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Despite being a basic bodily function, menstruation has lived in the shadows across cultures, geographies, and history. In recent years, global health, international development, and women’s rights communities have increasingly recognized the role that menstruation plays in achieving their respective sector objectives, and the many ways in which menstruation can prevent people from contributing freely to their societies. Approaches to addressing menstruation have often been centered within the water, sanitation, and hygiene (WASH) sector, which has resulted in a signifcant programmatic focus on access to latrines and menstrual hygiene products. Eforts from the WASH sector have made signifcant contributions to advance menstrual equity, but alone are insufcient. Holistic­ MHH interventions ­require­ multi-sectoral­ approaches ­that­ combine­ efforts ­from­ the ­health,­ education,­ gender,­humanitarian ­protection ,­ and ­WASH ­sectors ­to­ address ­the­ physical,­ emotional,­ economic,­ and­ social challenges ­related ­to­ menstruation­ and ­to­ meet ­the­ needs ­of ­all ­menstruators­across­ their­ life­ cycles. To maximize the impact of MHH investments, USAID staf and partners should consider several cross-cutting issues in activity design and implementation, monitoring and evaluation, and research, including: products and waste management, governance, social support, social and behavior change (SBC), and positive youth development (PYD).