Menstruation and menstrual hygiene management (MHM) are issues that have long been shrouded in shame and silence. Poor access to safe and dignified MHM impacts the ability of women and girls to reach their full physical, social, and psychological potential and significantly effects quality of life. However, since the turn of the millennium, MHM has been gaining traction in the humanitarian world. The emergence of MHM in policies and guidelines has been accompanied by a limited number of piloted projects implemented in East Africa, with the goal of testing the feasibility of MHM activities in refugee camp contexts. To situate the pilot project findings in existing knowledge, this research considers the issues of health, sanitation, education, and gender both in low-income and in displacement settings. It also considers MHM against the backdrop of sociocultural factors, such as period shaming, taboos, and misconceptions. Similarly, the presence of MHM in international frameworks and operational guidelines is explored.

This research uses an MHM Toolkit, widely appreciated as the frontrunner in its field, to conduct a comparative narrative analysis to evaluate learnings from four piloted MHM projects against the Toolkit guidance. It identifies and explores synergies and gaps and allows for conclusions to be drawn regarding recommendations for future toolkits, such as better training for refugee camp staff or the restructuring of MHM material distributions. On a higher level, the research finds that further focus should be placed on scaling up projects and addressing the subsequent sustainability and funding challenges. There is a need to magnify the focus from distribution of menstrual materials to scalable long-term strategies. Only then can MHM truly be considered at higher levels of programming, policy, and funding, comprehensively addressing women and girls’ rights to manage menstruation in a safe and dignified way.