Elialilia Okello

Co-Principal Investigator

Clare Tanton

Co-Principal Investigator

Siwema Keya


Partnering to support schools to promote menstrual health and wellbeing among secondary school girls in Tanzania (PASS-MHW) project


Negative menstrual experiences are associated with poor health and social outcomes including poor participation in schools. This  presents barriers to many girls and undermines progress towards many of the Sustainable Development Goals. Available data shows that negative menstrual experiences among school girls is driven by among other factors, a lack of knowledge about puberty in general and menstruation in particular. In sub-Saharan Africa, parents, relatives, and teachers are adolescents' main sources of puberty information. Often, these adults are ill-informed and/or uncomfortable discussing puberty and menstruation. Additionally, the school climate itself is often ill-equipped to support adolescent girls’ menstrual and broader puberty-related health for the following reasons: a) Poor water, sanitation, and hygiene (WASH) facilities prohibit effective menstrual management. b) Pervasive bullying and abusive behaviour from boys and teachers cause menstrual-related shame and anxiety.

Primary objective

To develop a scaleable, comprehensive menstrual sexual and reproductive health (MSRH) intervention that can be integrated into the government school system to improve school attendance and participation of secondary school girls.


This is a mixed methods study being implemented in two main phases for 36 months from November 2020. Phase 1 was a formative study involving qualitative methods whose results were used to refine the “Twaweza Intervention”, an NGO-developed menstrual sexual and reproductive health  intervention. Phase 2 was a longitudinal mixed-methods study  involving the pilot testing and implementation of the refined Twaweza intervention. This included a pre-post survey among students and qualitative interviews with students, teachers & local government officials to assess study outcomes, intervention implementation process, and economic costing.


MITU, Tanzania/London School of Hygiene & Tropical Medicine (LSHTM), UK: Saidi Kapiga, Philip Ayieko; LSHTM, UK: Belen Torondel, Giulia Greco; Femme International, Tanzania: Jennifer Rubli

Other Research Programmes