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Table 4 Progress and gaps related to priority 4

From: Menstrual hygiene management in schools: midway progress update on the “MHM in Ten” 2014–2024 global agenda

Priority 4: Allocate responsibility to designated government entities for the provision of MHM in schools including adequate budget and monitoring and evaluation [M&E] and the reporting to global channels and constituents
Engagement of multiple ministries on MHM Examples of government initiatives including MHM programmes:
   In Nepal, the ministries of Health, Education, Women and Children, and Water Supply and Sanitation co-signed a declaration in 2018 to make all schools in Nepal menstruation-friendly. MHM-related indicators around girls’ and adolescents’ school absenteeism, female-friendly WASH facilities, and school awareness sessions were integrated into the Ministries of Health and Education plans
   In Cameroon, two national plans formulated MHM goals, including the National Strategy for the Promotion of Drinking Water Supplies, Hygiene and Sanitation in Schools that focuses on MHM provision to primary schools in priority education zones
   In Punjab, Pakistan the governments demonstrated budgetary commitment; promising to allocate financial resources to implement the Girl Friendly Toilet model into its 2018–2023 strategy, in relation to the education system
  Multiple national and subnational governments have put forth MHM guidelines with proposed indicators for measuring progress since 2014:
   Range from MHM in schools operational guidelines to guidelines in other sectors that include MHM-sensitive indicators, or looser guidance documents (e.g. in the Solomon Islands)
   The Ugandan Ministry of Education published WASH guidelines for schools with integrated MHM components, and is now developing national guidelines specific to MHM in schools. The government also published a national training manual for teachers and other actors in MHM in schools, and integrated MHM into the sex education framework and the lower secondary curriculum in 2018
  Other illustrative countries with guidelines relating to MHM in schools include Ethiopia, Eritrea, Zimbabwe and Afghanistan
Monitoring MHM within education systems There is indication that more and more countries are collecting information on WASH in schools through Education Management Information Systems (EMIS) and other monitoring efforts, though MHM indicators are not collected uniformly within or across countries to enable comparison, and are still lacking overall:
   Philippines example (see Box 3)
   MHM indicators have been included in the education management information systems (EMIS) in Zambia and Sindh province (Pakistan)
   Ten MHM-specific indicators were integrated into the school monitoring system in several pilot schools in Sri Lanka, and Rajasthan (India) began collecting state-level data on MHM
  Despite progress, in many countries there is little to no focus on MHM in education sector plans and limited WASH indicators for assessing achievements and progress in MHM in schools
Recommendations to advance the agenda
 Education sector plans and education policies should include specific attention to MHM and/or its proxies (such as gender segregated toilets). Attention to MHM within policies is needed to assure financial allocations are to address MHM in education systems
 Addressing MHM at the Education sector should be an important requirement to be considered if we want girls to achieve different education outcomes, and it is key to attain Education SDG4
  1. This table comprehensively outlines specific Priority 4 progress and gaps to date