Many girls and women still lack the materials, facilities, knowledge, pain relief and support they need during menstruation: in surveys from 44 countries, 15% had missed school, work or social activities during their last period, and only about one school in three had a bin for menstrual waste in girls' toilets.
Written from the sources listed below, not independently peer-reviewed.
Out of every 100 schools worldwide with data, how many have a bin for menstrual waste in the girls' toilets?
15%
Women and girls who missed activities during their last period
Missed social activities, school or work days because of their last menstruation; pooled estimate from 47 household surveys in 44 low- and middle-income countries (fieldwork 2017 to early 2023). Ranges from 0.9% in Turkmenistan to 38% in Sindh province, Pakistan.
Data year 2023. Source: The Lancet Global Health 13(2):e285–e297, 2025
39%
Schools providing menstrual health education
About two in five schools. Preliminary global estimate from emerging national data with about 33% coverage; definitions vary between countries.
Data year 2023. Source: WHO/UNICEF Joint Monitoring Programme, 2024
460 million
School-age children without basic sanitation at school
Basic means improved toilets that are single-sex and usable. 244 million of these children attended a school with no sanitation service at all.
Data year 2025. Source: UNICEF and WHO, 2026
Only the two values reported in the WHO/UNICEF 2026 schools report are shown; years in between are not plotted. Separate, usable toilets are a precondition for managing menstruation at school, but this measure does not show whether toilets have water, bins or menstrual materials. On current trends coverage is projected to reach only 81% by 2030 (projection, not plotted).
There is no dedicated SDG target or indicator for menstrual health; it is monitored through emerging indicators alongside the sanitation and hygiene targets. The nearest tracked measure is basic sanitation in schools, which requires single-sex, usable toilets: coverage rose from 67% in 2015 to 77% in 2025 but, on current trends, will reach only 81% by 2030, far short of universal access. In sub-Saharan Africa only 43% of schools had basic sanitation in 2025.
Adolescents miss out most: among girls aged 15 to 19, 17.7% reported missing activities during their last period, the highest of any age group, and regional rates were highest in South Asia (19.7%) and West and Central Africa (18.5%).
Source: The Lancet Global Health 13(2):e285–e297, 2025In sub-Saharan Africa, only about 12% of schools have menstrual materials available, free or for purchase, and 11% have bins for menstrual waste in girls' toilets, compared with 31% of schools worldwide.
Source: WHO/UNICEF Joint Monitoring Programme, 2024Girls and women in low-income countries and rural areas are more likely to use reusable materials, and those who do are less likely to have improved water on their premises to wash them. In Mongolia, menstrual health differed between rich and poor, adolescents and adults, and women with and without disabilities.
Source: WHO/UNICEF Joint Monitoring Programme, 2025Information often comes too late: only 32% of girls in Bangladesh and 66% in Egypt knew about menstruation before their first period, and in 12 countries with data at least one in ten rural women and girls lacked a private place to wash and change.
Source: UNICEF, 2022Instead of one “percent solved” score, DO GOOD rates three separate dimensions. A problem can have mature solutions that still reach too few people. These ratings are an editorial reading of the sources on this page, not a measured index.
Has the situation improved in the real world?
LowThere are no global trend data on menstrual health itself. School sanitation is improving slowly, from 67% of schools with basic services in 2015 to 77% in 2025, but in sub-Saharan Africa the number of school-age children without it rose from 213 million to 264 million.
How mature and validated are the available solutions?
ModerateMenstrual materials, separate school toilets, puberty education and pain relief are well established. Evidence that bundling them improves wider outcomes is limited: a 60-school trial in Uganda improved confidence and pain management but not attendance during menstruation, mental health or exam results after one year.
How widely are effective solutions actually used?
LowEmerging data suggest that about 39% of schools provide menstrual health education and 31% have bins for menstrual waste in girls' toilets; in sub-Saharan Africa only 12% have menstrual materials available and 11% have bins.
Only 30 countries had national school data on at least one priority menstrual health indicator, with widely varying definitions, and few measured impacts or the social environment. Household survey estimates are growing, but cross-sectional surveys cannot show whether menstruation causes missed schooling.
Measurement is expanding: national household estimates now exist for 70 countries, including new indicators on enough materials, pain and help-seeking, and school sanitation coverage is rising. But progress on school toilets is too slow to reach everyone by 2030, and the evidence on which interventions improve education remains thin.
Managing menstruation in health and dignity takes more than a pad. Girls and women need enough clean materials to change as often as they want, a private place with water to wash and change, a way to dispose of used materials, accurate information before their first period, help for pain and other menstrual problems, and an environment in which they can take part in school, work and social life without shame. WHO/UNICEF estimates for 70 countries show that most girls and women aged 15 to 49 use menstrual materials, but far fewer have enough to change as often as they would like. In low-income countries and rural areas they are more likely to rely on reusable materials, and those who do are less likely to have water at home. Schools often fall short too: emerging national data suggest that only about two in five schools provide menstrual health education and one in three have bins for menstrual waste in girls' toilets.
The consequences reach into education and wellbeing. In household surveys from 44 low- and middle-income countries, 15% of women and girls said they had missed social activities, school or work during their last period, and girls aged 15 to 19 were the most affected. How much menstruation itself keeps girls out of school is less clear than often claimed. The surveys do not separate school from other activities, missing out was not consistently linked to whether women used menstrual materials, and lower rates among users of hormonal contraception point to pain and heavy bleeding as important causes. A large trial in Ugandan schools improved girls' confidence in managing menstruation, but found little evidence of an effect on attendance during menstruation, mental health or exam results after one year. Silence and stigma add to the burden: in Bangladesh only 32% of girls knew about menstruation before their first period.
Menstrual health is more than hygiene. WHO/UNICEF monitoring groups it into several domains, measured through household surveys of women and girls aged 15 to 49 and through school data. Comparable national data are still emerging, and definitions vary between countries:
Materials and facilities
Whether women and girls use menstrual materials, have enough of them to change as often as they want, and have a private place with water to wash and change at home and at school, including bins for used materials.
Knowledge
Whether girls know about menstruation before their first period, and whether schools provide menstrual health education.
Pain, disorders and care
Whether girls and women can reduce menstrual pain and feel comfortable seeking help from a health care provider for menstrual problems. These newer indicators capture challenges that earlier global monitoring missed.
Participation and social environment
Whether menstruation stops girls and women from taking part in school, work and social activities, and whether the people around them are supportive. These are the domains with the fewest data: in schools, only 9 of 30 countries with menstrual health data measured impacts and 2 measured the social environment.
What works
Single-sex toilets that are usable, with water for washing and bins for used materials, let girls change in privacy at school. Global basic sanitation coverage in schools rose from 67% in 2015 to 77% in 2025.
Limits
On current trends coverage will reach only 81% by 2030, and in sub-Saharan Africa just 43% of schools had basic sanitation in 2025. The basic standard does not include bins or menstrual materials, and toilets need budgets for cleaning and repairs.
What works
Teaching girls, and boys, about menstruation before puberty prepares them for it and is one of the priority areas monitored in schools. In Central and Southern Asia, 84% of secondary schools reported providing menstrual health education.
Limits
Only about 39% of schools worldwide provide it, and just 34% of primary schools in Central and Southern Asia. Whether lessons change attitudes and behaviour over time is rarely measured.
What works
Providing pads, cups or reusable products at school or through public programmes addresses cost. In Scotland, 64% of students had accessed free products at school, and 85% of them reported having enough.
Limits
Products alone do not remove other barriers: in large multi-country surveys, missing activities during menstruation was not consistently linked to whether women used menstrual materials. Reusable products also need water and privacy for washing and drying.
What works
Access to effective pain management addresses a cause of missed activities that products cannot. In the Ugandan MENISCUS trial, 75% of students in intervention schools used effective pain management, compared with 67% in control schools.
Limits
Pain relief does not address heavy bleeding or other menstrual disorders, which need health services, and few countries measure whether girls can reduce menstrual pain or feel able to seek help.
What works
Packages that combine education, products, pain relief, toilet improvements and a school action group improved girls' confidence in managing menstruation and made the school environment more supportive in a 60-school trial in Uganda.
Limits
The same trial found little evidence of an effect on attendance during menstruation and no improvement in mental health or exam performance after one year, so such programmes should be justified mainly on health, dignity and rights grounds.
Promising, but not proven at scale. The stage shows how far each approach has come; it is not a recommendation.
Household surveys increasingly ask women and girls whether they have enough materials, can reduce menstrual pain and feel able to seek medical help. The JMP now publishes national estimates for 70 countries, and the data can be broken down by wealth, age and disability, but many countries still have no estimates.
Some education ministries have added menstrual health indicators to their routine national school monitoring. Seven countries did so as of the 2024 global review; harmonised definitions are still lacking.
Pooled analyses of standardised surveys, such as one covering 673,380 women and girls in 44 countries, are starting to separate the roles of pain, materials, facilities and age. These analyses generate hypotheses but cannot establish causes on their own.
Knowledge gap
Of 30 countries with national school data on menstrual health, most measured facilities, knowledge and materials; only 9 measured impacts on girls, 5 measured discomfort or disorders and 2 measured the social environment.
Coordination gap
Countries and data sources define menstrual health indicators in very different ways, which makes comparisons difficult and calls for agreed, harmonised definitions across education, health and WASH monitoring.
Implementation gap
In sub-Saharan Africa only 43% of schools had basic sanitation in 2025, and the number of school-age children there without it grew from 213 million in 2015 to 264 million.
Technology gap
Girls and women who rely on reusable materials, more common in low-income countries and rural areas, are less likely to have improved water at home, which makes washing and drying them hygienically harder.
Implementation gap
Where menstruation is not discussed, girls face their first period unprepared: in Egypt, 74% of girls who had not known about menstruation beforehand reported feeling shocked, afraid or crying.
Knowledge gap
Claims that periods keep many girls out of school rest largely on surveys that cannot show cause and effect. A rigorous trial found little effect of a broad programme on attendance during menstruation, so it is unclear which investments would improve schooling.
Unresolved questions, not vetted breakthroughs. Answering any of them would change what is possible.
How many school days do girls actually lose because of menstruation, once pain, illness and other reasons for absence are measured separately, and does the effect differ between primary and secondary school?
How much of menstrual-related absence is caused by pain and heavy bleeding, by a lack of materials or facilities, or by stigma and social rules, and does the answer differ between countries?
Could longer-lasting or differently designed school programmes improve learning or mental health, given that a one-year multi-component trial did not, and what do they cost compared with simpler measures?
Which small set of agreed indicators would allow fair comparison across countries, including high-income countries that collect almost no national data, and across groups such as girls with disabilities?
Speak about menstruation in a plain, matter-of-fact way at home and at work, and make sure girls and boys in your life learn about it before puberty, not afterwards.
Ask local schools whether girls have private toilets with water, bins for used materials, access to products and menstrual health education, and raise gaps with the school or parent groups.
If you give to menstrual health projects, prefer organisations that combine products with facilities, education and pain relief and that report outcomes for girls, not only the number of pads distributed.
Where you have influence, at work or in public buildings, ask for bins in toilets and products in washrooms, and dispose of used materials in bins rather than toilets.
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WHO/UNICEF Joint Monitoring Programme, published 2024
Most recent global review of menstrual health in schools (May 2024): preliminary estimates that 39% of schools provide menstrual health education and 31% have bins for menstrual waste, regional figures, country examples on materials, and the gaps in national data (30 countries, varying definitions). The 2026 schools report was checked and its readable sections contain no updated menstrual health estimates.
UNICEF and WHO (Joint Monitoring Programme), published 2026
Latest global estimates for WASH in schools (September 2026): basic sanitation (improved, single-sex, usable) coverage of 67% in 2015 and 77% in 2025, the 81% projection for 2030, 460 million school-age children without basic sanitation and the situation in sub-Saharan Africa.
WHO/UNICEF Joint Monitoring Programme, published 2025
Latest household WASH report (August 2025), with menstrual health estimates for women and girls aged 15 to 49 in 70 countries: use and sufficiency of materials, reusable materials and water at home, participation of adolescent girls, and the Mongolia inequality example.
The Lancet Global Health 13(2):e285–e297 (Starr, Harding, Ataíde et al.), published 2025
Pooled analysis of 47 UNICEF MICS surveys (fieldwork 2017–2023) covering 673,380 women and girls aged 15 to 49: 15.0% missed social activities, school or work during their last period; highest among 15–19-year-olds and in South Asia and West and Central Africa; no consistent link with use of menstrual materials; cross-sectional and hypothesis-generating.
London School of Hygiene & Tropical Medicine, published 2025
Summary of a cluster-randomised trial in 60 secondary schools in Uganda (Nelson et al., Lancet Global Health 13(5):e888–e899): a multi-component programme improved confidence, the school environment and pain management (75% vs 67%) but showed little evidence of an effect on attendance during menstruation, mental health or educational performance after one year.
UNICEF, published 2022
UNICEF summary of national survey data available by 2020 (42 countries): awareness of menstruation before the first period in Bangladesh and Egypt, girls' reactions, private places to wash and change in rural areas, and the absence of national data from high-income countries. Used only for country examples not covered by newer reports.
DO GOOD International (2026). Menstrual Health and Dignity. Global Challenges. Updated October 15, 2026. https://www.dogood.world/challenges/menstrual-health
For figures, please cite the original sources listed above.