female literacy rate


girls’ net enrollment rate in middle school


girls’ net enrollment rate in secondary school

Status: Active


In early 2015, Dr. Marni Sommer of Columbia University, in collaboration with Real Medicine Foundation, and with funding from Grow N Know Inc (G&K), launched a research study to explore how the onset of menstruation and puberty influences Pakistani girls’ school-going experiences, including school retention, and to develop the Pakistan Girls’ Puberty Book in line with G&K’s model of similar puberty books in low and middle-income countries, with the aim to promote young women’s health and education during pubertal transitions. This project is an adaptation of similar research methodology previously used in studies conducted in Tanzania, Ghana, Ethiopia, and Cambodia which also developed context-specific, culturally sensitive girls’ puberty books; all above studies were conducted by the same principal investigator.

Beginning in December 2016, RMF is building upon the previous, successful studies in Punjab and Balochistan (conducted in collaboration with Columbia University) by extending our research to the province of Sindh. This current study is funded by UNICEF, follows the same research methodology as our previous studies, and collects data in Sindh to ensure that the diverse social and cultural norms and practices of Pakistan are included in the Pakistan Girls’ Puberty Book.

Action Plan

Data Collection

Three approaches will be adopted in both an urban school and a rural school:

  • Ethnographic observations
  • Key informant interviews with adults
  • Participatory group activities with adolescent young women aged 10-19

Creation of a Pakistan Girls’ Puberty Book

The goal of our research is to create a culturally sensitive Pakistan Girls’ Puberty Book, which will provide adolescent girls with an understanding of menstruation, help dispel taboos and superstitions, and empower girls to continue their education after puberty.


  • Menstrual taboos and misinformation
  • Insufficient or nonexistent WASH facilities at schools
  • Danger of harassment and physical or verbal attack
  • Lack of parental support for girls’ education

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