All children have the right to attend school and be actively engaged in their education without obstacles. Child-friendly environments are necessary for all children to thrive while at school. Creating and sustaining an enabling environment for children requires that their needs are known and met. Girls who are menstruating often do not have their needs fully met in their school environment. Many may face challenges managing menses in school that affect their overall educational experience. Menstrual hygiene management (MHM) has been recognized as a specific focus to be prioritized in schools. Stakeholders at the 2012 Menstrual Hygiene Management in Schools Virtual Conference recognized and agreed that guidelines for minimum standards on school-based menstrual hygiene management interventions were urgently needed to ameliorate the challenges that girls face in school related to menstruation. In order to understand the needs of girls who are menstruating at school and to inform a set of minimum standards UNICEF and Emory University collaborated to assess girls’ experiences of menstruation in four culturally and geographically diverse low-income settings: Bolivia, the Philippines, Rwanda, and Sierra Leone.