Objectives The objectives of the study was to assess improving knowledge, attitude and practice on reproductive health in adolescent girls attending monastic school (Ba Ka schools) through interactive health education.

Methods A school-based interventional study was conducted in two monastic schools situated in Mingalardon Township, Myanmar, using quantitative questionnaires and focus group discussion (FGD) during May to December, 2018. Altogether 150 adolescent girls involved in the quantitative survey and 18 participated in the qualitative study. Improvement of knowledge, attitude and practice of adolescent girls were assessed after six health education sessions by interactive small group discussion which are conducted by trained community volunteers. Six topics regarding reproductive health were puberty changes, reproductive anatomy and physiology, DOs and DON’Ts during menstruation, nutrition, hand hygiene, STIs including HIV/AIDS.

Results Proportions of age group among study population were early adolescent 80% and mid adolescent 19% and late 1%. Majority of adolescent girls showed ignorance of puberty changes, reproductive anatomy and physiology. Misperceptions of reproductive organs, fertile period, mechanisms of menstruation were observed. A variety of menstrual beliefs, taboos, dietary and behavioural restrictions are highly prevalent among adolescents.

Among the adolescent girls in this study, knowledge, attitude and practice of proper hand washing practices, knowledge about nutrition, knowledge, perception and practice about STIs and HIV/AIDS, and knowledge about contraception were also assessed.

In comparing mean scores of reproductive health knowledge in pretest and posttest of respondents, in almost all of the topics, mean scores showed dramatic improvement in posttest with statistically significant except hand hygiene practice. Total score for reproductive health knowledge was (21.66 ± 12.308) in pretest and (63.91 ± 16.643) in posttest that was statistically significant difference (p<0.001) between before and after health education.

Getting information about reproductive health issues was limited in those adolescent girls and most of the information received were wrong. Thirty two percent of respondents did not get any reproductive health information in the past. Most of the respondents would like to obtain reproductive health information from health staff (46%), family members (34.7%) and health talk (24.7%).

Conclusions To sum up, promoting sexual and reproductive health especially among Ba Ka school students in peri-urban area of Yangon. Interventional health education programme used in this study was short course, total six hours duration to cover all important topics for adolescents that was very applicable in resource limited setting. The findings of the study with the evidence of effectiveness of health education package could also be used for advocacy purposes for reproductive health policy and youth programme to design specifically for targeted adolescent populations.

Planning, implementing and evaluating adolescent reproductive health programme are challenges for ensuring the programme to reach adolescents of various social groups. Adolescents staying in monastic schools where population mobility is high and majority comes from lower social group, call for special attention. There is a great need for development of programme and approaches to reach adolescents in monastic schools.