From June through July 2012, Emory University and UNICEF collaborated in research aimed to understand the range of challenges faced by girls during menstruation in urban Freetown, as well as the determinants of those challenges. This report presents the methods, findings and key programmatic recommendations to address menstruation-related challenges among girls. More than 100 participants were engaged in eight schools and two communities, including teachers and girls, both in school and out of school.