Pakistan: UNICEF Implementing Partner for Menstrual Hygiene Management (MHM) Research

The intersections between menarche and education in Pakistan are still poorly understood. Nonetheless, existing reports suggest the dominance of male students in middle and high schools, and the absence of other “girl friendly” supports in the schooling environment are causes, e.g. water is rarely available in rural schools in Pakistan, with 75% of hand pumps and 28% of latrines being non-functional. Furthermore, female students lack separate, private latrines, and they often are attacked, sexually harassed, or shamed when waiting to use lavatory services, posing yet another barrier to school attendance. Female students may also have difficulty accessing sanitary materials owing to their high cost, especially if male family members make most major household purchases, as is the case in the majority of households in Pakistan. Given that menarche may be jeopardizing young women’s schooling and health in Pakistan, it is both timely and important to better understand the relationship between menstruation, education, and health for young Pakistani women, and to improve pubertal transitions.

• To describe local cultural understandings and meanings of menarche in urban and rural Pakistan through the use of ethnographic observations, interviews, and participatory activities with adolescent young women and the adults who play key roles in the lives of school-aged young women.

• To explore, through comparative case studies of young women’s lives, the ways in which local cultural meanings about menarche and menstruation interact with sanitary technology, school design, and peer group relations, creating intolerable menstrual-related stigma that leads to young women dropping out of school.

• To utilize adolescent young women’s own recommendations for improving the pubertal and menstrual management-related guidance adolescent girls receive through the development of a girls’ puberty book in Pakistan.