"One obstacle to girls attending school was a lack of segregated toilets in schools, review director Manos Antoninis said, adding the agency found there was “little focus” on menstrual hygiene in schools in 21 low and middle income countries. “Improved sanitation to address adolescent girls’ concerns over privacy, particularly during menstruation, can influence their education decisions. Single-sex toilets are desperately needed to overcome girls’ barriers to education.”