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UNESCO HIV and Health Education Clearinghouse

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  1. Menstrual health and school absenteeism among adolescent girls in Uganda (MENISCUS): A feasibility study

    Management of menstruation can present substantial challenges to girls in low-income settings. In preparation for a menstrual hygiene intervention to reduce school absenteeism in Uganda, this study aimed to investigate menstruation management practices, barriers and facilitators, and the influence of menstruation on school absenteeism among secondary school students in a peri-urban district of Uganda. …

  2. New directions for assessing menstrual hygiene management (MHM) in schools: A bottom-up approach to measuring program success

    This dispatch aims to share lessons learned from the process of developing instruments to measure school participation, stress, and self-efficacy – outcomes that qualitatively link to girls’ experiences managing menstruation in school.

  3. The precocious period: the impact of early menarche on schooling in India

    Improvements in childhood nutrition increase schooling and economic returns in later life in a virtuous cycle. However, better nutrition also leads to an earlier onset of menstruation (menarche). In socio-cultural contexts where menarche adversely affects educational attainments, early menarche can thus break the virtuous cycle of girls’ human development. This paper focuses on one such context, India, and uses the Young Lives Longitudinal Study to show that starting menses before age twelve causes a 13% decrease in school enrollment rate. …

  4. Pupil absenteeism, measurement, and menstruation: Evidence from Kenya

    Impact evaluations focused on school absenteeism commonly use school records of untested quality or expensive spot-check data. We use a large dataset on more than 30,000 unannounced random spot-checks for 6,000 female and male students across 30 schools in Western Kenya, with equivalent school record entries. First, we confirm that while absenteeism is common overall, pubescent girls miss more schooldays than boys because of high incidence of school transfers. …

  5. Menstruation and menstrual hygiene management in selected KwaZulu-Natal schools

    The focus of this study was on the impact of menstruation and menstrual hygiene management on girl learners in schools in the Province of KwaZulu-Natal, South Africa. Issues related to cultural practices, teachings about menstruation, access to sanitary supplies necessary during menstruation and to sanitation, as well as psychological trauma, particularly at menarche (the time of their first menstruation), were looked at. The study also attempted to capture the feelings and experiences of learners and their knowledge at menarche.

  6. Menarche and its implications for educational policy in Peru

    Indigenous girls in rural areas live in the most extreme poverty and make up the least educated groups in Peru. These girls face numerous constraints to obtaining an education. Enrollment rates are lower for girls in rural areas, and their grade repetition rates are higher than those for boys. Adolescence is particularly difficult, as girls face a number of risks during this time. Once they begin menstruation, completing their primary school education is a formidable challenge, and opportunities for advancing to secondary school are limited. …

  7. Menstrual hygiene management among Bangladeshi adolescent schoolgirls and risk factors affecting school absence: results from a cross-sectional survey

    Background: Many adolescent girls in low-income and middle-income countries lack appropriate facilities and support in school to manage menstruation. Little research has been conducted on how menstruation affects school absence. This study examines the association of menstrual hygiene management knowledge, facilities and practice with absence from school during menstruation among Bangladeshi schoolgirls. Methods: We conducted a nationally representative, cross-sectional study in Bangladeshi schools from March to June 2013 among girls 11 to 17 years old who reached menarche. …

  8. A time for global action: addressing girls' menstrual hygiene management needs in schools

    Summary Points: There is an absence of guidance, facilities, and materials for schoolgirls to manage their menstruation in low- and middle-income countries (LMICs). Formative evidence has raised awareness that poor menstrual hygiene management (MHM) contributes to inequity, increasing exposure to transactional sex to obtain sanitary items, with some evidence of an effect on school indicators and with repercussions for sexual, reproductive, and general health throughout the life course. …

  9. The Last Taboo. Research on menstrual hygiene management in the Pacific: Solomon Islands, Fiji, and Papua New Guinea. Final report

    Managing menstruation effectively and with dignity can be challenging for girls and women in low and middle-income countries. Currently there is limited research on menstrual hygiene management (MHM) in the Pacific region. This report presents general findings from research funded through the Australian Government, Department of Foreign Affairs and Trade (DFAT), including its innovationXchange. It represents collaboration between DFAT’s Pacific Division and DFAT’s innovationXchange following an internal DFAT Ideas Challenge. …

  10. Menstruation as a barrier to education?

    Increasing education for girls is an important policy priority in many developing countries, where secondary school enrollment often remains lower for girls than for boys. Some researchers and policymakers have argued that menstruation may be causing girls to miss a significant number of school days. At the maximum, some have estimated that girls might be missing as much as 10 to 20 percent of school days due to menstruation. Anecdotal evidence seems to support this. Girls report missing school during their periods and lacking access to modern sanitary products. …

  11. 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. …

  12. Menstruation and the cycle of poverty: a cluster quasi-randomised control trial of sanitary pad and puberty education provision in Uganda

    Background: Poor menstrual knowledge and access to sanitary products have been proposed as barriers to menstrual health and school attendance. In response, interventions targeting these needs have seen increasing implementation in public and private sectors. However, there has been limited assessment of their effectiveness. …

  13. Menstrual hygiene in schools in two countries of francophone West Africa: Burkina Faso and Niger. Case studies in 2013

    Menstrual hygiene management (MHM) has been under-researched by the WASH, health and education sectors. Menstruation is a sensitive subject and remains a taboo in many societies. Some cultural beliefs about menstruation reinforce gender inequities and have negative impact on the dignity, health and education of women and girls. There is a need to gather more information on MHM to improve WASH in schools programming and create more equal, safe and healthy school environments. …

  14. 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. …

  15. 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. …

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