Menstrual Health and Hygiene: A Cross-Cutting Impact Opportunity

Women and girls* who menstruate make up a quarter of the world’s people, yet too many of them lack the resources they need to manage their menstruation – including knowledge, products, sanitation and hygiene facilities, and positive social norms around menstruation. A new Dalberg report shows that addressing gaps in menstruation would improve health, education, employment, and environmental outcomes, driving gender equality.  

Every woman and girl needs to be able to manage her menstruation and understand how it ties to other aspects of her life. Menstrual health and hygiene (MHH) encompasses the elements needed for individuals to have a positive experience around menstruation. It includes a range of dimensions: access to affordable products; knowledge about menstruation; appropriate washing facilities; integration of menstruation into healthcare provisioning; and positive social norms and policies. 

But MHH outcomes are uneven. Among the 1.9 billion menstruating women and girls worldwide, a quarter lack the resources they need to effectively manage it.¹ The gaps are more acute in low and middle-income countries (LMICs) where poor sanitary conditions, limited awareness of MHH, and harmful taboos around menstruation compound existing barriers. As a result, women and girls cannot fully participate in their homes, schools, and workplaces, prompting ripple effects on inclusive economic development and gender equality. 

Something can be done. Working alongside Invest for Jobs — an initiative of the German Federal Ministry for Economic Cooperation and Development (BMZ), and with research support from WASH United, Dalberg explored the impact potential of investing in MHH. The study examines global trends with analysis from eight African countries: Côte d’Ivoire, Egypt, Ethiopia, Ghana, Morocco, Rwanda, Senegal, and Tunisia. Our findings show that key stakeholders across the private sector, governments, and philanthropy can improve health, education, employment, environment, and gender equality outcomes by adopting a focus on menstruation. Coming together to actively encourage menstrual health will shape stronger, more equitable societies. 

Although the report frames menstrual products as an entry point to improving overall MHH, it is crucial to recognize that advancing MHH goes far beyond product provision.

The right time for MHH

Our report coincides with a growing realization across sectors and geographies that enhancing MHH is central to development and gender equality. An opportunity can be realized building on the growth of the menstrual products sector, for which revenues grew by an average of 38 percent across the eight countries we studied. 

How can stakeholders achieve progress?

Building on the momentum, the private sector, governments, and funders can play specific roles to broaden MHH: 

Companies in the MHH space can scale localized production, promote novel distribution models, and build awareness through media campaigns. Companies outside the MHH sector can offer menstrual products and services to their employees, which boosts product growth along with women’s work attendance and productivity. 

National governments can create enabling policies, such as integrating menstruation into school curriculums and healthcare guidelines. Lowering consumer taxes and import duties, as well as incentivizing local MHH companies are all likely to help foster MHH access. Governments can also develop and implement quality standards to improve product acceptability, particularly among low-income users. 

Funders and investors can apply an MHH lens to their work by providing catalytic funding that enables MHH companies to scale. The menstrual product sector will thrive at a national level if funders and investors collaborate to build the capacity of different actors in the MHH ecosystem. For instance, funders and investors could offer technical assistance to improve the business models of domestic SMEs, support intermediaries to strengthen the value chain for menstrual product inputs like cotton, and partner with advocacy organizations to dismantle taboos and harmful social norms surrounding menstruation. They also have the ability to influence how health research and development considers menstruation – from health product development, to trials on how various treatments impact and are affected by menstruation.  

Improving menstrual health and hygiene for the 500 million women and girls who lack it has been a historical challenge, but there is a distinct opportunity for stakeholders to step up their support and accelerate change.  

Download the report here.


*A note on terminology. People who menstruate include those who have MHH needs: girls, women, transgender, non-binary and intersex persons. This report focuses on women and girls’ experience with menstruation but recognises that those who menstruate may not only identify as women or girls, and that not all women and girls menstruate. 

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