As the story goes, young women are missing up to one-fifth of their education because they lack access to modern sanitary products. Often left with soaked-through reusable pads, limited or no access to running water, or no menstrual hygiene management (MHM) resources at all, these girls face the difficult choice of braving school with stained clothing, using unhygienic and uncomfortable rags, or staying at home. This situation—further exacerbated in some contexts by cultural and religious taboos related to menstruation—is thought to lead to higher absenteeism, course failure, and, ultimately, dropout rates for young women in the developing world. In fact, some NGOs like Femme International have argued that periods are the “number one reason that girls miss school.”[1] Given that educational outcomes are tied to a wide variety of other indicators of social and economic progress, the effect of these estimates on development outcomes could be enormous if they are true.
As well-intentioned corporate philanthropists and nongovernmental organizations are wont to do, the release of these claims resulted in an outpouring of funds dedicated to financing eco-friendly sanitary products and providing MHM education to girls in the developing world. Campaigns such as the Procter & Gamble “Protecting Futures” program and commitments from prominent NGOs and the Clinton Global Initiative developed in earnest.[2] After all, the solution seemed so simple: if gender-based educational disparities are rooted in the fact that girls merely don’t have access to the proper MHM resources, then their provision could hypothetically be the silver bullet solution.
To gauge whether the anecdotal evidence regarding female absenteeism was supported by investigative scrutiny, J-PAL affiliates designed an impact evaluation that distributed reusable menstrual cups to girls in the seventh and eighth grades in Chitwan, Nepal. The evaluation was designed to test whether menstruation indeed served as a barrier to female education, and whether the provision of modern sanitary products would increase attendance and school performance among girls.[4]
The results of the study indicated that the menstrual cup intervention did not have its intended impact: researchers found that girls only missed half a day of school per year, on average, due to their periods. While the intervention had some positive impacts—the girls in the treatment group overwhelmingly chose to use the cup and continued to do so over time—it was not shown to reduce the small amount of school missed due to menstruation, nor was it associated with an increase in test scores. Moreover, 44% of girls in the study reported that while the cup did help manage menstrual blood, they typically missed school because of the cramps they got while on their periods—not necessarily because of stains or embarrassment.[5] As the researchers concluded, “the underlying causes of low school attendance for girls are complex, and … the relatively easy solution of providing sanitary products may not result in the educational gains policymakers had hoped for.”[6]
Social issues related to gender equity and female inclusion are complex and, unfortunately, are unlikely to be solved with a one-size-fits-all solution. This debate demonstrates that while social scientific evaluations like RCTs are undoubtedly useful, it is important to question their external validity: data certainly matters, but culture matters, too.
Sydney Taylor is a Master’s candidate in Global Policy Studies at the LBJ School of Public Affairs at The University of Texas at Austin.
[2] Claudia H. Deutsch, “A Not-So-Simple Plan to Keep African Girls in School,” The New York Times, Nov. 12, 2007, http://www.nytimes.com/2007/11/12/giving/12GIRLS.html.
[3] Ibid.
[4] “Menstruation as a Barrier to Education?” Abdul Latif Jameel Poverty Action Lab, June 2011, https://www.povertyactionlab.org/sites/default/files/publications/Menstruation%20as%20a%20barrier%20to%20education.pdf.
[5] “Menstruation and Education in Nepal,” Abdul Latif Jameel Poverty Action Lab, 2011, https://www.povertyactionlab.org/evaluation/menstruation-and-education-nepal.
[6] “Menstruation as a Barrier to Education?” op. cit.
[7] Deutsch, op. cit.