Menstrual Hygiene Management



Effective menstrual hygiene management (MHM) includes access to clean absorbents, facilities to change, clean or dispose of these as needed, and access to soap and water. However, many women and girls in Tanzania still do not have these basic essentials, while the taboo of menstruation endures today.

We conducted a baseline survey with over 400 women and girls in Babati, and learned that:

  • there is a significant lack of knowledge and understanding about menstruation, as well as the links between menstruation and reproduction
  • despite the existence of a curriculum to teach young people about puberty, it is not taught in practice
  • schools do not provide good-quality education on puberty or MHM because health teachers do not have the correct training
  • myths and cultural taboos surrounding menstruation result in discrimination against menstruating girls and women
  • boys and teachers are unsympathetic, occasionally denying girls time to go to the toilet when they need to
  • there is a lack of adequate toilet facilities. 

This study confirmed that action was drastically overdue. That is why we recruited a Development and Programmes Assistant intern from the Royal College of Obstetricians and Gynaecologists, who was tasked with the role of researching and developing a bespoke education programme in MHM.

Now the materials are complete, we are ready to begin trialling this exciting - and potentially life-changing - programme. 

The programme in practice

Our MHM programme mainly focuses on female students, but also includes workshops with teachers and school health workers, male students and parents. 

We begin by creating a safe environment, where the girls themselves create the rules that define how the group will work. This helps them feel free to discuss these sensitive and personal matters.

Over the next seven weeks, the girls will begin to discuss puberty and the physical, emotional and social changes it brings. They also consider how they might support each other through the process. The students then spend time identifying myths and truths surrounding menstruation.

With a renewed understanding of menstruation and why it happens, the discussion moves on to how to manage it. The programme also includes workshops on relationships and women's rights in terms of reproductive health.

Our programme has been localised, ensuring its suitability for primary and secondary schools. It also draws on a number of well-regarded resources and best practice in the Tanzanian context, including those by WaterAid, The International HIV/AIDS Alliance, Institute for Reproductive Health, Peace Corps, USAID and Dr Marni Sommers. 

Improving infrastucture

Our educational programme is just part of the solution to improving menstrual hygiene. We also need to make sure schools have the right facilities in place for girls to feel clean, supported and safe.

That is why we work with schools to ensure girls have a suitable place to change, clean or dispose of their absorbents at school.

We begin by examining the existing toilet facilities and, in consultation with the girls, make suitable adjustments and additions as necessary. As a result, girls feel able to attend school each day without the fear of embarrassment or humiliation.