London School of Hygiene & Tropical Medicine

The research is funded by the Department of Health and Social Care through the National Institute for Health Research; Foreign, Commonwealth and Development Office; the Medical Research Council and the Wellcome Trust; through the Joint Global Health Trials scheme.

Many girls around the world lack the knowledge, confidence, facilities and materials needed to manage periods safely and with dignity. Improving menstrual health not only has immediate benefits to their wellbeing, but can lead to long-term improvements to women’s education, health and development.

A new study, led by Helen Weiss, Professor of Epidemiology at LSHTM, in partnership with the MRC/UVRI & LSHTM Uganda Research Unit, WoMena Uganda and UCL, aims to improve teenage girls’ ability to manage their menstruation with confidence, and therefore improve their educational performance, mental health and quality of life.

The intervention will be trialled at 24 Ugandan secondary schools for a year, and involves:

• Training teachers to provide puberty education to both boys and girls
• Working with school drama clubs to tackle menstrual health issues, with performance to parents and teachers
• Providing menstrual kits, including training on and a supply of re-usable pads and optional menstrual cups
• Providing strategies for pain management, including vouchers for pain relief medication
• Simple upgrades to school toilets, including providing items such as bins and soap, and repairing locks
• Establishing a menstrual health leadership team to oversee the delivery of the intervention

The researchers will compare the education and health outcomes of girls at these schools with those among girls in another 24 schools who will receive the current standard of care (provision of Ugandan Government Menstrual Health guidelines and other printed materials).

Prof Helen Weiss said: “Improving menstrual health in schoolgirls can lead to long-lasting effects on women’s overall education, health and wellbeing. Lacking the basic tools needed to manage periods and the stigma surrounding it can lead to girls missing school and is hugely damaging to their self-esteem.

“Our previous work has shown the importance of improving girls’ confidence in managing their periods by addressing both the ‘software’ – that is, the knowledge and stigma around menstruation, as well as the ‘hardware’ of pads, pain relief medication and upgrading toilet facilities.”

Results from a pilot study indicated this intervention was popular with girls, parents and teachers, and helped them manage their periods. It is hoped this larger trial will provide much-needed evidence on a broad range of outcomes, to guide future menstrual health policies globally - a significant step towards levelling the playing field for boys and girls.