Menstruation is part of life and should be treated as such
Building confidence among schoolgirls across Cambodia and helping to keep their school attendance high

16 March 2022, Tramkak District, Takeo Province
“By learning at school, and from family and my own online research, I know that menstruation is natural. I have nothing to hide. I also know that if I have a problem and don’t speak up, it could lead to complications in my health. My teachers encourage me to ask questions about my growth and development so asking for advice feels normal. I even feel comfortable talking to some of my close male friends,” shared Grade 12 student, Dert Sivmean.
This kind of confidence about a subject that can, unfortunately, be viewed as taboo doesn’t happen overnight – it must be supported over time. Since 2018, the School Health Department (SHD) of the Ministry of Education, Youth, and Sports have been working to teach girls and boys across Cambodia, in Grade 5 and above, about their growth and development as part of a weekly school health hour. Prior to that, programmes varied widely from school to school and district to district, depending on what resources were provided by NGOs or individual initiatives by school leadership. The most recent development to standardize menstrual hygiene management (MHM) is a district-wide approach being piloted in three districts. Equal parts infrastructure building and educational programming, these pilots show improved socio-emotional wellbeing and a positive uptick in school attendance for schoolgirls who have begun menstruating.
Towards the end of 2021, the School Health Department (SHD) of the Ministry of Education, Youth, and Sports (MoEYS), with funding support from the UK Government’s Foreign, Commonwealth & Development Offices and technical guidance from UNICEF, conducted refresher trainings on the Minimum Requirements on WASH in schools. These requirements evaluate a school’s drinking water supply; the ratio of latrines to students, separated by gender; and the presence of MHM facilities, supplies and education. This latest training, emphasizing MHM, cascaded from the SHD to the Provincial Office of Education (PoE) and District Office of Education (DoE) all the way down to individual schools. After the training, each level developed their MHM implementation plan and got to work promoting MHM knowledge and practices in schools. The DoE is responsible for monitoring MHM progress in all their schools and helping those with lower levels improve.
Success shows up as girls having access to upgraded facilities and adequate sanitary supplies, plus the confidence, knowledge, and skills to manage their menstruation safely. The 81 schools of Tramkak District in Takeo province are making amazing headway in doing just that with their students.

“I’m proud to say that what I’ve learned in school has helped me be more prepared when I get my period,” beamed Grade 9 student Teng Phalla.
“The more knowledge I gain, the more comfortable I feel talking about menstruation, especially to support other girls. But I don’t talk to the boys in my class about it because they sometimes tease us. I hope that with continued focus from our teachers, the boys will become more supportive and show more respect.”
The school leadership in Tramkak District is listening and has plans to make the programme even better.

“In the past, girls would often miss a week of school each month. Since we started our MHM programme, school attendance is up” Suong Sethy proudly exclaimed, adding that it’s been a process to get here.
“First, we had to improve basic hygiene and sanitation like the toilets, handwashing supplies and drinking water. Then we taught kids about proper handwashing. We’ve slowly put growth and development education in place. The Growth and Changes and To Become a Young Man booklets provided with support from UNICEF are wonderful learning tools and we accompany that with small group sessions with designated teachers.”
For the future, he wants to build on the strong foundation they’ve built. “Now we are focused on ensuring we have a consistent supply of sanitary pads, disposal bins in the girls’ latrines and MHM education even for the boys. It’s covered in the boys’ book, but we have to keep reinforcing that girls need privacy and respect.”

“My time as a primary and secondary school student was difficult. I knew how to manage my period, but the traditional cloth pads we had were hard to clean and managing hygiene with the school’s latrine was a challenge. Girls missed school more often,” remembered Ms Chuon Sophath, the Grade 6 teacher, school librarian, and MHM focal point at Ang Run Primary School.
She is encouraged to see the generational changes in her students. “They are much more willing to ask questions and even talk to their parents. It also helps that we have an emergency supply of sanitary pads and proper washroom facilities for girls, so there is no need to rush home.”

“My teacher regularly invites a group of female students to the library to talk about the Growth and Changes booklet and to answer our questions. I feel a little shy talking to people I don’t know very well, but I never feel shy with my teacher, female classmates, or my mom. If I ever get my period at school or home and have questions, I know who to talk to,” confided Voeurn Sreysras, a Grade 6 student at Ang Run Primary School.

“When I was young, we followed advice passed from mother to daughter for generations, not all of which was correct. We were told it wasn’t a subject to discuss in public. I’m happy to see today’s young women talking openly and with confidence,” said Ms Nheup Houry, librarian and MHM focal point at Samdech Krom Preah Ang Roneab High School.
“When we first received the Growth and Changes booklets last year, I read it myself so I could discuss the details with students. Every time a class comes to the library, I ask them if they have read it and quiz them on key messages. The book is a great source of information. I would like to see more schools having this booklet because knowledge creates confidence.”

“Knowledge is important, but everything works together – the books, the emotional support of key teachers, and having the WASH facilities in place so they can practice what they’ve learned,” explained Mr. Ou Heng, Director of Samdech Samdech Krom Preah Ang Roneab High School, adding “We are working to make sure every child feels comfortable coming to school and won’t fall behind.”
At a time when so many students are struggling to close the gaps of lost learning, eliminating additional hurdles has never been more important. UNICEF, with support from partners like UK Government’s Foreign, Commonwealth & Development Offices, will continue supporting the SHD of the MoEYS to expand the district-wide approach by providing further cascade training, distributing the Growth and Changes booklets and To Become a Young Man booklets, helping monitor the implementation of MHM and ensuring that this district-wide approach is included in the provincial and district annual operational work plans.