Limitations
A key limitation of the study is that not all teachers participated in the three FGDs for their school, with some only participating in one or two. However, while this prevented some teachers from commenting critically on students before, during, and after the interventions, many who were new to the focus groups were able to draw upon their previous experience which informed their opinions.While we have knowledge of the fact that both male and female teachers participated in each of the FDGs, gender was not recorded in the transcripts to maintain the confidentiality of the participants, thus we do not have a ratio of the male to female teacher participation per FGD and were unable to conduct further analysis on differences in opinion by gender. While gendered language was sometimes used in the FDGs, allowing some conclusions to be made about how students approached teachers, the lack of availability of this information makes it difficult to make wider assessments of gendered expectations of teachers in addressing menstruation in schools.In addition, this analysis is based on results from the MS study in the year following intervention. There is no information on whether this study had a longer-term impact on teachers or the effect on school culture around menstruation. The study authors also recognize that the data was collected 10 years ago and that current advancements may impact the utility of the results. Study findings and study researchers helped to inform limited progress over the past decade in guidelines for teachers as well as establishing MHH strategies and policies, including the Ministry of Health Menstrual Hygiene Management strategy and Menstrual Hygiene Management in Schools: A Handbook for Teachers (