FACT SHEET: Menstrual health and hygiene management still out of reach for many

24 May 2022
A woman holds a reusable menstrual napkin.

NEW YORK, 26 May 2022 – Stigma, poverty, and lack of access to basic services like toilets and water are causing menstrual health and hygiene needs to go unmet and increasing women and girls’ risk of infections, UNICEF warned ahead of Menstrual Hygiene Day. These challenges are particularly acute among the poorest, ethnic groups, refugees, and people with disabilities.

“Menstrual health and hygiene management, when available to all, can help dismantle barriers and support adolescent girls to become healthy, educated, and empowered women,” said Kelly Ann Naylor, UNICEF Director of Water, Sanitation, Hygiene (WASH) and Climate, Environment, Energy, and Disaster Risk Reduction (CEED). “Yet, until recently, little attention has been paid to defining, monitoring, and investing in menstrual health.”

The importance of menstrual health and hygiene management is slowly but increasingly being recognized and monitored. By 2020, 42 countries had nationally representative data on at least one of four indicators*, of which 31 had information on at least three indicators. Nearly half of the countries are in sub-Saharan Africa. No high-income countries had national data on any of the indicators.

According to the latest analysis, limitations on participation in school, work, and social activities while menstruating varied by geographical, socio-economic, and individual characteristics. Among those held back, stigma and lack of access to menstrual hygiene products were common factors. Many girls were also unaware of periods before their first cycle, which can affect their perception and understanding of menstruation.

  • On average, non-participation was higher among girls and younger women: 15 per cent of girls in Burkina Faso; 20 per cent in Ivory Coast; and 23 per cent in Nigeria had missed school in the past 12 months because of their period.
  • More than half of women in Bangladesh and more than two-thirds in Nepal said they did not participate in everyday activities while menstruating. In Chad and the Central African Republic, one in three said they were missing out.
  • Of the two countries with national data, only 32 per cent and 66 per cent of girls were aware of menstruation before their first period in Bangladesh and Egypt, respectively. In Egypt, 74 per cent of girls who were unaware felt shocked, afraid or cried during the first occurrence. Similarly, in Bangladesh, 69 per cent felt scared.

The use of menstrual materials and the availability of a private place to wash and change is high in most of the reporting countries. However, the most vulnerable women and girls continue to face major challenges.

  • The use of menstrual materials ranged from 81 per cent to universal in most countries. However, 6 per cent of women used paper in Niger; 12 per cent used only underwear in Burkina Faso; 11 per cent used nothing in Ethiopia.
  • The availability of a private place to wash and change ranged from 80 to 99 per cent in most countries with data. Still, in Niger, Tunisia, and Burkina Faso, only 52 per cent, 56 per cent, and 74 per cent had such spaces, respectively.
  • There was little variation in the use of menstrual materials between urban and rural areas, except in Lao People’s Democratic Republic, Ethiopia and Niger, where the use of materials was more than 10 per cent higher in urban areas compared with rural.
  • Private facilities, though, were less available in rural areas compared to urban settings. In 12 countries with data, at least 1 in 10 women and girls in rural areas lacked a private place to wash and change during their last period.

Ethnic groups and those living in emergency settings face even greater challenges, with less access to menstrual products and basic facilities and more limitations on participation than the rest of the population.

  • In Lao People’s Democratic Republic, there was a gap of more than 30 per cent between Mon-Khmer and Lao-Tai for the proportion with a private place to wash and change and the use of menstrual materials. In the Central African Republic, Haoussa women were around 20 per cent more likely to participate in daily life during their period than Mboum women.
  • Data from refugee camps in eight countries show a range of satisfaction levels. Nearly all women reported they were satisfied with the menstrual materials and facilities in Mozambique and Iraq, compared with less than half of women in refugee camps in Cameroon, Malawi, and South Sudan.

“Investment in menstrual hygiene management will benefit girls today, the women they will become tomorrow, and the next generation,” added Naylor.


Notes to editors:

* The JMP UNICEF-WHO report on WASH in households includes data on efforts to provide households with water, sanitation, and hygiene services, including menstrual hygiene management (MHM). This is the first time that MHM national data from 42 countries is collected and harmonized, to the extent possible, for cross-country comparison. The national household surveys included separate questionnaires for women and girls aged 15-49.

The four indicators related to menstrual health and associated WASH service are as follows:

  1. Awareness of menstruation before menarche (first menstruation).
  2. Use of menstrual materials to capture and contain menstrual blood, such as pads, cloths, tampons or cups. These can also be grouped into single-use and reusable materials.
  3. Access to a private place to wash and change while at home.
  4. Participation in activities during menstruation, such as school, work and social activities.


UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across more than 190 countries and territories, we work for every child, everywhere, to build a better world for everyone.

Follow UNICEF on TwitterFacebookInstagram and YouTube