Bigger Than Boxes: Menstrual Hygiene Management (MHM) in Thai Schools

Bigger Than Boxes presented by GAD (Gender and Development Committee)
Rae Richards, 129 TESS

“It’s simple: women and girls have human rights, and they have periods. One should not defeat the other.”
-Hannah Neumeyer, head of human rights at WASH United[1]


The topic of menstruation is difficult to discuss in most countries worldwide, yet half of the world’s population experiences menses during most of their lives. Our understanding and treatment of menses in Thailand is directly linked to students’ self confidence, outcomes in education, and their sexual and reproductive health.[2] By exploring this oft neglected subject and preparing ourselves with accurate information about what girls experience, we can better serve our communities as educators and mentors who more fully understand the context of menstrual hygiene management in Thailand’s schools.

Current School Context

Starting with what we know about sexual maturation in Thailand, we can orient the rest of our discussion below. In a sample of 8,200 Thai girls between the ages of 10-17, a study conducted by Mahidol University found that the average menarcheal age in Thailand is 12.3 and that over 70% of girls use 2-4 napkins per day of their period. They also found that an overwhelmingly large proportion of Thai girls seek advice from their mothers concerning menarche.[2] While this study was conducted in 1997, the data tells us what we already know: Thai girls, on average, start their periods in Prathom 6. They have to visit the restroom several times each day while menstruating, which requires clean, accessible facilities. Additionally, maternal figures in the home are usually the ones helping educate Thai girls on this subject, not schools or local health clinics.

As mandated by the Office of the Basic Education Commission (OBEC) in what is called “The Guideline on Sexual Education’s Learning Activity”, Thailand does explicitly address MHM when teaching sexual and reproductive health for all grade levels. When Thai students are asked to self-assess their knowledge of menstruation, they indicate a high level of knowledge. Yet when tested on said knowledge, “only a minority [give] correct answers to multiple-choice questions about menstruation or the menstrual cycle.”[3] There is a clear gap between how Thai curriculum explores these difficult topics and what Thai students actually take away from the classroom.

ASEAN Context and Barriers

With regards to all ASEAN countries, the Philippines and Cambodia have progressed farthest with their formal research on MHM realities, while Thailand and Myanmar have progressed the slowest, with limited research being done. While Thailand has ample curriculum on MHM, teachers often site discomfort and a lack of confidence when approaching these topics. Other country-specific barriers to MHM friendly schools include lack of leadership and training for teachers working on SRH lessons, as well as a lack of safe, hygienic school bathrooms, with only 45% of Thai bathrooms being adequately sanitary.[4]

Other classroom barriers cited by UNICEF’s assessment of MHM in ASEAN countries include:

  1. Teachers are frightened of the opinions of parents and the wider community, due to the sensitive nature of sexuality and the linkage of menstruation to this subject.
  2. They may be embarrassed and lack knowledge and confidence to teach this subject.
  3. Teachers may not feel the need to prioritize the subject or may not feel that teaching any subject related to SRH is appropriate and hence deliberately leave the subject out.
  4. Curriculum may be different to local traditions and beliefs.
  5. Lack of availability of teaching and learning materials.
  6. The subjects may be optional or not assessed.
  7. Teachers may already feel overwhelmed with existing curricula and hence do not want to take on additional subjects if introduced.[5]

Current Opportunities

While it can be overwhelming to assess feminine hygiene in Thai schools overall, there do exist concrete ways to support MHM friendly endeavors without a complete overhaul of the current situation. As educators, we can continue to expand our own knowledge of these topics and how they function in Thai school ecosystems. We can more fully engage our students in these difficult conversations with sexual and reproductive camps and clubs that actively work to address MHM in ways that are culturally appropriate and realistic.

We can also work to make our school environments healthier for our students. One such glaring opportunity is to pursue the access and use of hand soap in Thai school bathrooms– as stated above, the majority of Thai schools lack hygienic bathrooms and would benefit from accessible soap and hygienic practices. Starting with small, actionable projects like this can positively impact the lives of our students when the only thing they should be worrying about is schoolwork, not their period.

Appendix of Basic Terminology[6]

Menstruation/ menses The natural bodily process of releasing blood and associated matter from the uterus through the vagina as part of the menstrual cycle.
Menarche The onset of menstruation, the time when a girl has her first menstrual period.
Menstruation hygiene management (MHM) Women and adolescent girls are using a clean menstrual management material to absorb or collect menstrual blood, that can be changed in privacy as often as necessary for the duration of a menstrual period, using soap and water for washing the body as required, and having access to safe and convenient facilities to dispose of used menstrual management materials. They understand the basic facts linked to the menstrual cycle and how to manage it with dignity and without discomfort or fear.
MHM friendly/ supportive Facilities, institutions or other environments that are supportive of MHM, which allow girls and women to manage their menses hygienically, safely, in privacy and with dignity.

Click here to find a classroom activity pertaining to this topic.

[1] Human Rights Watch. Menstrual Hygiene a Human Rights Issue. August 2017.

[2] Sexual Maturation in Thai girls. Mahidol University, Bangkok. 1997.

[3] UNICEF. Review of Comprehensive Sexuality Education in Thailand. 2016.

[4] UNICEF. Advancing WASH in schools monitoring, 2015.

[5] UNICEF. MHM Realities, Progress and Opportunities. February 2016.

[6] UNICEF. Review of Comprehensive Sexuality Education in Thailand. 2016.

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