Menstruation is a healthy biological process experienced by half the world’s population. Yet in many regions of the world, it remains widely stigmatized and misunderstood. This is especially true in areas where resources and relevant education are limited. Around the world, menstrual health management (MHM) products and education are often inaccessible to the women and girls who need them. According to UNICEF, only 39% of schools globally provide menstrual health education, and millions of girls are unprepared for their first period.
MHM isn’t just about hygiene—it’s about education, dignity, and health. It means ensuring that women and girls have the tools, knowledge, and support they need to manage their periods safely and confidently.
The Outreach team in Malawi recognized the critical role menstrual health education plays in the broader development of a community. For true community-led development to thrive, every member must be included. And that includes young girls. That’s why Outreach facilitators, Wishes and Kelvin, launched the first-ever menstrual health training in two communities.
Understanding the Need: Listening First
Before beginning the training, Wishes and Kelvin wanted to understand what the girls already knew about menstruation and how it impacted their daily lives. Many girls who had already begun menstruating shared that they felt confused and scared, having no idea what was happening to their bodies. Cultural taboos meant that many parents didn’t talk about menstruation until after it had already begun. This leaves girls to navigate this major life change alone.
Mothers and older women also admitted that they don’t openly share information about menstruation with their daughters. This is because of deep-rooted cultural norms and fear that they would lose their children’s respect. This silence contributes to a cycle of shame, misinformation, and isolation.
Globally, these challenges are referred to as the effects of “period poverty”. This is a term the National Institutes of Health uses to describe the lack of access to menstrual education, products, hygiene facilities, and waste management. And the consequences are severe. Girls miss school, they have high drop-out rates, they’re more likely to marry early, and the overall community well-being remains low.
In fact, UNESCO reports that 1 in 10 menstruating adolescents in Sub-Saharan Africa misses school during their period. For some, this absence becomes permanent due to shame, discomfort, or lack of resources.
A Safe Space to Learn and Share
Graphic Courtesy of WASH United, Rosie’s World (Menstrual Health Management).
Wishes and Kelvin conducted the first menstrual health trainings at primary schools in two communities.
The facilitators used the Rosie’s World menstrual education guide developed by WASH United. Many WASH programs bring clean water and hygiene practices to communities. Rosie’s story is a relatable and culturally-sensitive educational tool designed specifically for girls in Sub-Saharan Africa.
Through Rosie’s story, the girls engaged in interactive lessons on the biology of menstruation, hygiene practices, and how to use sanitary pads and cloth. But more importantly, the training created a safe, supportive space for girls to share their own stories and break the silence surrounding menstruation.
One activity involved the girls standing in a circle and passing a ball of red yarn. Each time a girl received the unrolling yarn, she shared a piece of knowledge she learned from Rosie’s story. As the yarn wove around the circle, it formed a web—a powerful visual representation of community, connection, and support. The facilitator then cut one strand to show how fragile the web becomes when even one girl is left unsupported.
The girls were then invited to cut their piece of yarn into five red bracelets—each to be shared with mothers, sisters, or friends—while the girls spread the message beyond the classroom.
This is transformation driven by girls, for their communities.
Impact and Results: Shifting Attitudes and Building Knowledge
The menstrual health trainings reached a total of 66 participants—girls, teachers, and women from the community. They lay the groundwork for long-term, community-led change. And the impact of these sessions went far beyond basic education. It sparked real transformation in how girls understand and experience menstruation.
Graphic Courtesy of WASH United, Rosie’s World (Menstrual Health Management).
Awareness Increased Dramatically
- 65 out of 66 girls, or 98.48% increased their knowledge about menstruation
- After the education session, 100% of the girls agreed that it is important to openly talk about menstruation
Emotional Well-Being Improved
Graphic Courtesy of WASH United, Rosie’s World (Menstrual Health Management).
Among the 37 girls who had already begun menstruating, 22 (59.46%) admitted to experiencing negative emotions (like feeling ashamed, scared, dirty, helpless, or unhappy) when they have their period before participating in the education session, but none expressed these emotions after the education session.
Creating a safe space to ask questions, hear each other’s stories, and learn without judgment helped replace shame with pride and isolation with support.
Challenging and Changing Harmful Myths
Prior to the training, 79.25% of participants believed that girls should face restrictions while menstruating, such as avoiding physical activity, salty foods, or religious spaces. After the session, 100% of the girls understood that they can do anything during their period, and that menstruation is a natural, healthy part of life—not something to fear or hide.
These outcomes show that menstrual health management is not a peripheral issue—it’s central to dignity, education, and equality. And for facilitators like Kelvin, the experience was just as transformative.
“The great smiles I received from the girls after the training really touched and encouraged me to impart the knowledge and skills to as many girls as I can through Menstrual Health Management training. In addition to that I am also thinking that there are many boys who have been in the dark as I was to know more about what girls go through,” shared by Kelvin, Malawi Outreach Facilitator.
A Future of Confidence, Education, and Dignity
In Malawi, Outreach facilitators have held menstrual health management-related activities in nine field program locations. The facilitators have trained 21 women who will then teach their own menstrual health education sessions with adolescent girls. They are not just teaching menstrual health—they are shifting mindsets, breaking taboos, and planting seeds for long-term, community-led change.
The vision is clear: a future where every girl is informed and empowered before her first period; where menstruation is no longer a source of fear or shame but a natural part of growing up. With increased awareness and access to sanitary materials, more girls can stay in school and pursue their goals with confidence.
With the help of menstrual health education resources like Rosie’s World, local facilitators, and trusted relationships, the impact on girls’ lives is immeasurable. Each training builds momentum. Each red bracelet shared tells a story. And each girl reached becomes part of a growing movement for dignity, knowledge, and equality. Menstrual health management is not a side issue—it’s a foundational piece of global development. Outreach Malawi’s work shows what is possible when change starts from within the community.
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