Sanitary Pad Interventions for Girls' Education in Ghana: A Pilot Study

Abstract

Background

Increased education of girls in developing contexts is associated with a number of important positive health, social, and economic outcomes for a community. The event of menarche tends to coincide with girls' transitions from primary to secondary education and may constitute a barrier for continued school attendance and performance. Following the MRC Framework for Complex Interventions, a pilot controlled study was conducted in Ghana to assess the role of sanitary pads in girls' education.

Methods

A sample of 120 schoolgirls between the ages of 12 and 18 from four villages in Ghana participated in a non-randomized trial of sanitary pad provision with education. The trial had three levels of treatment: provision of pads with puberty education; puberty education alone; or control (no pads or education). The primary outcome was school attendance.

Results

After 3 months, providing pads with education significantly improved attendance among participants, (lambda 0.824, F = 3.760, p<.001). After 5 months, puberty education alone improved attendance to a similar level (M = 91.26, SD = 7.82) as sites where pads were provided with puberty education (Rural M = 89.74, SD = 9.34; Periurban M = 90.54, SD = 17.37), all of which were higher than control (M = 84.48, SD = 12.39). The total improvement through pads with education intervention after 5 months was a 9% increase in attendance. After 3 months, providing pads with education significantly improved attendance among participants. The changes in attendance at the end of the trial, after 5 months, were found to be significant by site over time. With puberty education alone resulting in a similar attendance level.

Conclusion

This pilot study demonstrated promising results of a low-cost, rapid-return intervention for girls' education in a developing context. Given the considerable development needs of poorer countries and the potential of young women there, these results suggest that a large-scale cluster randomized trial is warranted.

Trial Registration

Pan African Clinical Trials Registry PACTR201202000361337

Citation: Montgomery P, Ryus CR, Dolan CS, Dopson S, Scott LM (2012) Sanitary Pad Interventions for Girls' Education in Ghana: A Pilot Study. PLoS ONE 7(10): e48274. doi:10.1371/journal.pone.0048274

Editor: Hamid Reza Baradaran, Tehran University of Medical Sciences, Islamic Republic of Iran.

Received: January 23, 2012; Accepted: September 21, 2012; Published: October 31, 2012

Copyright: © 2012 Montgomery et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.