Inadequate school water and sanitation facilities in many low-income countries, including Cambodia, are problematic for pubescent girls as they reach menarche and must subsequently manage monthly menses while attending school. This comparative case study explored girls' own suggestions for improving the pubertal guidance they receive in the classroom, and for modifications of existing school water, sanitation and hygiene (WASH) facilities in order to better meet schoolgirls' menstrual hygiene management needs. Key findings included girls' recommendations for teaching methodologies that encourage questions and practical content regarding puberty and menstrual management before the onset of menarche, and WASH-specific recommendations for the increased availability of water and sanitary materials in toilet stalls and greater privacy from boys and other girls. Incorporating girls' recommendations into WASH, health and education related policy and programming in low-income countries would allow girls to comfortably and confidently manage menses within the school environment.

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