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Principal Investigator: Marni Sommer, Columbia University

Research Snapshot

Mainstreaming is key for integrating menstrual hygiene management (MHM) effectively into emergency response


What did this study set out to achieve?

The project sought to better understand the ways in which humanitarian emergency organisations respond to adolescent girls’ and women’s menstrual hygiene management (MHM) needs in humanitarian emergency contexts, through key informant interviews and qualitative assessments with women, girls and staff in two different emergency contexts (in Myanmar and Lebanon). Informed by this research, a comprehensive Menstrual Hygiene Management toolkit was developed. The toolkit was piloted in a refugee camp setting in Tanzania using a process and endline evaluation to establish its effectiveness and use in an emergency setting. There was strong engagement of NGOs and UN agencies in the development of the final version of the toolkit, which has been published in open access format and widely disseminated within the sector.

What were the key findings?

  • There was broad consensus on the value of the toolkit and the training activities for improving basic MHM understanding for an MHM response. The toolkit trainings were also important for convincing other sectoral actors, outside of the WASH sector, that they had a role to play in supporting MHM.
  • Specific gaps in the tool-kit content were identified, for example the need for more guidance on vulnerable populations and links with the shelter sector. The indicators also needed to be simplified.
  • There are three essential components for an MHM response – to ensure girls and women have access to: a) materials and supplies; b) information (including menstrual hygiene promotion and health education), and c) MHM supportive facilities (toilets and washing spaces).
  • Consultation with girls and women remains the single most effective tool for ensuring that each of these three components are effectively and appropriately addressed.
  • Undertaking direct qualitative consultations with women and girls about their experiences with menstruation was very successful and should be more routinely conducted in emergency contexts.


Across sectors and organisations, there was consensus about the need for introducing structured guidance on MHM into response operations, tailored for humanitarian settings.

MHM responses are more effective when integrated into existing responses and activities, rather than ‘added-on’ as a new intervention. However, for long-term impact, efforts are needed to translate the key concepts into organisations and introduce a practice of follow-up within clusters for continued accountability and sustainability.

Strong buy-in across sectors and amongst humanitarian leadership is needed to frame MHM as an integrated and essential component of a routine response.

The toolkit will require revisions as further evidence is generated about effective MHM strategies in emergency contexts.


Impact Case Study Research Uptake, Water, sanitation & hygiene

Impact Case Study: Developing an evidence-based menstrual hygiene toolkit for humanitarian emergencies

Peer Reviewed Water, sanitation & hygiene

Pilot testing and evaluation of a toolkit formenstrual hygiene management in emergencies in three refugee camps in Northwest Tanzania

Tool Sexual and Reproductive Health, Water, sanitation & hygiene

Menstrual Hygiene Management in Emergencies Toolkit

Peer Reviewed Sexual and Reproductive Health

Understanding the menstrual hygiene management challenges facing displaced girls and women: findings from qualitative assessments in Myanmar and Lebanon

Peer Reviewed

What is the scope for addressing menstrual hygiene management in complex humanitarian emergencies? A global review

Research Snapshot Sexual and Reproductive Health, Water, sanitation & hygiene

Research Snapshot: Mainstreaming is key for integrating menstrual hygiene management (MHM) effectively into emergency response

Latest Updates

Research Impact Case Study Published

Jul 2023

This study was selected by the R2HC for our Impact Case Study series. The case study is now available to view online.


The need for expanding the scope for addressing the menstrual hygiene needs of girls and women during emergencies

Oct 2017

Menstruation does not know you are displaced or that you are traveling. It will just come; so it came while we were on the road [and] for others it came…


MHM in Emergencies Toolkit now launched!

23 Oct 2017

The Toolkit was launched at a ‘launch & learn’ event in London on 23 October 2017 as a multi-sectoral resource that to guide humanitarian responders on how to support women and girls with menstruation in emergencies.


Global Survey on Menstrual Hygiene Management

27 Sept 2017

Columbia University, the International Rescue Committee (IRC), UNICEF, UNFPA, and UNHCR invite you to share your expertise as they work to improve the lives of displaced girls and women around the world.

Woman in Goma receives dignity kit. Credit: Sinziana Demian/IRC.

Related News


What next for menstrual hygiene in emergencies – a call for further action

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