Development of MSF’s Menstrual Health Management (MHM) Toolkit

MSF Inclusive Innovation

Development of MSF's Menstrual Health Management (MHM) Toolkit

Consultancy: Development of Practical MHM Guidance and Information, Education and Communication (IEC)/Health Promotion (HP) Materials for MSF

Background

Médecins Sans Frontières (MSF) is an international, independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters, and exclusion from healthcare. Through its Inclusive Innovation team, MSF has been working to strengthen menstrual health management (MHM) support across diverse humanitarian settings.

Menstrual health is more than hygiene, it is fundamentally tied to dignity, health, protection, and participation. Yet in humanitarian contexts, it remains widely overlooked. Periods do not pause in crises, but access to the resources, facilities, and knowledge needed to manage them safely often does. Across many MSF settings, menstruation is highly stigmatised, and women and girls lack access to safe, private facilities and practical information, limiting their ability to move freely and participate fully in daily life.

In response, MSF's Inclusive Innovation team has taken a holistic and participatory approach to MHM that goes beyond simply providing MHM products to address the full spectrum of needs, including stigma, knowledge, infrastructure, and community dynamics. This work has been grounded in seeking to understand the lived experiences of women and girls.

Since 2018, MSF have implemented 11 MHM projects across eight countries, including the Democratic Republic of Congo, Mali, Sierra Leone, India, Bangladesh, Iraq, Ethiopia, and Bhutan. These projects have explored a range of approaches, including community-based participatory methods, menstrual underwear (MU) distribution, hygiene kit provision, Water, Sanitation, and Hygiene (WaSH) facility assessments, and health promotion activities. Together, these experiences represent a growing but previously fragmented body of operational knowledge within MSF.

In January 2026, MSF's Inclusive Innovation team produced the MSF MHM Synthesis Report , a comprehensive consolidation of this body of work. The report brings together qualitative and quantitative insights from across projects to identify common patterns, context-specific differences, and recurring operational challenges. It captures three core areas of learning:

MHM knowledge, beliefs, and practices across different communities project outcomes, including the acceptability and feasibility of different approaches operational learnings related to design, implementation, and delivery. From this analysis, the report presents 44 structured recommendations across five key implementation domain - context, organisational systems, project design, project delivery, and individuals - supported by an evidence confidence framework. While the report provides a strong evidence base, it is primarily a technical and analytical document and is not designed for direct use in implementing integrated MHM interventions as part of MSF operations.

This synthesis serves as the foundation for MSF's