15 May 2018
Research by Dr Catherine Dolan, Reader in Anthropology at SOAS University of London has found that better sanitary care and reproductive health education for poor schoolgirls, delivered over two years, improved attendance at school. On average, girls increased their attendance by 17 per cent, which equates to 3.4 days out of every 20 days.
The ESRC-DFID funded project ‘Menstruation and the Cycle of Poverty: does the provision of sanitary pads improve the attendance and educational outcomes of girls in school?’ built on a small pilot study in Ghana which found a relationship between menarche, sanitary provisions, reproductive health and girls' educational outcomes.. The pilot was scaled up in Uganda to identify the effects of puberty education and sanitary pads on school attendance—and to determine how the absenteeism and anxiety that goes otherwise unchecked results in poor performance, discouragement, and drop out. Dr Dolan led the randomised control trial in partnership with Plan International Uganda across eight schools, involving 1,008 girls, in Uganda’s Kamuli District, an area observed as having low learning levels and gender disparity in health and education.
Image credit: Jim Hecimovitch
The project tested whether school attendance improved when girls were given either reusable sanitary pads, adolescent reproductive health education, neither, or a combination of both. The research significantly strengthened awareness that sanitary pad provision and puberty education are both vital in improving attendance. The research recommended that even in the absence of resources to provide sanitary pads, the inclusion of adequate and gender-sensitive puberty education in the school curriculum can improve attendance. Importantly, the study also showed that psychosocial wellbeing, dignity, comfort, and ability to manage menstruation without shame are all essential for girls responding to the challenges presented by menstruation in low-income contexts.
The research team continues to use the results as part of a push to promote female hygiene onto the global development agenda. Ghana’s Deputy Minister of Education referenced the research when defending the decision to allocate part of the country’s 2014 World Bank loan to providing sanitary pads for female students in need. The findings also featured in preparatory documents for the World Health Organization (WHO)/UNICEF Joint Monitoring Programme indicators for menstrual hygiene management, and have been cited in the UNESCO Puberty Education & Menstrual Hygiene Management report, which aims to promote sexuality education as part of skills-based health education for young people. Organisations such as UNICEF and the NGO CARE have also used the evidence to identify solutions to barriers to girls’ schooling associated with puberty.
The project collaborated with Save the Children, UNESCO, WaterAid, and AFRIpads to lobby for menstrual hygiene management to be included as an indicator in post-2015 sustainability goals. The project was funded by ESRC-DFID’s Joint Fund for Poverty Alleviation Research and composed of a team led by Dr Dolan with Paul Montgomery, University of Birmingham and Linda Scott, Chatham House, with the assistance of Julie Hennegan, Johns Hopkins University, Maryalice Wu, University of Illinois, and Laurel Steinfield, Bentley University.