Written by Andrew Culver (IMHER Student Researcher)
Edited by Dhwani Kharel (IMHER Student Researcher)

One of the puzzles in menstrual hygiene work is why some countries have so much more activity in the menstrual hygiene sector than others, even among countries with similar income levels and product and education challenges. 

As one example, the materials below suggest that, as in many lower-income countries, girls and women Ethiopia – especially those in rural areas – face an array of challenges pertaining to menstrual hygiene product access, limited education about their bodies, and WASH-related infrastructure needs. However, MHM in Ethiopia still seems to command a relatively small footprint in global discussions and reports about menstrual hygiene.

This post is designed to assemble some recent resources focusing on MHM in Ethiopia. In particular, we highlight a report by PSI that focuses on menstrual hygiene product usage issues for low-income populations in Ethiopia.  Other relatively recent supplementary resources are also listed (readers will note that many of those additional resources were authored by Professor Marni Sommer, who has made a notable investment in studying MHM issues and developing adolescent learning materials within that country).

Moreover, we encourage readers to add other related resources in the comment section, so that this post can be a useful searchable resource for anyone who might want to learn more about research findings in Ethiopia 

The 2018 PSI Report & its Key Findings

Population Services International is a non-profit organization focused on global health, which takes “a business approach to saving lives.” Its relatively short 2018 report, with the title “Increasing Access to Menstrual Hygiene Management Products in Ethiopia,” integrates original survey research conducted with adolescent girls (13-24) in both rural and urban settings in Ethiopia. It focuses primarily on product access, with a secondary focus on some MHM-related WASH issues, and summarizes the structure of the country’s market for commercial menstrual products. 

  • A need for more education: Only 39% of urban adolescent girls and only 1 in 4 girls from rural areas report that someone talked to them about menstruation before their first period.  Nearly 1 in 3 urban adolescent girls, and 44% of rural girls report having no discussions with anyone about menstruation at any time.
  • High levels of dissatisfaction with current disposable pads: In a market dominated by two brands, dissatisfaction with disposable options is high.
  • Urban areas dominated by disposable pad use, with mixed use in rural areas: Most urban girls (86%) use disposable sanitary pads, versus 49% of rural girls. 
  • High cost of disposable pads is a deterrent for use by rural girls: The report suggests that there is a preference for disposable pads (in contrast to folded cloth), but 30% of the respondents in their study could not afford the average cost of disposable pads there.  Costs were a deterrent to buying disposable pads for 41%-49% of rural girls studied.
  • Water for sanitation and privacy are an issue everywhere, but especially in rural areas.  Only 18% of rural girls report having access to running water near a toilet at school (compared to 49% of urban girls, which is still a high number).  Only 3% of rural have a private place to change their pads at home and 17% at school (compared to 38% and 46%, respectively, for urban girls).
  • Disposal of disposable pads is a major issue, especially in rural areas. As in many countries, few rural girls have garbage cans as an option for disposable menstrual pads (<10%, vs. about ¾ of urban girls).  Over half of rural girls throw disposable pads in the toilet or latrine after using them.
  • Soap is very rarely available in schools anywhere in Ethiopia.  Just 1% of rural girls and 9% of urban girls report that soap is available at their schools.

Other Resources about MHM in Ethiopia

The FSG Report (2016)

This 2016 FSG report called “Menstrual Health in Ethiopia: Country Landscape Report” (information about FSG can be found here) explores the state of MHM experiences for girls in Ethiopia as of 2016, the responses of public and private actors in response to these issues, and opportunities for future research and advocacy to improve menstrual health conditions in Ethiopia. 

Grow and Know Books for Adolescents in Ethiopia

ABOUT:  The Grow and Know series found here was developed by Marni Sommer and a team of local partners in order to develop culturally compatible learning materials about puberty in different countries. Ethiopia is one of the seven countries with its own book in this series.

Research Study – Wall, Teklay, Desta, & Belay (2018)

“Tending the ‘Monthly Flower:’ A Qualitative Study of Menstrual Beliefs in Tigray, Ethiopia” can be found here.

Research Study – Azage, Ejigu, & Mulugeta (2018)

“Menstrual Hygiene Management Practices and Associated Factors Among Urban and Rural Adolescents in Bahir Dar City Administration, Northwest Ethiopia” can be found here.

Research Study – Blake, Boone, Yenew Kassa, & Sommer (2018)

“Teaching Girls About Puberty and Menstrual Hygiene Management in Rural Ethiopia: Findings From a Pilot Evaluation” can be found here.

Research Study – Anchebi, Shiferaw, Fite, & Abeya (2017)

“Practice of Menstrual Hygiene and Associated Factors among Female High School Students in Adama Town” can be found here.

Research Study – Smiles, Short, & Sommer (2017)

The article, ” ‘I Didn’t Tell Anyone Because I was Very Afraid’: Girls’ Experiences of Menstruation in Contemporary Ethiopia” can be found here.

Research Study – Tiju & Shekar (2017)

“Design and Development of Feminine Re-usable Maxi Pads for Economically Challenged People” can be found here.

Research Study – Belay, Shewaye, Alemayehu, Salih, & Gabrehiwot (2016)

“A Community-Based Study of Menstrual Beliefs in Tigray, Ethiopia” can be found here.

Research Study – Tegegne & Sisay (2014)

“Menstrual Hygiene Management and School Absenteeism among Female Adolescent Students in Northeast Ethiopia,” can be found here.


Help to grow and update this post as a searchable resource for others regarding this country.  Please leave any other recent reports or publications you have found to be useful about MHM issues in Ethiopia in the comments section below.