Free Sanitary Pads—Facts That Government Does Not Talk About

The Minister of Gender Children and Social Protection has released the latest response from government to the 'unfavorable reactions by certain members of the public and Parliamentarians' about the sanitary pad scholarship component of the Secondary Education Improvement Project approved by Parliament on 3rd July, 2014.

She just as other government functionaries have done cites a research conducted in Ghana in 2008/9 to back her claims. I think it is commendable that government is rooting policy implementation in evidenced based research findings. The development is very healthy - gradually, politics of insults and name calling in Ghana is giving way to serious discussion and intellectual analysis of the ramifications of policies.

It must also be pointed out quickly that we all love the girls, they are Ghanaians, our sisters. The case therefore must not be seen that people are rather throwing mud at a policy meant to benefit girls. Indeed, the timeless statement of Dr. KwegirAggrey that 'if you educate a girl you educate a nation' is even more relevant today than before. I believe that all the argumentations for and against the free provision of sanitary pads are all being made in good faith with the sole view of helping the government to make the best use of the loan. It is in this light that I express the below views for the attention of government and the general public.

In her justification of government's decision to distribute sanitary pads free of charge to the intended girls, the Gender Children and Social Protection Minister, Mrs. Nana OyeLithur argued that research ( I believe she was referring to the study by Linda Scott Sue Dopson, Paul Montgomery, Catherine Dolan, Caitlin Ryus all of University of Oxford conducted in Ghana in 2008/9) has 'showed that the provision of free disposable pads, and education about menstruation improved school attendance among girls, and potentially improved retention'. Also, the Education Minister, Prof. Naana Jane OpokuAgyemang has made similar arguments citing the same or similar studies.

Truthfully, the study by Scott et al (2009) cited by government found that potentially, free disposable pads may lead to improved retention. However, what they cautioned governments NOT to do is exactly what the government has contracted the World Bank loan for. At page 7 of the study report, Scott et al (2009) sounded loudly that: 'We do not know whether the gains achieved would be sustained once the girls became accustomed to the pads. Therefore, it is essential that further study over a longer period of time be done before policy decisions committing substantial funding, especially from poor governments, occurs.'

The researchers had good reasons for this caution. There are rigorous evidences elsewhere indicating that 'the impact of menstruation on school attendance is extremely small" and that there is 'no impact of having access to menstrual cup [pad] on school attendance' (See Oster & Thornton, 2010). In this study the researchers noted this: 'Overall, we highlight two results. First, the attendance gap induced by menstruation is very small,at less than one day per year. Second, we are able to reject that better sanitary technology closes this small gap. We conclude that policies to address this issue are unlikely to result in schooling gains (Oster & Thornton, 2010: 3). Thus menstruation problems account for 'less than one day per year' of a girl's absence from school. Other studies have reported similar findings (see for instance Jameel, 2011:3). The implication of this is that the case of Ghana where according to the Education Minister, it is reported that school girls "consistently miss 4 to 5 days every month of the term" cannot be properly and solely attributed to menstruation problems let alone, girls or parents inability to buy pads to warrant the procurement of loans by government to supply sanitary pads to them free of charge.

Thus menstrual problem does not fully explain why girls in Ghana miss 4 to 5 days every month of the term and the study by Scott et al (2009) copiously cited by government actually made note of this observation. Scott et al argue that in Ghana there are 'other factors that conspire against [girls'] school attendance, such as the need to help with housework' (Ibid: 7). The making of free provision of sanitary pad fetish by government is actually problematic given that whilst the attribution of girls missing 4 to 5 learning days every month of a term is faulty, even if that was to be the case, hardly will the free provision of sanitary pad reverse this problem. This is so because the government's own often cited research (Scott et al, 2009) made a serious finding at page 2 that the girls they studied 'in all sites reported missing about one [learning] day a month because of menstrual cramping'. I wonder how the government's decision to provide free sanitary pads will address the excruciating menstrual cramping the school girls go through!

Again not even a single study (not even the government's often cited study - Scott et al, 2009) has decisively established that the provision of free sanitary pads actually lead to improved retention - such arguments are mostly inferences made from 'conversations and observations' as admitted in the government's-often-cited-research-document (Scott et al, 2009: 7). This is so because what actually leads to girls dropping out from school is not necessarily because of their inability to buy sanitary pads but because of other crucial factors which were all noted in the government's-often-cited-research-document, yet those factors are shockingly not mentioned. Thus there are 'a complex of other factors clearly at work' which necessarily are unrelated to menstruation. As noted in the 'government's-often-cited-research', 'as a proxy indicator for adulthood and a traditional announcement of a girl's sexual availability, menarche brings on an array of negative practices, including sexual harassment (even from teachers), withdrawal of economic support from the home, and sudden pressure to marry, to take a boyfriend (for economic reasons), or to leave the community to find work (and thus hazard the risk of falling into slavery or prostitution).' This and other reasons explain why the researchers did not urge 'especially poor governments' to roll 'policy decisions committing substantial funding' in providing free sanitary pads to school girls (Scott et al, 2009: 7). Rather in view of the nature of the problems identified, the researchers wisely counseled that 'community engagement efforts should continue to support the girls' education after menstruationand protecting menstruating girls from sexual harassment should become a policy focus' not free provision of sanitary pads. Indeed the researchers expressly cautioned that 'distributing either sanitary pads or puberty education through the schools was, at least in Ghana, entirely inappropriate because it contributes to the already high risk of in-school sexual abuse when teachers are mostly males' (Ibid).

As to why government is ignoring all these unambiguous warnings from the very Oxford Researchers whose study findings it is using as basis for the implementation of this free sanitary pad project is what is baffling!

Again, I may need to respectfully commend to the attention of the Honourable Minister of Gender Children and Social Protection, the Minister of Education and the Government that there is an updated (2012) version of their 2009 'often-cited-research' which was done by these same Oxford Researchers. In the updated study (Sanitary Pad Interventions for Girls' Education in Ghana: A Pilot Study, 2012), the researchers were even more cautious of their claims than they were with their 2009 one. In cases where they saw that the provision of free sanitary pads appeared to come with increased school attendance, they were agnostic attributing causality to freely supplied sanitary pads. This is what they stated at page 6: 'At a proximal level, the [Puberty and Menstruation Management] education component is the active ingredient' (Montgomery et al, 2012:6). The current research evidence is that girls who received ONLY Puberty and Menstrual Management Education 'produced similar results to that of Pads-with-Education [those who received Sanitary Pads and Education]'. The above evidence entirely voids the plausibility (if any) of the decision to provide free sanitary pads to improve retention.Crucially, in the course of the 2012 study, FREE UNDERWEAR AND SANITARY PADS were distributed. However, the Oxford Researchers stated that'the girls [rather] found the education component of the intervention enjoyable and helpful' (p.7). This means that government's idea to freely distribute sanitary pads is likely NOT to resonate well with girls. Government may conduct a study to determine this!

One of the issues raised against the decision is about the cost involved and long term sustainability. However, the Education Minister offers a nicely worded rebuttal: "Because I don't know about what I will eat tomorrow does not mean I will not eat today". Whilst a fair response, I but with the utmost respect find the position of the Honourable Minister quite simplistic. It is important government is reminded that what is cardinal to its decision to give scholarships and distribute sanitary pads on gratis is poverty. From the evidence available it does not seem that poverty in Ghana is going away any time soon.

Per World Bank's figures and Ghana's 2010 Population Census Report and finalized in 2012, Ghana's poverty population stands at a whopping 28.5%of the total population. Given our declining growth, poor fiscals and other economic challenges, we cannot easily wish away poverty, it is going to be with us for some time. Whether we can for instance sustainably source loans to provide let's say 12 sanitary pads to school girls every month free of charge for say 5 to 10 years is something the Education Minister's response to the long term sustainability concern does not readily address. I am mindful of the fact that Teacher Training Students' Allowances have been scrapped because of sustainability problems. That of Nursing Training Students may also be scrapped (there was a hint from government on this)!

Clearly, as discussed herein and in my earlier piece ('Will free Sanitary Pads address School Attendance by Females?'), there is no evidence that the investment in the provision of free sanitary pads (however small it may be) will yield the intended results of improving retention in school. Indeed the current evidence is that in Ghana, 'the degree to which menstruation acts as a barrier to education is more closely related to cultural dynamics'(Montgomery et al, 2012:6). As such no amount of freely distributed sanitary pads can surmount this barrier.

However, I will revise my earlier views and urge the general public to support the decision not for the reasons stated by the government. Evidence abounds that when girls use sanitary pads, they experience inter alia improved self- confidence, they become less ashamed of menstruation and less fearful of 'soiling' and spend less time on laundry and changing themselves. I believe such a situation and feeling among girls in that time of the month will make them able to for instance concentrate in class and therefore may worth the investment.

God bless our homeland Ghana.
FESTIVAL GODWIN BOATENG
An Ordinary Ghanaian
References
 Abdul Latif Jameel Poverty Action Lab, (2011) Menstruation as a Barrier to Education? - www.povertyactionlab.org

 Montgomery P, Ryus CR, Dolan CS, Dopson S, Scott LM (2012) Sanitary Pad Interventions for Girls' Education in Ghana: A Pilot Study. University of Oxford

 Oster E. & Thornton R., (2010) Menstruation, Sanitary Products and School Attendance: Evidence from a Randomized Evaluation

 Scott L., Dopson S., Montgomery P, Dolan, C. Ryus C. (2009) Impact of Providing Sanitary Pads To Poor Girls in Africa. University of Oxford