Periods don’t pause in crises - Why menstrual health demands our attention
Every day, women and girls experience menstruation in some of the most difficult conditions imaginable – in protracted crises, overcrowded camps, and conflict zones. In these settings, access to acceptable menstrual products is often severely limited, with water, sanitation, and hygiene (WaSH) infrastructure often inadequate.
Everyone deserves the means to manage their menstruation safely and with dignity, no matter where they are. Menstrual health shapes access to health care, education, and livelihoods. Yet menstrual health is rarely prioritised in humanitarian work. It is underfunded, under-discussed, and too often overlooked.
In this article, we look at how the Médecins Sans Frontières (MSF) Inclusive Innovation Partnership works to design and pilot stronger, more inclusive approaches to Menstrual Hygiene Management (MHM) in humanitarian crises, and why this work matters now more than ever. The MSF Inclusive Innovation Partership is a collaboration between the MSF Sweden Innovation Unit and the Manson Unit’s Innovation team in MSF UK.
In Mombasa, Kenya, MSF organises awareness sessions addressing menstrual periods, the use of hygiene products, and menstrual cups. © Laurence Hoenig/MSF
Why menstrual health matters in humanitarian settings
It is a matter of dignity and human rights
Menstrual health is intrinsically linked to human dignity. No one should have to manage their period with inadequate menstrual products such as rags, newspapers, mattress foam that can lead to infections or leakages, or using nothing at all which can limit participation in daily life. Yet this is the reality for many women and girls today. When toilets have no doors or do not lock, when products are unavailable or inadequate, when there is no clean water for washing and maintaining hygiene, and when there are no appropriate disposal routes for used products – what should be a routine part of life becomes a monthly source of fear and shame.It is a health and protection imperative – not just hygiene
Without access to safe, clean menstrual products and private WaSH facilities, women and girls are forced to manage their periods in unsafe, unsanitary, and undignified conditions. This can lead to infections, rashes, and other preventable health issues. In overcrowded camps or insecure environments, or even in social spaces that have not been developed with menstrual management in mind, the lack of safe latrines or washing areas increases the risk of harassment and gender-based violence. Prioritizing menstrual health is essential to safeguarding physical health, minimizing protection risks, and ensuring that no one is put at greater harm simply for having a period.It impacts participation, education, and economic mobility
Menstrual health shapes women and girls’ ability to show up, for educational and livelihood opportunities, as well as social activities. When they lack supplies, facilities or privacy, they are often forced to stay home during their period. This compounds existing inequalities, particularly those felt by women and girls, and this can have lifelong impacts on learning, income, and feelings of self-worth.Tackling stigma strengthens mental health and social cohesion
In many communities, menstruation is shrouded in shame and secrecy. This stigma can cause psychological distress – especially in already traumatizing environments. Addressing menstrual health openly helps normalize the experience, build confidence and understanding, and reduces harmful and restrictive taboos.
How we work to improve Menstrual Hygiene Management in MSF projects
Over the past four years, the MSF Inclusive Innovation team have supported seven Menstrual Hygiene Management pilot interventions and research studies across a range of humanitarian and emergency contexts, collaborating with colleagues from different parts of MSF. These projects have explored menstrual health beliefs, norms and behaviors in places such as Kalehe, Democratic Republic of Congo (DRC), and Ansongo, Mali, a refugee camp in Mizoram, India, and an adolescent youth center in the urban area of Mile 91, Sierra Leone.
We are actively working to:
Pilot and scale context-appropriate menstrual products – We are testing a range of products – including menstrual underwear – to determine what works best across different cultural and logistical contexts. Our focus is on what menstrual hygiene management alternatives are acceptable, feasible, and sustainable for women and girls.
Understand the lived experiences of women and girls – Our work digs deeper into menstrual norms, beliefs, and practices, both past and present. We explore and document the real-world challenges that women and girls face, such as stigma, shame, and lack of resources, and use these insights to shape better, more responsive interventions.
Engage and amplify the voices of women and girls – Using human-centered design and participatory approaches, we work with women and girls and others in their communities to actively shape solutions. We do not design for communities– we design with them.
Build a comprehensive menstrual health response – Our approach goes beyond product distribution. We integrate health promotion, stigma reduction, and psychosocial support into our programming to address the full scope of menstrual health needs.
Engage men and boys as allies in menstrual health – We are beginning to explore how to meaningfully engage men and boys in menstrual health—not only as supporters of women and girls, but also as participants in dismantling stigma and restrictive norms. Understanding their views, beliefs, and roles is still a novel area of work in humanitarian contexts, but critical to building inclusive, community-wide solutions.
Equip MSF staff and partners with practical tools – Through training sessions, hands-on guidance, and the plans to develop an MSF MHM Toolkit, we are building capacity within MSF to deliver safe, effective, and context-sensitive menstrual health services across all the kinds of settings we work.
Strengthen multi-sectoral collaboration – We are working to embed MHM initiatives across MSF’s work – including sexual and reproductive health and rights, sexual and gender-based violence response, protection, education, mental health, health promotion and WaSH – ensuring menstrual health is integrated and mainstreamed, not siloed.
Looking forward
At MSF, we know that achieving menstrual health for all requires more than product distribution – it requires true partnership and meaningful engagement. That is why we are looking ahead with a commitment to co-creating solutions with communities, embedding MHM more deeply into our health promotion strategies, and ensuring every MSF-supported facility has the tools, products, and infrastructure needed to meet the needs of women and girls. We are also expanding our investment in research and knowledge sharing to scale what works. Our commitment is rooted in the belief that everyone deserves the right to manage their health, including menstrual health, with dignity.