In October 2017, Columbia University Mailman School of Public Health in New York City, New York, and the International Rescue Committee published A Toolkit for Integrating Menstrual Hygiene Management (MHM) into Humanitarian Response. Researchers Marni Sommer, Margaret Schmitt, and David Clatworthy collaborated on the Toolkit to benefit women and girls in Lebanon, Myanmar, and Tanzania. The Toolkit serves as a guideline for humanitarian organizations to ensure better menstrual hygiene management, or MHM, in low and middle-income countries. MHM includes clean water, private hygiene facilities for women and girls, materials such as sanitary pads, and accurate literature on menstruation. The authors of the Toolkit provide ways in which humanitarian organizations can work in communities to address social and physical barriers to managing menstrual health in low and middle-income countries.
In “Beyond Menstrual Hygiene: Addressing Vaginal Bleeding Throughout the Life Course in LMICs,” hereafter “Beyond Menstrual Hygiene,” Marni Sommer, Penelope A. Phillips-Howard, Therese Mahon, Sasha Zients, Meredith Jones, and Bethany A. Caruso explored the barriers women experience in managing menstruation and other forms of vaginal bleeding in low and middle-income countries, which the researchers abbreviate to LMICs. The medical journal British Medical Journal Global Health published the article on 27 July 2017. As little literature existed at the time concerning the topic of vaginal bleeding for women in LMICs, Sommer and her team state that they were motivated to assess the topic in order to better understand how issues concerning the health of women and girls are managed in limited-resource contexts. In “Beyond Menstrual Hygiene,” the authors assert that females in LMICs need access to better resources, education, and supplies to manage menstruation.
In 2010, Sophia and Paul Grinvalds founded the organization AFRIpads in Kampala, Uganda, to provide reusable cloth pads to menstruating women and girls throughout the country. At that time, the Grinvalds wanted to help implement better menstrual health and hygiene in Uganda to encourage women and girls to engage in work and school. While living in Kampala, in 2010, they employed Ugandan women to sew cloth pads daily and sell to others living in the local village. In 2018, the United Nations Human Rights Council, or UNHRC, conducted a study in Uganda to test the efficiency of AFRIpads and found that a majority of women and girls studied favored reusable cloth pads. Since then, as of 2021, AFRIpads has expanded to collaborate with other organizations to distribute their reusable cloth pads to women and girls living in African countries. By doing so, AFRIpads has helped introduce a sustainable method for managing menstrual hygiene and teaching menstrual education in low-income countries.
On 5 April 2018, the documentary Period. End of Sentence. premiered at the Cleveland International Film Festival in Cleveland, Ohio. In the documentary, Rayka Zehtabchi, the director of the film, documents the stigma surrounding menstruation in India and follows a group of women in Kathikhera, a rural village in the Hapur district of India, as they manufacture and distribute sanitary pads. A group of high school students at Oakwood High School in Los Angeles, California, raised money to produce the documentary after one student was inspired by her visit to the United Nations Commission on the Status of Women in New York City, New York, which focused on the stigma surrounding menstruation in low-income countries. Period. End of Sentence. draws attention to the obstacles impeding proper menstrual health management in low-income contexts by documenting the women of Kathikhera’s journey to manufacture and sell sanitary pads.
Developing a codebook of definitions and exemplars of significant text segments and applying it to the collected data revealed several themes. For example, mothers, friends, teachers, the Internet, and social media are among the most common sources of information about menstrual hygiene and health. Yet, women reported that those sources of information often echoed stigmatized ideas about menstruation, eliciting feelings of shame and fear. That poor quality of information was instrumental to women’s abilities to detect and report abnormal menstrual bleeding.
Menstrual hygiene management, or MHM, is a concept that concerns girls' and women’s access to the appropriate information and resources to manage menstruation. In December 2012, the Joint Monitoring Program, or JMP, was one of the first organizations to define MHM as a global development goal. Since then, other organizations like WaterAid and the United Nations have expanded MHM’s definition to include menstrual education that is biologically accurate and free of taboo and stigma. Many women in low-income countries lack those necessities for MHM due to high prices of menstrual sanitary products, lack of access to clean water and sanitation facilities, and social stigma surrounding menstruation that prevents it from being talked about. However, as more organizations began to frame MHM as an issue of public concern rather than a woman’s private problem, more researchers, organizations, and governmental bodies have begun to address issues at the root of inadequate MHM.
In 2008, Celeste Mergens founded the organization Days for Girls to address obstacles impeding women’s and girls’ access to sustainable hygiene and health education by enlisting volunteers around the world to construct reusable menstrual hygiene products for girls in low-income countries. Mergens founded Days for Girls in the US in 2008 after learning that an orphanage she was working with in Kenya did not have resources for girls to manage their menstrual cycles. She provided those girls with reusable sanitary pads, and later that year, she decided to provide Days for Girls Kits, or DfG Kits, that volunteers from around the world made for women and girls in parts of the world lacking access to menstrual hygiene products. By 2012, Mergens launched chapters across the United States to allow volunteers to hand-sew the DfG Kits, and by 2019, the organization expanded to include chapters in Zimbabwe, Ghana, and Uganda. Days for Girls provides women and girls with education and resources necessary to manage menstruation, which can help reduce the instances of absenteeism for girls in schools and reduce the risk of contracting infectious diseases.