Table 5 Progress and gaps related to priority 5

Resources and technical support for governments

In many contexts, multi-sectoral actors are contributing to the delivery of MHM within the education system:

An example includes USAID’s support for renovations of government school WASH facilities delivered by Plan India and Save the Children Malawi

Multiple social enterprises provide menstrual products and MHM education to schoolgirls:

This illustratively includes Afripads in Uganda and ZanaAfrica in Kenya; Mariam Seba Sanitary Products factory in Ethiopia, and numerous menstrual cup companies (https://menstrualcupcoalition.org/)

Product-based initiatives have developed new innovative products for girls to expand their choices, and some provide better solutions for the environment

Education initiatives have generated useful approaches and materials using child-centered design

Some have focused on particular marginalized groups including girls with disabilities, girls from minority ethnic groups, and targeting boys with information about menstruation

A few countries are integrating MHM into the national curriculum

Philanthropic organizations have partnered with NGOs and national governments to implement promising initiatives towards MHM school integration

Dubai Cares funded Sesame Workshop and World Vision to scale up the WASH UP! Girl Talk programme to 150–200 schools in rural Zimbabwe. The approach includes delivery of an educational curriculum on health, puberty, WASH, and MHM to be implemented by public school teachers, with monitoring conducted during the scale-up

Other innovative activities that have been implemented to improve MHM in schools include:

Integrating more inclusive MHM

School clubs, peer-to-peer education, puberty books, online apps and games to promote knowledge and hygiene practices related to MHM, and sewing sanitary pads activities by both boys and girls in school

Some national governments have dedicated resources to providing more inclusive approaches to MHM, in some countries, NGOs have partnered with governments to deliver such service:

In Kenya, Huru International in collaboration with the Ministry of Health and local Ministry of Education offices has delivered an MHM programme for girls with disabilities

In Uganda, the PEPFAR-funded Determined Resilient Empowered AIDS-Free Mentored and Safe (DREAMS) programme has included boys in addressing MHM in schools

In Chad, UNICEF supported WASH in schools programming included attention to nomadic herders, and children in refugee settings in their MHM efforts

In India, WaterAid and UNICEF designed and delivered MHM in schools for residential schools in one state that are specifically for students from minority tribal and ethnic groups

Recommendations to advance the agenda

 Increased inclusiveness, including attention to the needs of transgender youth and other vulnerable populations

 Sustainability of local supply chains is still to be demonstrated in many locations, particularly when menstrual hygiene supplies are subsidized

 Address continued stigma around menstruation that serves as a barrier to MHM integration into education systems even where there is government commitment and engagement

 Attention is needed to institutionalize MHM information to ensure that it is delivered at scale through the education system, and that teachers have the confidence and capacities to teach the topic

National governments must lead the coordination of external inputs, combined with domestic resources and commitment to MHM, in order to achieve scale across a country