New study shows sanitary protection for girls in developing countries may provide a route to raising their educational standards

A new study into the impact of the provision of sanitary pads for girls in developing countries shows significant educational and social benefits.

The education of girls is a primary focus of development efforts in poor countries because female achievement, especially at the secondary level, is believed to have long-lasting and far-reaching economic effects. Complex multiple factors work against girls' education in developing countries, including entrenched beliefs and practices that devalue female education. However, one simple contributing factor has recently been suspected of having an impact on girls' remaining in school: poor girls often have no access to sanitary products and, as a result of feared embarrassment, attend irregularly, perform poorly, and then drop out.

Professor Linda Scott of Saïd Business School is leading a research project in Ghana to investigate whether the provision of sanitary products in developing countries may offer a faster, more direct, and less expensive means of raising school attendance and academic performance among girls than is seen from the more common community engagement programmes aimed at retaining girls in school. Though the international aid community has speculated on the potentially positive effects of providing sanitary care materials, this study, conducted by Scott with colleagues Catherine Dolan, Sue Dopson, and Paul Montgomery, is the first empirical research ever to investigate the question.

The study had two parts: an in-depth qualitative investigation of the circumstances surrounding schoolgirls' menstruation in poor districts, and a quantitative pilot trial of pads and puberty education provision. The first phase indicated that post-pubescent girls were missing school as many as five days each month due to inadequate menstrual care. Other activities such as work, chores and playing with other children are also restricted. In rural locations the impact of menstruation upon the girls was particularly noticeable where there were no, or inadequate, toilet or washing facilities, no privacy, and the girls had walks of 2 hours or more to attend school.

The second phase tested a combination of sanitary pads provision and an education module about menstruation and hygiene. After six months, the girls in the treatment groups where pads were provided missed significantly less school than before the test. On average, the rate of absenteeism was cut by slightly more than half, from about 21% of school days to about 9% of school days. In the village where education only was provided, there was also a reduction in absenteeism, but the effect was delayed. “Further work is needed to determine the long-term relationship between information, pads provision, and school performance,” observed Scott, who added that a larger study was in planning.

The girls also reported an improved ability to concentrate in school, higher confidence levels, and increased participation in a range of everyday activities while menstruating. Negative experiences relating to soiling and embarrassment declined, as did feelings of shame and isolation, and measures of well-being improved.

“These improvements in girl's self-esteem are particularly important,” said Dolan. “A positive self-image will not only provide girls with a more rewarding and effective experience of school but will help them to participate fully in their families, communities and societies.”

Dr Paul Montgomery, Reader in Psycho-Social Intervention agrees: “The potential impact of this study for the life chances of these girls is profound, as it is already well known that it is women who are main players in driving economic development in many parts of Africa.”

"While it is important to recognise that the provision of sanitary protection is important, the study also revealed the value of puberty education particularly concerning menstruation and hygiene. While we think that this education may not to be sufficient in itself, it is essential that it be provided."

The study points to a number of important issues for policy makers and NGOs in developing countries, not least how to fund and implement a programme of sanitary product provision, and how to dispose of the pads with minimal environmental impact particularly in rural areas. Yet the benefits appear such that further research is warranted.

The study clearly shows that sanitary pad provision may have significance for female education in the developing world, but the researchers draw attention to other factors at work. They observe that the onset of menstruation itself puts the girls at educational risk, bringing an array of negative practices, including sexual harassment (especially from teachers, who, in such areas, are mostly young males), withdrawal of economic support from home, sudden pressure to marry or to leave the community to find work.

Noting that the girls themselves consistently express a strong desire to finish their education, Scott observes that, “To overcome community beliefs about the unimportance of educating girls will take at least a generation of intense effort on the part of NGOs and governments, but the simple intervention of educating the girl about her period and providing her with a reliable, clean, and private way to manage it, could have a dramatic impact on female educational achievement within only a few years.” Scott points further to the accumulating evidence showing that higher female education levels have a rapid impact on a number of key, measurable indicators that positively affect the society, the economy, the health, and the environment in poor nations. “If we can keep even a percentage of these girls in school only another year or two, it could pay off enormously, in terms of the effect on fertility rates, child mortality, disease transmission, and other matters of urgent concern,” she says.

The study has been supported by CARE International, FURDEV of Ghana, Plan International, Afrikids, and CENSUDI of Ghana, as well as by the Ghanaian national Ministries of Education and Health. In addition, local health and education authorities, especially the Girls' Education and School Health Coordinators provided ground support. Procter & Gamble provided some sanitary pads for the study, as well as background information on the consumer market in Ghana. The study was funded by the John Fell Oxford University Press Fund and Green Templeton College, Oxford.

For further details of the research or to speak with Professor Linda Scott, please contact the press office at Saïd Business School, University of Oxford:

Clare Fisher, Head of PR, Saïd Business School
Mobile: +44 (0) 7912 771090, direct telephone: +44 (0) 1865 422713, Email: [email protected]

Josie Powell, Public Relations Coordinator
Direct telephone: +44 (0) 1865 422573, Email: [email protected] or [email protected]