An Oxford University pilot study, published in the journal PLoS One, shows that providing free sanitary pads to teenage girls in Ghana markedly improved attendance levels at school over just three months.
More surprisingly perhaps, the attendance levels of girls who did not get free pads but had lessons on puberty also improved by the same rate over a slightly longer period of five months. The lessons included information on personal hygiene during menstruation, as well as the biological processes behind their developing bodies and pregnancy.
Researchers chose secondary schools in four different sites in Ghana – three of them in urban areas and one in a remote rural area. The study involved a total of 120 teenage girls with an average age of 15.7 years. Intervention strategies were used at three sites, but pupils received neither free sanitary pads nor puberty classes at one school (the control group).
At the two schools where the girls received both the free sanitary pads and puberty education, attendance levels rose by an average of six days per 65-day-term or by nine per cent of a girl's school year. At the school where female pupils only received classes about the process of puberty, attendance levels rose to a similar level after five months. There was no difference in attendance levels in the school where no interventions took place.
The researchers also compared attendance levels of pupils at the school in the remote, rural area with the school in the urban area when pupils at both schools were given free sanitary pads and puberty classes. They found no significant difference between them.
Interviews with the girls revealed that those with no access to sanitary pads had missed three to five school days per term, data that was also confirmed by their teachers and parents. These girls used 'found' cloth instead of pads, had limited access to soap and water to keep the cloth clean, and no private place for drying. The researchers found these were reasons for why some girls generally chose to stay away from school while they were having their periods.
Professor Paul Montgomery, from the Centre for Evidence-Based Intervention at the University of Oxford, said: 'This pilot study is the first of its type to examine how free sanitary pads and puberty education can improve the attendance levels of African schoolgirls once they reach an age when they have regular periods. Previous research in this area has been based on observation alone. Our research indicates that where there is less intervention and the girls only receive puberty classes, the positive effects take longer but produce a similar rise in attendance levels. This could be because it encourages the girls to openly discuss menstruation, a hitherto taboo subject in many African towns and villages. This approach could help to foster a more supportive school environment for girls starting their periods and it also helps the girls to manage any hygiene problems they might encounter.
'Many of the features and problems experienced by the schoolgirls in this study are common to sub-Saharan Africa and the promising results of this pilot study suggest this type of intervention might work in other countries too. The feedback we received was that the girls also found the classes exploring puberty issues enjoyable and helpful.'
Catherine Dolan, One of the team members from the Saïd Business School at the University of Oxford, said: 'This study suggests how effective a simple, low-cost intervention might be in improving the school attendance of African girls. While the study was small, the promising findings point to the need for a large-scale randomised study to test the results. We have recently received money from the ESRC-DFID joint fund to launch a substantial, randomised control trial, which will help us to explore in more depth the relationship between the provision of sanitary care and the educational attainment of schoolgirls.'
The study cites other research that shows increased schooling for girls can sharply reduce fertility rates and points out that population growth has profound implications for a country’s economic well-being, social stability and the environment.