A comprehensive approach to Menstrual Hygiene Management (MHM) is still neglected and not sufficiently addressed at the policy and program level in Ethiopia. Most rural school girls in Ethiopia do not attend school during their menstrual cycles because of the inadequate toilet facilities in schools, high cost of purchasing sanitary pads, taboos, and the fear of accidental leaks. The current practice is to use unhygienic rags which cause leakages and present a high risk of urinary tract infections. Due to possibility of leakages, the girls remain at home, missing 3-5 days of school each month. This results in the girls falling behind in school work and ultimately dropping out of school. By dropping out of school, the girls are unable to complete their education and unable to break out of poverty.
In addition, MHM is not also integrated with WASH and Sexual Reproductive Health (SRH) teaching. Integrating Sustainable Health and Educational Development (SHED) with MHM programming has the potential to improve the health and educational achievement of rural girls.