Background Increased education of girls in developing contexts is associated with a number of important positive health, social, and economic outcomes for a community. The event of menarche tends to coincide with girls' transitions from primary to secondary education and may constitute a barrier for continued school attendance and performance. Following the MRC Framework for Complex Interventions, a pilot controlled study was conducted in Ghana to assess the role of sanitary pads in girls' education. Methods A sample of 120 schoolgirls between the ages of 12 and 18 from four villages in Ghana participated in a non-randomized trial of sanitary pad provision with education. The trial had three levels of treatment: provision of pads with puberty education; puberty education alone; or control (no pads or education). The primary outcome was school attendance. Results After 3 months, providing pads with education significantly improved attendance among participants, (lambda 0.824, F = 3.760, p<.001). After 5 months, puberty education alone improved attendance to a similar level (M = 91.26, SD = 7.82) as sites where pads were provided with puberty education (Rural M = 89.74, SD = 9.34; Periurban M = 90.54, SD = 17.37), all of which were higher than control (M = 84.48, SD = 12.39). The total improvement through pads with education intervention after 5 months was a 9% increase in attendance. After 3 months, providing pads with education significantly improved attendance among participants. The changes in attendance at the end of the trial, after 5 months, were found to be significant by site over time. With puberty education alone resulting in a similar attendance level. Conclusion This pilot study demonstrated promising results of a low-cost, rapid-return intervention for girls' education in a developing context. Given the considerable development needs of poorer countries and the potential of young women there, these results suggest that a large-scale cluster randomized trial is warranted. Trial Registration Pan African Clinical Trials Registry PACTR201202000361337
References
[1]
United Nations (2004) World Population Monitoring: Populations education and development. New York: United Nations.
[2]
Kirk J, Sommer M (2006) Menstruation and Body Awareness: Linking Girls' Health with Girls' Education. Available: http://www.schools.watsan.net/content/do?wnload/323/2726/. Accessed: 1 September 2010.
[3]
Mahon T, Fernandes M (2010) Menstrual Hygiene in South Asia: A Neglected I ssue for WASH (Water, Sanitation and Hygiene) Programmes. Gender & Development 18: 99–113.
[4]
Ten VTA (2007) Menstrual Hygiene: A Neglected Condition for the Achievement of Several Millennium Development Goals. Zoetermeer, The Netherlands: Europe External Policy Advisors.
[5]
Buckley T, Gottlieb A, editors (1988) Blood Magic: The Anthropology of Menstruation. Berkeley: University of California.
[6]
Burrows A, Johnson S (2005) Girls' Experiences of Menarche and Menstruation. Journal of Reproductive and Infant Psychology 23: 235–249.
[7]
Lloyd CB, Young J (2009) New Lessons: The Power of Educating Adolescent Girls. New York: Population Council.
[8]
Sommer M (2009) Where the Education System and Women's Bodies Collide: The Social and Health Impact of Girls' Experiences of Menstruation and Schooling in Tanzania. Journal of Adolescence 30: 1–9.
[9]
Dasgupta A, Sarkar M (2008) Menstrual Hygeine: How Hygienic is the Adolescent Girl? Indian Journal of Community Medicine 33: 77–80.
[10]
Plan International (2009) Because I am a Girl. Available: http://plan-international.org/about-plan?/resources/publications/campaigns/becaus?e-i-am-a-girl-girls-in-the-global-econom?y-2009. Accessed: 1 September 2009.
[11]
CARE (2010) Power Within. Available: http://www.care.org/campaigns/powerwithi?n/index.asp. Accessed: Sept 1, 2010.
[12]
Bronfenbrenner U (1979) Ecology of Human Development. Cambirdge, MA: Harvard University Press.
[13]
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, et al. (2008) Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 337.
[14]
Bollen K, Glanville J, Stecklov G (2002) Economic Status Proxies in Studies of Fertility in Developing Countries: Does the Measure Matter? Population Studies 56: 81–96.
[15]
Commonwealth Secretariat and Healthlink Worldwide (2001) Gender and Relationships: A Practical Action Kit for Young People. In: Commonwealth Secretariat and Healthlink Worldwide, editor. London.
[16]
Sen A (1999) Development as Freedom. New York.
[17]
Dolan C, Ryus C, Dopson S, Montgomery P, Scott LM Menstruation, Sanitary Pads and Educational Outcomes in Ghana. In preparation.
[18]
Des Jarlais DC, Lyles C, Crepaz N (2004) Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement. American Journal of Public Health 94: 361–366.
[19]
Alkire S (2007) The Missing Dimensions of Poverty Data: Introduction to the Special Issue. Oxford Development Studies 35: 347–359.
[20]
McGregor JA, Sumner A (2009) ‘After 2015: ’3D Human Wellbeing. In: Studies IoD, editor. Focus Policy Briefings Brighton, .