The operation research on Menstruation Hygiene Management (MHM) as an initiative approach was designed by MOVE with technical and financial support of HEMAYAT, a baseline evaluation utilized a quantitative approach to collect valuable information concerning the existing MHM conditions using cross-sectional methodology in the selected treatment and control districts, data are collected from women and teenagers using a household questionnaire (quantitative). A household questionnaire formed the backbone of the baseline research and included four sections designed to evaluate knowledge, attitude and current practices in case and control areas in terms of demographics, health-seeking behavior, awareness of MHM, practices, and attitudes towards MHM. A pooled cross-sectional survey used quota sampling with random selection in baseline and end-line assessment was conducted to see the output and outcomes of the approach using Difference in Difference methodology. The Primary Sampling Unit (PSU) reflected the ratio of that district’s population and The Secondary Sampling Unit (SSU) were villages, approximately 25 SSU for intervention and 25 SSU for control districts are randomly selected from PSU. Data collection and Analysis: The booth study was conducted in four districts of Kabul province, two districts as control (Kalakan and Dehsaba) and two as treatment (Farza and Guldara), for baseline and end-line- a total of 625 respondents from control and 625 respondents from treatment districts were planned to be interviewed, at baseline study, from 1250 planned respondents, about 1224 have been interviewed and about 26 respondents have been missed (rejected, not completed, household vacated/destroyed) and 3 questionnaire missed by the system. The analysis was applied on 1221 respondents’ questionnaire. While at an end-line study, 1250 have been interviewed and 3 questionnaires missed by the system. The analysis was applied on 1247 respondents’ questionnaire. Following to data collection and entry, the transfer of data to the appropriate SPSS database is done for cleaning and analysis. The results of the baseline assessment were used for the bases of the data on knowledge, attitude, practice, and access to sanitary napkins, In line with the operation research ToR, the treatment districts were exposed with a series of activities including community-based health education and outreach in the target population. There is an absolute lack of awareness about sanitary napkins and its usage, in the baseline; about 56.5 % of the respondents are reported not familiar on sanitary napkins and its usage and disposal, Though, the end-line assessment shows significant differences in the level of awareness, 86.8 % of respondents are familiar about sanitary napkins and its disposal. The majority of women/girls were not aware of their menstruation before menarche-61.5 %, and about 38.5 % have information from different sources, so the information was not adequate and that they needed more insight into the topic. The baseline data shows that there are some miss-practices amongst the respondents regarding their personal hygiene including handwashing, washing of the genital areas and washing of the underwear/re-usable pads during menstruation period. As per end-line assessment data, there were significant changes in the personal hygiene (Washing practice of genital area during menstruation from 57.2%-Baseline to 83.8 %-end line). There is a similarity in disposal strategies used by the women/girls in baseline vs end-line and control and treatment districts. The study data revealed that, girls/women are having experience restriction in specific foods, physical activities, social gathering, pray, taking shower and school attendance, the end-line data shows that there are likely changes occurred in attitudes, restriction to women and girls during menstruation decreased from 91.6% at baseline to 76% at end-line study, it seems the MHM project likely impacted the community and family attitudes towards menstruation. Comparison of baseline vs end-line shows that restriction to bath and shower during menstruation is decreased by 25.2% from baseline, this difference mostly occurred in the treatment group. Overall, increases in demand of sanitary napkins usage, awareness and knowledge of girls/ women on menstruation and menstruation management, personal hygiene and health practices and individual, family and community attitudes towards menstruation and menstruation management suggest that the MHM pilot project was successful in promoting intended objectives. In order to capitalize on current successes, and prepare for a possible future rollout, implementation of the MHM concept in the country is important, so require widely advocacy at a policy level, national and international contribution and community support, there are several recommendations that come out of this analysis.