Menstrual hygiene management (MHM) barriers facing schoolgirls in Tanzania, Ghana, Cambodia and Ethiopia

1) Purpose: The presentation will describe findings from studies conducted in Tanzania, Ghana, Cambodia and Ethiopia with adolescent girls (aged 16-19 years old) in and out of school on the barriers faced in managing menstruation in school. The presentation will describe the development of girl's puberty books aimed at 10-14 year old girls that were developed and adapted in each of the four countries, for scale up and dissemination. 2) Data and Methods: Qualitative data from in-depth participatory research conducted with girls in and out of school, including observation of school environments, in-depth interviews with girls and with the adults who interact in their lives (e.g. parents, teachers, health workers), and participatory activities with groups of girls (e.g. writing of menstrual narratives). Findings were utilized to adapt the original Tanzania book (over 320,000 copies disseminated) to each of the new countries. 3) Major Results: The major findings suggest that girls across all four country contexts are struggling to manage their menses in school with dignity, comfort and privacy due to inadequate water and sanitation facilities, insufficient sanitary materials, and teachers who are not sensitized to girls' needs. Findings also indicate that many girls receive inadequate guidance on the onset of menses and successful menstrual hygiene management. 4) Recommendations: Additional research, program and policy efforts are needed across low-income countries to identify and document the menstrual management-related barriers faced by schoolgirls, along with the adaptation of girl's puberty books in more contexts to fill the gap in menstrual-related guidance being conveyed.