Menstrual Hygiene Management is an essential part of WaterAid’s integrated approach to water, sanitation and hygiene (WASH), and of our contribution towards gender equity in homes, communities, education, health and the workplace.

What is Menstrual Hygiene Management?

Women and adolescent girls are using a clean menstrual management material to absorb or collect menstrual blood, that can be changed in privacy as often as necessary for the duration of a menstrual period, using soap and water for washing the body as required, and having access to safe and convenient facilities to dispose of used menstrual management materials. They understand the basic facts linked to the menstrual cycle and how to manage it with dignity and without discomfort or fear.

(JMP hygiene working group 2012)

MHM facts1

WaterAid Pakistan’s approach

Menstrual hygiene is an integral part of WaterAid's integrated approach to water, sanitation and hygiene (WASH) and of our contribution towards gender equity in communities, institutions, workplaces and markets.

In Pakistan, we have been working on MHM for more than eight years and have covered a wide range of initiatives involving adolescent girls, parents, teachers, school management committees, district, provincial and national level service providers, parliamentarians and civil society organisations. WaterAid has plans to build upon its MHM model and ignite a national MHM movement that would aim at the provision of women-friendly sanitation facilities in every public building in the country in the next five years.

1. Inclusive WASH facilities adapted for MHM

We promote and provide WASH facilities that are suitable for managing menstruation and for disposing of menstrual hygiene materials. It is essential that women and girls have a clean, private and safe place to wash and change their absorbent materials, to wash reusable cloths with soap and water and dry them effectively. Key features of an MHM facility include a full-size mirror, a handwashing facility inside the toilet, a hook to hang the trouser/scarf and a disposal facility (incinerator built with the toilet with disposal chute inside the toilet), operation and maintenance, and training of the caretakers. School management committees and WASH group members are also oriented on its operation and maintenance.

2. Menstrual hygiene information and social support

We have created social support mechanisms in schools and communities through the formation of WASH clubs, women groups, involving local community health workers. This is critical to enable females to understand the facts and how women and girls can take care of themselves during periods and tackle the taboos and misconceptions around menstruation through informed discussion.

Women and girls, who are often left out of decision making, also need to voice their needs and concerns and contribute to making decisions and finding solutions.

3. Informed choices for menstrual management material

Menstrual hygiene management implies that adolescent girls and women use clean menstrual management materials. Therefore, we promote the continuous supply, use and safe disposal of appropriate, affordable material. It is essential that women and girls can make choices about what is most suitable for them in the context of their lives. In addition to this, menstrual hygiene kits were introduced in schools to ensure access to the materials.

4. Institutional accountability and ownership

Institutional strengthening, integration and responsibility is a critical area for the sustainability of the intervention. In order to institutionalise MHM, it is imperative to involve government officials and parliamentarians at various stages through different activities.

A joint monitoring committee comprised of representatives from departments of health and education, and a WASH forum formed at the district level to help in monitoring the MHM interventions in the field.

Knowledge Management

From our experience, we have realised that the first step towards addressing MHM is to build the knowledge and skills of our staff and partners to engage with other organisations and governments to understand how we can embed menstrual hygiene in schools.

Based on our learning, we have developed a guide on MHM in schools for master trainers, focal teachers and WASH club members that provides guidance on creating awareness around the subject matter. We introduced girls’ friendly toilets in schools with a specific design which have a menstrual waste disposal facility.


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Aao Baat Karein

Pakistan's first ever animation film on menstrual hygiene management, raising the issue in a subtle and interesting way for young girls.

Title page of MHM flipbook