BACKGROUND:
Sustainable menstrual hygiene management (MHM) continues to be a significant social justice issue within the public health sector, with low-and-middle income countries accounting for a significant proportion of this rate. In the African region more than half of women have an unmet need for MHM. This refers to the lack of resources, facilities and supplies for MHM. Additionally less than two thirds of senior primary school learners had been educated on their menstrual cycle. Approach: We work to address the stigma associated with MHM among adolescents aged 11–19. Since March 2024, we have recruited focus group participants from two sites: a rural school in Temba and an informal settlement in Munsieville, Gauteng. We conducted FGs with girls as the primary target audience (n=131), adolescent boys (n=17) and teachers (n=10). Semi-structured guides were developed and used during FGs and supplemented by field notes. Outcomes: Across workshops, girls consistently reported high levels of menstrual pain and limited coping strategies, while boys initially showed low awareness of menstrual health. To date, the program has improved understanding of menstruation from 65% to 76%, knowledge of menstrual hygiene practices from 53% to 59%, and access to menstrual products from 65% to 76% post-workshops. Long term sustainable efforts require prevention models that address the root cause of the lack of access to menstrual hygiene products. Significance: The SOS MENHEMA program adds unique stakeholder perspectives to provide a more diverse view of the social stigmas around menstruation. Additionally, this study offers a fresh insight into how sustainable menstrual hygiene products can be used to integrate sustainability and climate adaptation practices in MHM. The findings from this project may be used to influence policy recommendations around the socio-economic factors that serve as a barrier to sustainable menstrual hygiene management within rural South Africa.