September 20, 2021—An exciting, new study from the Population Council’s Kenya office and Girl Innovation, Research, and Learning (GIRL) Center tested the assumption that sanitary pads would improve girls’ education outcomes and ultimately found that distribution of sanitary pads did not in fact impact school attendance, performance, or the transition to secondary school, contrary to popular belief.
However, the adolescent health education curriculum component of the intervention did indeed improve attitudes regarding reproductive health, demonstrating increased pride and comfort about menstruation, as well as enhanced knowledge of reproductive health, endorsement of equitable gender norms, and general self-confidence.
This study, published in Reproductive Health, is a central example of how critical it is to test assumptions around barriers to education and to base programs and investments in rigorous evidence rather than intuition. While adolescent girls face myriad challenges in school attendance and completion, as well as sexual and reproductive health, menstruation is often seen by girls as shameful, and a lack of sanitary products to manage menstruation was assumed to be a complicating factor in their access to and achievements in education.
However, this cluster randomized controlled trial evaluated the impact of the Nia Project —a program, led by ZanaAfrica, that provides girls with sanitary pads and adolescent health education—with nearly 3500 girls in 140 primary schools within the rural county of Kilifi in Kenya, finding that neither sanitary pad distribution nor reproductive health education, on their own or together, were sufficient to improve primary school attendance.
The authors, including the Council’s GIRL Center Director Karen Austrian, Senior Program Officer Beth Kangwana, and former Associate Eunice Muthengi, along with Erica Soler-Hampejsek, an independent consultant, assert, “The study results underscore the benefits of tackling challenges around menstrual health via comprehensive sexuality education programs that not only address access to menstrual products, but also tackle stigma and shame associated with menstruation, inequitable gender norms, and sexual and reproductive health knowledge gaps. The findings additionally serve as a powerful reminder that we must continue to use evidence, rather than assumptions, to determine the best programs and policies to address barriers to education for girls worldwide. Anything else is a disservice to girls.”
The authors add, “Regardless of whether sanitary pads or adolescent health education translate into improved attendance at school, it is a basic right that girls have can manage their menstruation safely and with dignity and have access to adequate sexual and reproductive health information.”
Read the study in Reproductive Health, and learn more about the Evidence for Gender and Education Resource (EGER), a freely available resource containing essential evidence and evaluations of programming in global education to help identify what interventions work for which outcomes and where research gaps remain.