Promoting Puberty Education and Menstrual Hygiene Management in Schools


(Puberty Education & Menstrual Hygiene Management, Published in 2014 by UNESCO, ISBN: 978-92-3-100011-9)

“I don’t exactly remember who told me or how old I was when I found out about menstruation. However I do remember my feelings about this new-found knowledge. I thought it was disgusting and I still think it’s disgusting. The first time I can remember hearing about menstruation was probably around sixth grade. I remember my peers joking about periods and blood often. It always seemed like something that guys could make jokes about to make girls seem embarrassed or to seem superior to them.”(Comments from an anonymous girl)

One of the most challenging times for a person’s life is puberty, when the body goes through multiple changes all at once as it makes the transition to adulthood. But many students enter puberty unprepared. On average, females begin puberty between 10 and 11 years of age (the age  varies depending on such factors as nutrition), males a year later.  The information they receive is often selective and surrounded by taboos. Often the parents as well as education sector avoid the issue by considering it a private matter or a problem to be addressed personally. But by facing this pivotal phase of life unprepared, learners are left confused and unsupported, which in turn affects the quality of their education. Since parents can find it difficult to speak of sensitive and sexual issues with their children, even while admitting it is also their responsibility, schools have a central role in puberty education. The book ‘Puberty Education & Menstrual Hygiene Management’ lays out the context and rationale for education sector involvement, the characteristics of good quality puberty education and menstrual hygiene management, as well as key issues for programme development, implementation and sustainability. It encourages a holistic approach to health promotion, starting with education, creation of healthy environments, and linkages to health services.

The book puts forth a vision of puberty education that is skills-based, inclusive and comprehensive. It also reminds us that puberty is not a problem to be solved; it is simply a time of accelerated physical growth and sexual development experienced by every human. For girls, puberty means the onset of menstruation. In many contexts menstruation is considered a private issue, making it difficult to speak about it in public, for instance in a classroom. Numerous studies, particularly from low-income countries, show that a very high number of girls start menstruating without having any idea what is happening to them or why. Puberty is marked by first menstruation for females and the development of sperm and the first ejaculation for males.  Girls are faced with challenges related to management of menstruation in public places. UNICEF estimates that 1 in 10 school-age African girls ‘do not attend school during menstruation’ Lack of information, misconceptions and adverse attitudes to menstruation may lead to a negative self-image among girls who are experiencing menses for the first time, and can result in a lack of self-esteem as they develop their personality as women. The culture of ‘silence’ around menstruation increases the perception of menstruation as something shameful that needs to be hidden, and may reinforce misunderstandings and negative attitudes toward it.

To impart puberty education the book suggests alternative teaching-learning methods beyond lecturing. Learner-centered participatory methods – such as peer-led activities, group problem-solving and dramatization – are needed to go beyond knowledge to address values, attitudes and skills. Peer education can fill the gap in more traditional curriculum based education allowing young people to ask questions in a non-threatening, non-embarrassing setting and get answers they might not get in a traditional classroom.  The online materials which include audio and video contents, interactive games, quizzes and other resources can also be useful tools as these opens safe space for students and teachers to feel free to discuss sensitive topics.

The book gives emphasis for including boys and men in puberty education as puberty affects both girls and boys, and addressing one without the other will reduce the effectiveness of any programme.  Not properly engaging with boys about a major topic of puberty, menstruation, allows them to misunderstand  an essential part of womanhood, reducing it to something unpleasant that should be concealed and invisible. Teachers are often unprepared to teach puberty and menstrual hygiene management. Studies indicate teachers may feel uncomfortable with modules relating to sex and sexuality. In addition, the topic is not always a priority in schools and is generally taught as part of an after-school club or not covered at all by curricula, leading teachers to spend less time on it compared to topics on which students will be tested.

This book has demonstrated a range of ways the education sector can engage with the issues of puberty education and menstrual hygiene management. It has covered aspects such as curricula, teacher training, community involvement, peer education, and public-private partnerships, among others. The book emphasis on the involvement of ministries of education on these crucial issues. Puberty education and menstrual hygiene management in schools relate to international agreements about access to education, the quality of education, and sexual, reproductive and gender equity and rights.  Governments are responsible for the delivery of education, gender equality, access to safe water and sanitation, and sexual and reproductive health rights, among others. Ministries of education and their partners are responsible for adapting (if necessary) existing curricula, teaching materials and teacher training curricula to align with the requirements for providing quality puberty education as laid out in this book.

The wide range of examples presented in this book provides ideas for translating concepts into action in diverse contexts which will serve to move the education sector toward comprehensive, systemic and sustainable policies and programmes for a high-quality education for all.  Rather than a barrier to education, puberty is an opportunity to help learners to understand human development and to begin building skills for creating a healthy future.

The writer is an independent researcher. E-mail:

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