Do Menstrual Hygiene Management Interventions Improve Education and Psychosocial Outcomes for Women and Girls in Low and Middle Income Countries? A Systematic Review

Key Information


Hennegan, Julie; Montgomery, Paul

Year published


Study type

Journal article

Countries in analysis

  • Ghana
  • Iran
  • Kenya
  • Nepal
  • Saudi Arabia
  • Zimbabwe


The study is subnational.


  • Boys (both in school and out of school)
  • Girls (both in school and out of school)

Population description

Study characteristics are presented in Table 2. Six countries were represented; Iran, Saudi Arabia, Zimbabwe, Ghana, Nepal, and Kenya. Sample sizes ranged from 120 to 1823. Five studies included only girl’s post-menarche. Exclusion and non-participation rates were typically not reported, although the majority of papers implied that few invited girls declined to participate. Studies typically included school-aged girls, (approximately 11–18 years) (pg 7).

Age range

10 - 25

Analysis type

Meta-analysis / Systematic review

Intervention Description

Hardware interventions. 1. The provision of clean absorbents/sanitary products (disposable or reusable), 2. Improved WASH or girl-friendly facilities. Key aspects of WASH interventions relevant to menstruation were derived from the WHO report on Water, Sanitation and Hygiene standards for schools in low-cost settings, the UN Gender, Water and Sanitation Policy Brief. Studies could include any number of these aspects where authors’ hypothesised that the intervention was sufficient to improve MHM practices: a. Improved clean water supply for menstruation management (e.g., access to water within latrine or private areas); b. Provision of soap or disinfectant for body and absorbent cleaning; c. Improved absorbent disposal facilities; d. Improvements to latrine privacy or safety. Software interventions. Interventions that delivered sufficient education to provide an understanding of the biological process of menstruation (e.g., the cyclic nature of menses, origin of menstrual blood), and which authors hypothesised was sufficient to improve either MHM practices or misconceptions and confusion. Information could be provided in person or via printed or electronic resources.

Approaches and Outcomes

  • Educating girls about menstruation / Improved social and emotional learning/skills and mindsets
  • Educating girls about menstruation / Reduced absenteeism
  • Sanitary product distribution / Reduced absenteeism
  • Sexual and reproductive health (including puberty education) / Reduced absenteeism