Table 3 Progress and gaps related to Priority 3

Inter-national level advocacy

MHM in Schools Virtual conference (Columbia University, UNICEF) (Burgers, Yamakoshi, and Serrano 2019)

Menstrual Hygiene Day 28th May led by WASH United generates media attention and global momentum, with local, national and regional events organized around the world, including attention to girls in school

The Global Menstrual Collective (est. 2019) aims to drive and guide improved investment in menstrual health through evidence-based advocacy, including for schools

African Coalition on MHM has galvanized national advocacy efforts, e.g., Break the Silence in Uganda); other regional initiatives incorporating MHM in schools are South Asian Conference on Sanitation (SACOSAN), and the UNICEF- and GIZ-led WinS-International Learning Exchanges (ILE) (SACOSAN n.d.)

National level advocacy

Numerous advocacy campaigns are led by national alliances, international organizations, and UN agencies. Examples include:

 In Nepal, the Practitioners Alliance on Menstrual Health and Hygiene Management formed in 2016 to bring together different ministries, sectors, researchers, and academics to find solutions to MHM challenges, including in schools

 In India, the MHM advocacy landscape is multi-sectoral and multi-dimensional, with initiatives launched by the private sector such as the Touch the Pickle campaign by Procter and Gamble, WaterAid (the #noshame in menstruation campaign), UNICEF (the #LetsTalkAboutPeriods campaign) and Menstrual Health Alliance India (MHAI), a national inter-agency advocacy group. In Namibia, Power Pad Girls was launched on MH Day 2018 by UNFPA as a 5-day advocacy campaign with MHM messaging. Schoolgirls are a key focus on these advocacy efforts

In recent years, the MHM advocacy movement has expanded to high-income countries, although sufficient empirical evidence may not yet exist:

 The U.K., recognizing MHM as an issue of human rights, committed to providing free sanitary products in all primary and secondary schools in early 2020, and developed a period poverty taskforce to focus on tackling stigma, access to products, and data and evidence

 In the U.S., in addition to expanding state efforts to eliminate the tampon tax, some state and city legislators have introduced policies mandating menstrual hygiene products to be provided free of charge in all public schools. In British Columbia and Toronto, Ontario (Canada), the governments passed similar mandates on the provision of products in schools

 Numerous other high-income countries have tackled the tax on sanitary products, although low-income countries led the way on such efforts (e.g. Kenya removed tax in 2004); both have implications for the affordability of products for schoolgirls and female teachers

Recommendations to advance the agenda

Effectively translate and disseminate evidence-based research on MHM in schools to varied audiences

Continue expansion of advocacy efforts to local, rural, and underserved communities

Engage with growing platforms, alliances, and networks to achieve wider dissemination of messaging around MHM in schools, and clarify how differing collaborations interact, and how gaps between alliances can be filled while minimizing duplications

Acquire costing information (e.g. cost effectiveness evaluations) of school-based MHM interventions on which to base advocacy

Integrate MHM into other school-related advocacy campaigns, such as female genital mutilation, reducing child marriage, iron supplementation and HPV vaccination (e.g. distribute girl’s puberty books with HPV vaccines)