```mdx
title: "Reducing Period Poverty: What a Systematic Review of 49 Studies Tells Us About What Works"
description: "A systematic review of menstrual health interventions, innovations, and policies across high- and low-income countries finds that multidimensional approaches perform best."
published: true
study_type: systematic_review
journal: Global Public Health
pubmed_id: "42891658"
A systematic review of 49 studies finds that reducing period poverty works best when product access, menstrual education, stigma reduction, infrastructure, and policy are combined rather than delivered in isolation. The evidence is largely narrative and heterogeneous, so it supports a directional conclusion rather than precise effect sizes.
Period poverty, the difficulty some people face in affording or accessing menstrual products, facilities, and information, is a persistent inequity. It affects health, school attendance, work, and dignity, and it occurs in both high-income countries (HICs) and low- and middle-income countries (LMICs). This systematic review set out to synthesise the responses that have been tried, and the barriers and facilitators that shape whether they succeed.
The authors followed PRISMA 2020 reporting standards and the SPIDER framework for qualitative and mixed-methods evidence. They searched ProQuest Central, Scopus, MEDLINE, and PsycINFO for English-language studies from inception to 15 December 2024, identifying 8,385 records. After screening, 49 studies were included. These spanned interventions, other initiatives, innovations, and policy analyses across school, community, workplace, humanitarian, and policy settings. Because the included studies were highly heterogeneous in design, population, and outcome measures, the authors conducted a narrative synthesis rather than a quantitative meta-analysis. The review does not report a pooled sample size, and this limits how confidently any single effect can be read.
The central finding is that effective responses were multidimensional. Product provision on its own was not described as sufficient. Instead, the most promising responses combined product access with menstrual education, efforts to reduce stigma, and enabling infrastructure such as water, sanitation, and hygiene (WASH) facilities. Education was associated with improved menstrual literacy and confidence. In specific studies, product-access strategies were linked to reduced absenteeism and less social withdrawal, though these findings came from individual studies rather than a consistent body of evidence.
Innovations received considerable attention. Biodegradable disposable products, reusable products, and community-managed pantries expanded access in various settings. However, these innovations repeatedly ran into constraints. Inadequate WASH infrastructure limited the usability of reusable products, stigma continued to shape which products people felt comfortable using, and cultural concerns about insertable products (such as menstrual cups and tampons) affected uptake in some communities. The review notes that acceptability is not uniform, and that an innovation successful in one cultural context may not translate to another.
Policy measures showed promise, including the removal of taxes on menstrual products and the provision of free products in schools and public institutions. Yet the authors identify persistent gaps between policy adoption and implementation, particularly around funding continuity and delivery at the local level. In other words, a policy existing on paper does not guarantee that people can access products in practice. The review's conclusion is that sustainable progress requires context-sensitive action that integrates education, product choice, infrastructure, stigma reduction, and effective policy implementation. The authors emphasise that interventions are most effective when culturally adaptive and responsive to local needs, rather than when a single template is exported across settings.
It is worth being clear about the limits of this evidence. The included studies vary widely in quality and rigour, the review is narrative rather than quantitative, and many outcomes were measured in small or context-specific samples. The conclusions are best read as well-supported directions for action and design, not as a ranking of which individual intervention is most effective.
This review concerns access and systems, not personal health supplementation or habits. For broader guidance on menstrual and general health, speak with a qualified healthcare provider.
| Field | Detail |
|---|---|
| Study type | Systematic review (PRISMA 2020, SPIDER framework) |
| Databases searched | ProQuest Central, Scopus, MEDLINE, PsycINFO |
| Search window | Inception to 15 December 2024 |
| Records identified | 8,385 |
| Studies included | 49 |
| Synthesis method | Narrative synthesis |
| Settings | School, community, workplace, humanitarian, policy |
| Countries covered | Low- and middle-income and high-income |
| Journal | Global Public Health |
| PubMed ID | 42891658 |
1. Reducing period poverty through interventions, innovations, policies and multilevel barriers and facilitators: A systematic review. *Global Public Health*. PubMed. https://pubmed.ncbi.nlm.nih.gov/42891658/
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