title: Menstrual hygiene management among adolescent schoolgirls in low- and middle-income countries: research priorities.
abstract: BACKGROUND
  A lack of adequate guidance on menstrual management; water, disposal, and private changing facilities; and sanitary hygiene materials in low- and middle-income countries leaves schoolgirls with limited options for healthy personal hygiene during monthly menses. While a plethora of observational studies have described how menstrual hygiene management (MHM) barriers in school impact girls' dignity, well-being, and engagement in school activities, studies have yet to confirm if inadequate information and facilities for MHM significantly affects quantifiable school and health outcomes influencing girls' life chances. Evidence on these hard outcomes will take time to accrue; however, a current lack of standardized methods, tools, and research funding is hampering progress and must be addressed.
  
  
  OBJECTIVE
  Compile research priorities for MHM and types of research methods that can be used.
  
  
  RESULTS
  In this article, we highlight the current knowledge gaps in school-aged girls' MHM research, and identify opportunities for addressing the dearth of hard evidence limiting the ability of governments, donors, and other agencies to appropriately target resources. We outline a series of research priorities and methodologies that were drawn from an expert panel to address global priorities for MHM in schools for the next 10 years.
  
  
  CONCLUSIONS
  A strong evidence base for different settings, standardized definitions regarding MHM outcomes, improved study designs and methodologies, and the creation of an MHM research consortia to focus attention on this neglected global issue.
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Penelope.Phillips-Howard@lstmed.ac.uk.
authors.forename: Penelope A
authors.initials: PA
authors.lastname: Phillips-Howard
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Bethany
authors.initials: B
authors.lastname: Caruso
authors.affiliation: Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Belen
authors.initials: B
authors.lastname: Torondel
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Garazi
authors.initials: G
authors.lastname: Zulaika
authors.affiliation: WASH Section, Programme Division, United Nations Children Fund, New York, NY, USA.
authors.forename: Murat
authors.initials: M
authors.lastname: Sahin
authors.affiliation: Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
authors.forename: Marni
authors.initials: M
authors.lastname: Sommer
keywords: adolescent sexual and reproductive health; equity; hygiene; menstruation; school health