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Menstrual Health in Schools

Universal access to basic water, sanitation, and hygiene (WASH) services is not sufficient for creating a supportive environment for students who menstruate. There are additional elements of menstrual health that need to be considered and monitored. 

girls show homemade menstrual pads
Schoolgirls show homemade menstrual pads

Defining Menstrual Health

Menstrual health (MH) refers to ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in relation to the menstrual cycle’. A detailed definition was agreed upon by the Global Menstrual Collective through a multi-stage process and published in 2021.

Based on the definition of MH and the specific needs of adolescent girls, the Global MHH Monitoring Group convened stakeholders and experts to develop a list of recommended priority indicators for girls, covering the following seven domains: 

  • Materials
  • Facilities
  • Knowledge
  • Discomfort / Disorders
  • Supportive Social Environment
  • MH Impacts
  • Policy

Monitoring SDG targets related to MH in schools

Menstrual health is central to achieving multiple Sustainable Development Goals (SDGs) and fulfilling basic human rights. It is directly linked to SDG target 4.a to ‘build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all,’ and WASH in schools programmes have dedicated more attention to menstrual health needs in recent years.

The 2024 JMP progress update on WASH in schools therefore has a special focus on MH in schools. The MH chapter highlights currently available national data and examples of subnational data related to each of the domains of the global priority indicators for girlsReferences and data used in the charts are also available as a separate Excel file.

By 2024, the JMP had identified 30 countries with national data related to at least one of the emerging priority indicators for schools or schoolgirls. One third (10) are from sub-Saharan Africa, but seven out of eight SDG regions have data for at least one country and available data span low-income to high-income countries. 

Most of these countries (22) had national data related to facilities for managing menstruation at school, while 19 and 15 had national data related to knowledge and menstrual materials, respectively. Fewer countries had data related to the other domains of menstrual health impacts (9) and menstrual discomfort/disorders (5). Only two countries had national data on a supportive social environment for MH at school. 

Enhancing data collection

The 2024 special focus on MH in schools shows that a growing number of countries are monitoring different aspects of MH in schools but national definitions and indicators vary widely, making it difficult to compare progress across countries. Further work is therefore required to progressively harmonize the indicators used in national monitoring systems. 

While the new MH module in the UNICEF Multiple Indicator Cluster Survey (MICS7) will provide harmonized data for women and adolescent girls aged 15 to 49, upcoming school surveys and annual censuses in primary and secondary schools provide an opportunity to gather harmonized data for younger adolescent girls, a group that is often left behind in MH data collection. 

The global priority indicators for girls provides a list of harmonized school-level (7), individual-level (11), and national-level (3) indicators that can be selected from based on national and/or programme priorities. Associated guidance can support integration of these emerging indicators into school censuses and surveys. 

Acknowledgments

The JMP team is grateful to the following menstrual health experts for their review of the menstrual health chapter in the 2024 school report: Marni Sommer (Columbia University), Marije Broekhuijsen (UNICEF HQ), Therese Mahon (WaterAid), Belen Torondel-Lopez (London School of Hygiene and Tropical Medicine), Jacquelyn Haver (Save the Children), Penelope Phillips-Howard (Liverpool School of Tropical Medicine)