SuSanA - Forum Kunena Site Syndication Sun, 29 Mar 2015 23:46:00 +0000 Kunena 1.6 SuSanA - Forum en-gb Re: free peer-reviewed MHM articles in WaterLines - by: PennyPH
Many thanks Doreen for your comments

In response to your concern about hygiene, the paper published reported qualitative findings generated after girls had experienced use of menstrual cups, or sanitary pads. We also conducted extensive activities to monitor safety, which will be reported duly. No hazards were reported over the study duration. Schools were evaluated pre-intervention for WASH conditions. Because most lacked soap we provided monthly soap powder to all schools (across the three study arms) to support hand-washing throughout the study. We allocated research nurses to schools, who provided regular screening with girls (approx twice each term). These screenings, plus girls self-reports, include information collected on girls' hand-washing behaviour before and after using the latrines at school. A paper is in press with Waterlines which examines this.

As there was no assurity of the quality or availability of 'clean' water in or close to latrines, girls were advised to empty their menstrual cup then immediately reinsert, to minimize any risk of contamination.

Note below -the article authorship is incorrectly referenced - the correct reference is:

Linda Mason, Kayla F. Laserson, Kelvin Oruko, Elizabeth Nyothach, Kelly T. Alexander, Frank O. Odhiambo, Alie Eleveld, Emily Isiye, Isaac Ngere, Jackton Omoto, Aisha Mohammed, John Vulule, Penelope A. Phillips-Howard.

very best, Penny]]>
Menstrual hygiene management (MHM) Mon, 16 Mar 2015 11:57:36 +0000
Finished Master Thesis in MHM - Re: Research of the effects of menstrual hygiene interventions on school attendance - - by: Steff
sharing is caring! Attached you can find my finished Master Thesis.
Deppest gratitude to everyone who supported this work.
The document is also assessible at the SuSana library here.

If you have any questions or remarks please do not hesitate to contact me ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).


Dropping out of school because of Menstruation?
An analysis of factors of success for Menstrual Hygiene Management-projects in low and lower-middle income countries


Background and aims: Former research reveals that many girls in developing countries are challenged by the management of menstruation in their educational settings. Absenteeism dur-ing menstruation is a consequential occurrence that can potentially lead girls to drop out of school completely. Over the past decade, these findings have led to increased interest in Men-strual Hygiene Management by developmental organisations. The aim of this thesis is to ana-lyse whether the interventions such organisations conduct in order to improve these situations indeed lead to improvements in school attendance and, if so, to identify factors of success.
Methodology: The socio-ecological framework for Menstrual Hygiene Management is used as a theoretical foundation for the topic. A qualitative approach, based on a comparison of four case studies together with results from seven expert interviews, is used to gather information.
Results: The case studies show that the interventions ‘education’, ‘provision of sanitary items’, and the combination of both, have a positive impact on the reduction of menstruation-related school absenteeism but cannot completely prevent it. Analysis of the studies as well as the interviews suggests that, in addition to the promotion of sanitary items and sanitary infra-structure, the provision of menstruation-related education to girls and their communities is a key factor of success to keeping girls in school.
Conclusion: Menstrual Hygiene Management projects should include a holistic educational programme that is adapted to cultural contexts that focuses on teaching not only girls, but also their families, schools and communities. Furthermore, the promotion of access to sanitary items and adequate sanitary infrastructure is advised and a programme to support this should involve local stakeholders to ensure its long-term utilisation.]]>
Menstrual hygiene management (MHM) Wed, 11 Mar 2015 14:45:35 +0000
Re: Keep the Flow Going - MHM and MH Day newsletter - by: inajurga

With 28 May just three months away, we're unveiling the new slogan for 2015, giving you a sneak-peek at the MH Day POP-UP Exhibition Toolkit and sharing the latest MHM updates!]]>
Menstrual hygiene management (MHM) Tue, 03 Mar 2015 15:09:09 +0000
Re: Menstrual Hygiene Management in household water & sanitation programs - by: saurya I find two issues shared here:

i. On MHM:
Attitudes towards Menstruation: while in some parts a celebration is done on onset of puberty and in other it is kept a secret.
I have worked with different communities and experienced:
1. Raised MHM awareness through school/ Peer Educator strategy
2. Co-funding thru convergence with Govt. schemes as they have their own targets on MHMs
3. Increase of use of sanitary pads @ penetrating Price: 0.33 USD/8 pads

ii. Decomposition of Human Waste through Chemical Substance.
Dear Thilde, Can you share more about this, what type of chemical & the amount?

Menstrual hygiene management (MHM) Tue, 03 Mar 2015 07:59:15 +0000
Key documents for the sub-category on menstrual hygiene management - by: muench For more information about why I am creating this new thread, please see here:


This thread is a "sticky thread" which means it will always remain at the top of this sub-category.
It contains a recommendation for new people regarding the most important 3-5 documents in the thematic area of "menstrual hygiene management (MHM)".

The initial selection was done by me and Ina Jurga, but this is open for discussion and can be adjusted regularly.

Recommended top 5 documents in the thematic area of "menstrual hygiene management (MHM)": *

House, S., Mahon, T., Cavill, S. (2012) Menstrual hygiene matters - A resource for improving menstrual hygiene around the world, WaterAid, UK
Link to WaterAid page for download

The main purpose of this resource is to provide a comprehensive resource on menstrual hygiene that supports the development of context-specific information for improving practices for women and girls in lower- and middle-income countries.

UNICEF, Columbia University (2014). WASH in Schools - Empowers Girls' Education - Proceedings of Menstrual Hygiene Management in Schools Virtual Conferences (2012 and 2013). UNICEF and Columbia University, USA

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. Such interventions are increasingly implemented in both development and humanitarian emergency contexts.

Kjellén, M., Pensulo, C., Nordqvist, P., Fogde, M. (2012). Global review of sanitation systems trends and interactions with menstrual management practices - Report for the menstrual management and sanitation systems project. Stockholm Environment Institute (SEI), Stockholm, Sweden

This review of sanitation system trends and interactions with menstrual management practices has been conducted as part of the broader project on Menstrual Management and Sanitation Systems. It starts with a review of trends in the development of urban sanitation systems and then explores the interaction between menstrual management and sanitation systems, mainly relating to the issue of disposal of used menstrual blood absorption materials. Finally, it proposes a framework of interactions by positioning a range of issues of particular relevance for menstrual management into the different parts of the sanitation system.

UNESCO (2014) Puberty Education & Menstrual Hygiene Management, Good Policy and Practice in Health Education, Booklet 9, United Nations Educational, Scientific and Cultural Organization, Paris, France
Link to download

Every year a new cohort of learners reaches puberty. Yet, despite the urgent and recurring need, there is little systematic and comprehensive guidance on this vital subject for the education sector. UNESCO and partners have teamed up to fill this gap by developing the next volume in the UNESCO series on Good Policy and Practice in Health Education. This volume is designed to articulate a rationale for the education sector to improve school health by addressing puberty education and menstrual hygiene management; to describe good policies and practices from different global contexts; and to provide clear action steps for administrators, practitioners and advocates to take on these issues in their education sector.

Sumpter C., Torondel B. (2013): A Systematic Review of the Health and Social Effects of Menstrual Hygiene Management PLoS ONE 8(4): e62004. doi:10.1371/journal.pone.0062004
Link to download

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. - There is a gap in the evidence for high quality randomised intervention studies which combine hardware and software interventions, in particular for better understanding the nuanced effect improving MHM may have on girls’ attendance at school.

The following Wikipedia articles exist on related topics:
  • Menstruation:
  • A dedicated article on MHM, including aspects of developing countries, has not yet been created (this should perhaps still be added in order to raise awareness)
  • Separate pages exist for the main menstrual products: Pads, tampons, Menstrual cup

(7) Further resources

There are many more important documents dealing with this topic. Here is how to find them:
  1. We invite you to browse the SuSanA library by using the search term MHM:
  2. 28 May has been declared as Menstrual Hygiene Day, hopefully one day this will become an offical annual United Nation's Day. This initiative has a website (set up by WASH United) which has a page with many resources on MHM:


* The documents recommended here all focus on issues in developing countries and countries in transition. However, some of the underlying principles would apply more or less to all countries of the world.]]>
Menstrual hygiene management (MHM) Tue, 24 Feb 2015 13:00:10 +0000
Re: free peer-reviewed MHM articles in WaterLines - by: Doreen here in this other post. I've had the chance to read the following article:

Adolescent schoolgirls' experiences of menstrual cups and pads in rural western Kenya: a qualitative study
by Linda Mason, Kelly T. Alexander, Penelope A. Phillips-Howard, et al.

The article is available online for free here:

Was very interesting to read about the girls perspectives on cups and pads.
However I felt like we still lack a clear understanding of the use of cups in areas or schools with poor hygiene facilities (hand washing facilities, water etc.). This would give a proper analysis on the acceptability of the cups for girls who unfortunately attend schools that do not have appropriate hygiene facilities.

I am referring to the need to clean your hands well, with clean water, when removing and inserting the cup.

Nevertheless I was pleased to read such an article comparing different MHM products and see the positive acceptance level of the girls regarding the cups.

Best regards,




Linda Mason1, Kelly T. Alexander1, Penelope A. Phillips-Howard1, Kayla F. Laserson2, Kelvin Oruko3, Elizabeth Nyothach3, Frank O. Odhiambo3, John Vulule3, Alie Eleveld4, Emily Isiye5, Isaac Ngere6, Jackton Omoto7, Aisha Mohammed8
1Liverpool School of Tropical Medicine, UK
2Center for Global Health, Centers for Disease Control and Prevention, Atlanta, US
3KEMRI/CDC Research and Public Health Collaboration, Kisumu, Kenya
4Safe Water and AIDS Project, Kisumu, Kenya
5District Education Office, Gem District, Sawagongo, Siaya County, Kenya
6District Medical Office, Gem District, Yala, Siaya County, Kenya
7Department of Obstetrics and Gynaecology, Siaya District Hospital, Ministry of Health, Siaya, Kenya
8Division of Reproductive Health, Ministry of Public Health and Sanitation, Kenya

Poor menstrual hygiene management (MHM) among schoolgirls in low income countries affects girls' dignity, self-esteem, and schooling. Hygienic, effective, and sustainable menstrual products are required. A randomized controlled feasibility study was conducted among 14-16-year-old girls, in 30 primary schools in rural western Kenya, to examine acceptability, use, and safety of menstrual cups or sanitary pads. Focus group discussions (FGDs) were conducted to evaluate girls' perceptions and experiences six months after product introduction. Narratives from 10 girls' and 6 parents’ FGDs were analysed thematically. Comparison, fear, and confidence were emergent themes. Initial use of cups was slow. Once comfortable, girls using cups or pads reported being free of embarrassing leakage, odour, and dislodged items compared with girls using traditional materials. School absenteeism and impaired concentration were only reported by girls using traditional materials. Girls using cups preferred them to pads. Advantages of cups and pads over traditional items provide optimism for MHM programmes


menstruation, menstrual cups, sanitary pads, WASH in schools, MHM
Menstrual hygiene management (MHM) Mon, 23 Feb 2015 11:17:53 +0000
free peer-reviewed MHM articles in WaterLines - by: inajurga
just wanted to make sure you are aware of the articles on MHM from a recent waterlines publication - all accessible for free.

Volume 34, Number 1 / January 2015 of Waterlines is now available on the website at

This issue contains:

Guest editorial: tackling the stigma and gender marginalization related to menstruation via WASH in schools programmes
by Murat Sahin

Putting the men into menstruation: the role of men and boys in community menstrual hygiene management
by Thérèse Mahon, Anjali Tripathy, Neelam Singh

Adolescent schoolgirls' experiences of menstrual cups and pads in rural western Kenya: a qualitative study
by Linda Mason, Kelly T. Alexander, Penelope A. Phillips-Howard, et al.

Uncovering the challenges to menstrual hygiene management in schools in Mali
by Victoria Trinies, Bethany A. Caruso, Assitan Sogoré, et al.

Mainstreaming menstrual hygiene management in schools through the play-based approach: lessons learned from Ghana
by George Dorgbetor

Menstrual hygiene management: education and empowerment for girls?
by Deepa Joshi, Gerlinde Buit, Diana González-Botero

Developing games as a qualitative method for researching menstrual hygiene management in rural Bolivia
by Jeanne L. Long, Bethany A. Caruso, Matthew C. Freeman, et al.

Unpacking the policy landscape for menstrual hygiene management: implications for school WASH programmes in India
by Arundati Muralidharan, Hemalatha Patil, Sweta Patnaik

Towards a sustainable solution for school menstrual hygiene management: cases of Ethiopia, Uganda, South-Sudan, Tanzania, and Zimbabwe
by Selamawit Tamiru, Kuribachew Mamo, Pasquina Acidria, et al.

Learning, acting, and learning (LAL) research on schools' menstrual hygiene management (MHM): Pakistan
by Kamran Naeem, Simone Klawitter, Abida Aziz]]>
Menstrual hygiene management (MHM) Wed, 18 Feb 2015 04:40:21 +0000
Buzzfeed post on digestion during menstruation - by: jkeichholz
"Why Your Period Wreaks Havoc On Your Poop Habits"

The various Facebook comments maybe illustrate how even in a seemingly open society there's a still a need for various explanations and how listicle sites such as buzzfeed are being used to convey these important messages. I find this interesting from a knowledge management perspective.]]>
Menstrual hygiene management (MHM) Mon, 12 Jan 2015 21:54:06 +0000
Re: Research of the effects of menstrual hygiene interventions on school attendance - by: BrigitteRasmus Menstrual hygiene management (MHM) Sun, 04 Jan 2015 15:59:07 +0000 Re: Research of the effects of menstrual hygiene interventions on school attendance - by: Steff
thank you very much for your recommondations.

I agree on the point that the interlinkage between menstruation and school attendance is quiet well investigate, but this is unfortunatly not exactly what I was looking for. Sorry if my explainations where not clear enough.
I was looking for studies which show a causal connections between MHM interventions and higher school attendance. In other words: Do "MHM interventions in fact lead to a higher school attendance among adolescent girls and, if so, what are the factors of their success"? This aims at the investigation of projects that already conducted interventions and assessed an impact.

Sumpter et. al actually underlines the need for research in this field by saying:
"There is a gap in the evidence for high quality randomised intervention studies which combine hardware and software interventions, in particular for better understanding the nuanced effect improving MHM may have on girls’ attendance at school.

Furthermore the only study withhin his comprehensive review that clearly considered "school attendance" as the outcome, asserts that "menstruation has a very small impact on school attendance" and rejects "that the claim that better menstruation products close the attendance gap". (Oster, 2010)

I hope the idea I follow became a bit clearer and the discussion continues!
Menstrual hygiene management (MHM) Wed, 24 Sep 2014 12:11:53 +0000
Re: Research of the effects of menstrual hygiene interventions on school attendance - by: thilde From searching in PubMed, I have located more than 50 publications on menstrual hygiene - quantitative as well as quantitative. School attendance/absentiism is actually among the most well investigated factors, since it is fairly easy to correlate with a pad/menstrual cup intervention.

The auhors of Sumpter (the most comprehensive review to date - attached), McMahon, Kirk, Summer,Burrows, and Santina are key authors of the field but many others have published single papers with experiences.

Interventions taking place in Kenya, Uganda, Ghana, Ethiopia and Tanzania have brought many new findings to the table.

I would be very interested in reading your report once finished - All the best with seaching more.
Menstrual hygiene management (MHM) Fri, 19 Sep 2014 07:45:14 +0000
Re: Research of the effects of menstrual hygiene interventions on school attendance - by: Steff thank you very much for your support and sharing the documents! It’s great to see how much is actually happening on MHM!

Still it seems challenging to generate but also find quantitative data about the effects of improved MHM on school attendance & performance of girls. (tried GoogleScholar, JSTOR, ResearchGate, SuSana library etc.)

So once again, if anybody has anything to share I would be more than happy to have a look on it. Quantitative as well as qualitative data, project reports or simply ideas you have in your mind are more than welcome!

To those of you who are also interested in the field I have some recommendations of literature I so far found and used for my investigations. Please find the major scientific generated ones attached. Additionally the “Final report on the impact of feminine hygiene on girls participation in education in Kenya “ from FAWE (Forum for African Women Educationalists) is very advisable.

Best regards
Menstrual hygiene management (MHM) Thu, 18 Sep 2014 20:18:19 +0000
Re: Research of the effects of menstrual hygiene interventions on school attendance - by: JKMakowka these conference proceedings? Should give you a good starting point for activities in East Africa.

Also have a look at some of the documents I shared on UWASNETs working-group page.]]>
Menstrual hygiene management (MHM) Fri, 12 Sep 2014 10:31:59 +0000
Research of the effects of menstrual hygiene interventions on school attendance - by: Steff
my name is Steffi Rönitzsch and I am enrolled in the Master’s program ’International Development Studies’ at the University of Marburg, Germany.
I intend to write my Master’s thesis about Menstrual Hygiene Management (MHM) and in this respect I contact you.

Literature review has so far shown that there is a need for a better understanding of the effects of improved MHM. It seems that there is a gap in the evidence if interventions on MH (hardware as well as software) indeed have an effect on girls' school attendance.

In order to contribute to the scientific debate about this topic and to help facilitate practical work, my Master’s thesis aims at answering the questions, whether MH interventions in fact lead to a higher school attendance among adolescent girls and, if so, what are the factors of their success.

Therefore I would very much like to learn from your practical knowledge. I am currently looking for organisations/institutions that carried out projects aiming at the improvement of Menstrual Hygiene (especially in schools) and can share their experiences. Thus I search for project reports, working papers or any other kind of documented information. Especially interesting are those projects that have well documented information on the conducted measures and on school attendance rates of adolescents before and after the measures.
Please don’t hesitate to also share experiences that might have not had the desired effects, as they can be seen as a ’lesson learned’ for all of us. I am also planning to conduct interviews with the persons in charge of ‘selected’ projects in order to get the full picture of a project.

I am very thankful for your support und will of course share key findings later on.
You can either contact me via Email ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ) or post your ideas here in the forum.

I am looking forward to hearing from you

Yours Sincerely
Steffi Rönitzsch

Contact: This e-mail address is being protected from spambots. You need JavaScript enabled to view it ]]>
Menstrual hygiene management (MHM) Fri, 12 Sep 2014 10:03:39 +0000
Re: Solid research on the ruby cup - by: PennyPH In answer to your questions:

(1)When do you think it will all be ready for dissemination?

We are currently preparing analyses - we anticipate completion, ready for dissemination, mid-2015.

(2) What was the role of the Moon Cup company ( by the way? Are they excited about this, too? Do they see it as a potential business opportunity or more as a social venture activity?

The company provided us with Mooncups at a prearranged discount price.
We do not know the views of the company - should there be any interest to discuss with the company then please communicate with them.

(3) What are your plans regarding larger scale trials and who would fund those?

We would be most keen to move forward to a larger trial, and are currently exploring opportunities for funding.

very best, Penny]]>
Menstrual hygiene management (MHM) Wed, 10 Sep 2014 09:21:12 +0000