background: Increased education of girls in developing contexts is associated with a number of important positive health, social, and economic outcomes for a community. The event of menarche tends to coincide with girls’ transitions from primary to secondary education and may constitute a barrier for continued school attendance and performance. Following the MRC Framework for Complex Interventions, a pilot controlled study was conducted in Ghana to assess the role of sanitary pads in girls’ education. …

  13. Menstruation, sanitary products and school attendance: Evidence from a randomized evaluation

    Policy-makers have cited menstruation and lack of sanitary products as barriers to girls' schooling. We evaluate these claims using a randomized evaluation of sanitary products provision to girls in Nepal. We report two findings. First, menstruation has a very small impact on school attendance: we estimate that girls miss a total of 0.4 days in a 180 day school year. Second, improved sanitary technology has no effect on reducing this (small) gap: girls who randomly received sanitary products were no less likely to miss school during their period. …

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