This thesis investigates the extent to which national menstrual health management (MHM) policies in Kenya and South Africa reduce educational inequality for menstruating pupils. Guided by the Capabilities Approach and Sommer’s Theory of Change, the study evaluates whether policy frameworks enhance girls’ educational opportunities and how implementation quality shapes outcomes. By using a deductive qualitative content analysis of policy documents, academic literature, and Non-Governmental Organisation (NGO) reports, the research compares the foundational elements, implementation activities, as well as outcomes and impacts of MHM policies in both countries. Findings reveal that Kenya and South Africa have made policy advances with several context-specific examples serving as best practices for MHM implementation. Nevertheless, the analysis reveals that persistent challenges remain. These mainly include infrastructural gaps, uneven implementation, and inadequate monitoring. The study concludes that, if comprehensive MHM interventions are effectively implemented, they show positive outcomes. Still, although national policies are necessary for promoting educational equality and menstrual dignity, their effectiveness is constrained by contextual barriers and insufficient data. The research highlights the need for more comprehensive, context-sensitive approaches, improved monitoring, and intersectional analyses. Ultimately, this thesis contributes to the academic and policy discourse by offering a comparative, theory-driven evaluation and by identifying priorities for future research and policy improvement in MHM.
Table of Contents
- 1. Introduction
- 1.1 Background and Context
- 1.2 Research Question and Sub-Questions
- 1.3 Structure of the Thesis and Research Approach
- 2. Theory
- 2.1 Conceptual Clarifications of Menstrual Health and Education
- 2.2 Theories and Hypotheses
- 2.2.1 Capabilities Approach
- 2.2.2 Theory of Change
- 3. Research Design and Methodology
- 3.1 Research Design and Case Studies
- 3.2 Method of Data Collection
- 3.3 Method of Data analysis
- 3.4 Limitations and Ethical Considerations
- 4. Results: Context and Implementation of Menstrual Health Policies
- 4.1 Contextual Factors and Challenges
- 4.1.1 Kenya
- 4.1.2 South Africa
- 4.2 Menstrual Health Policy Frameworks
- 4.2.1 Kenya
- 4.2.2 South Africa
- 4.3 Implementation Frameworks and Scale-Up Activities
- 4.1 Contextual Factors and Challenges
- 5. Results: Educational Outcomes and Impacts
- 5.1 Analysis of Policy Outcomes
- 5.2 Analysis of Policy Impacts
- 6. Interpretation and Hypotheses Discussion
- 6.1 Comparative Evaluation
- 6.2 Evaluating Hypotheses
- 6.3 Recommendations for Policy Improvement and Implementation
- 7. Conclusion
- 7.1 Summary of Findings and Answer to Question
- 7.2 Contributions to Research
- 7.3 Final Remarks and Future Research Directions
- 7.4 Limitations
Research Objectives & Themes
This thesis examines the extent to which national Menstrual Health Management (MHM) policies in Kenya and South Africa mitigate educational inequality for menstruating pupils. By utilizing the Capabilities Approach and Sommer’s Theory of Change, the research evaluates the effectiveness of these policy frameworks in enhancing girls’ educational opportunities, participation, and dignity, while identifying how implementation quality influences these outcomes.
- Comparative analysis of MHM policy frameworks in Kenya and South Africa.
- Evaluation of policy effectiveness regarding educational equality using the Capabilities Approach.
- Assessment of implementation quality through the lens of the Theory of Change (ToC).
- Identification of gaps in policy delivery, infrastructure, and monitoring.
- Synthesis of best practices for policy improvement and future research directions.
Excerpt from the Book
2.1 Conceptual Clarifications of Menstrual Health and Education
There is a wide range of terms across diverse cultures and languages, many of which are euphemisms, to name the natural biological process experienced by approximately half of the global population at some point in their lives, and central to this work. I refer to it as Menstruation, which is the: “Periodic discharge of blood and mucosal tissue shed from the uterus and expelled through the vagina [which] Occurs approximately monthly (~28 days) from puberty to menopause in nonpregnant menstruating people” (Casola 2023, 67).
Menstruating people refers to “[a]ny person who experiences a menstrual cycle. This includes but is not limited to cisgender women and transgender men who retain physiologic ability to menstruate.” (Casola 2023, 67). Much of the literature I engage with uses “girls” instead of menstruating people, which is not intended to be restrictive in this work. I will try to adopt a gender-inclusive language approach where possible while acknowledging the predominant framing of MH within the context of girls' education.
But Menstruation goes beyond the biological—it is a gendered social experience, shaped by stigma and cultural beliefs. Moreover, scholars examine it as “an issue of public policy” (Olson 2022, 2) as these social constructions influence how MH is prioritized, funded, and addressed in policy frameworks (Sommer 2021). The concept of Menstrual health and hygiene (MHH) or Menstrual Hygiene Management (MHM) “is used to describe the needs experienced by people who menstruate, including having safe and easy access to the information, supplies, and infrastructure needed to manage their periods with dignity and comfort […] as well as the systemic factors that link menstruation with health, gender equality, empowerment, and beyond”. Thus, a term to describe the ability to manage menstruation safely, hygienically, and with dignity (Sommer 2015), which for instance includes the availability of menstrual products. In this thesis due to its limited reach, references to menstrual products primarily denote disposable sanitary pads, although it is acknowledged that a diverse range of products are available and relevant.
Summary of Chapters
1. Introduction: This chapter provides the background on period poverty and its impact on girls' education, establishing the research question and objectives.
2. Theory: This section defines core concepts like MHM and period poverty, while presenting the Capabilities Approach and the Theory of Change as the primary analytical frameworks.
3. Research Design and Methodology: The chapter outlines the comparative case study design, the qualitative textual analysis approach, and discusses methodological limitations.
4. Results: Context and Implementation of Menstrual Health Policies: This chapter presents the contextual landscape and evaluates specific policy frameworks and implementation strategies in Kenya and South Africa.
5. Results: Educational Outcomes and Impacts: The section analyzes empirical findings regarding product accessibility, MHM education, and their influence on school participation and engagement.
6. Interpretation and Hypotheses Discussion: This chapter synthesizes the results, compares findings across both countries, evaluates the research hypotheses, and provides policy recommendations.
7. Conclusion: The final chapter summarizes key findings, reflects on the research contributions, and suggests areas for future study while noting research limitations.
Keywords
Menstrual Health Management, Period Poverty, Educational Inequality, Capabilities Approach, Theory of Change, Kenya, South Africa, School Absenteeism, Sanitary Policy, Gender Equality, Public Policy, Menstrual Hygiene, Girls' Education, Implementation Quality, Social Stigma
Frequently Asked Questions
What is the core focus of this thesis?
This thesis examines the impact of national Menstrual Health Management (MHM) policies in Kenya and South Africa on reducing educational inequality for menstruating pupils.
What are the primary themes addressed?
Key themes include period poverty, access to menstrual products, the quality of MHM education, school attendance, and the role of sociocultural stigma in educational settings.
What is the main research objective?
The primary objective is to determine to what extent these national policies enhance girls' capabilities and foster educational equality.
Which scientific methodology does the author use?
The study employs a deductive qualitative content analysis, using policy documents, NGO reports, and academic literature, analyzed through the lens of the Capabilities Approach and the Theory of Change (ToC).
What does the main body cover?
The main body evaluates the context of MHM in both countries, compares their specific policy frameworks, assesses the quality of their implementation, and analyzes the resulting educational outcomes and impacts.
Which keywords characterize this work?
Key terms include Menstrual Health Management, Period Poverty, Educational Inequality, Capabilities Approach, Theory of Change, and Policy Evaluation.
How does the author evaluate the "Capabilities Approach"?
The author uses Nussbaum's framework to argue that MHM is a fundamental capability. The study finds that while policies address some aspects of bodily health, they often fail to support other capabilities, such as bodily integrity and affiliation, due to structural barriers.
What is the significance of the "Theory of Change" for this study?
The ToC provides a structured causal model to evaluate how policy inputs and scale-up activities lead to outcomes. It helps the author identify that implementation quality at the school level is a critical determinant of policy success.
What are the major barriers to effective MHM identified?
The study highlights persistent infrastructural gaps, inconsistent distribution of products, inadequate teacher training, and deeply rooted sociocultural taboos as major obstacles to effective policy implementation.
- Citar trabajo
- Janna Hettlich (Autor), 2025, Breaking the Cycle. Evaluating Period Poverty Policies and Their Impact on Girls’ Education, Múnich, GRIN Verlag, https://www.grin.com/document/1705463
