There is increasing recognition that women and girls’ experiences of menstruation and menstrual hygiene practices can negatively impact on their health, education and psychosocial outcomes in low and middle-income countries (LMICs). Managing menstruation effectively and with dignity can be especially challenging in these settings, and may result in adverse consequences such as behavioural restrictions, reduced school or work attendance, or shame and embarrassment. Research from Africa and Asia suggests that lack of adequate knowledge, materials and facilities to manage menstrual bleeding can impact negatively on girls’ and women’s participation in education and employment. In the Pacific region however, there is a dearth of research regarding the determinants and impacts of menstrual hygiene management (MHM), and of effective interventions to improve this.