Gender inequality, cultural taboos, poverty and lack of basic services undermine many girls’ and women’s ability to meet their health and hygiene needs in Somalia. Menstruation is associated with stigma and girls feel embarrassed, often excluding themselves from school and other social activities including generating vital income to support themselves or contribute to their community. Sanitary pads are expensive and often inaccessible and some girls resort to managing their periods with pieces of rags or paper which are often unhygienic and uncomfortable causing chafing, urinary tract infections, reproductive tract infections, and other reproductive health problems, including fatal toxic shock syndrome and infertility.