Menstrual Health and Worker Productivity in the Bangladeshi Garment Sector

Last registered on November 16, 2018

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Pre-Trial

Trial Information

General Information

Title

Menstrual Health and Worker Productivity in the Bangladeshi Garment Sector

RCT ID

AEARCTR-0003298

Initial registration date

October 08, 2018

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published

October 09, 2018, 1:52 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated

November 16, 2018, 9:08 AM EST

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Country

Bangladesh

Region

Dhaka Division

Primary Investigator

Name

Andreas Menzel

Affiliation

CERGE-EI

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Other Primary Investigator(s)

PI Name

Martina Miotto

PI Affiliation

University of Warwick

Contact Investigator

PI Name

Kristina Czura

PI Affiliation

LMU Munich

Contact Investigator

Additional Trial Information

Status

In development

Start date

2018-09-22

End date

2020-12-31

Keywords

Firms & Productivity, Gender, Health

Additional Keywords

MHM, Stigma, Taboo

JEL code(s)

O15 O22 J24 M52

Secondary IDs

PEDL ERG 5549

Abstract

We conduct a randomized controlled experiment in which randomly selected female workers in Bangladeshi garment factories will be given access to free menstrual health classes and free disposable menstrual pads to manage their period. Recent studies indicate that no more than 40 percent of garment workers in Bangladesh regularly use hygienic menstrual pads to manage their menstruation. We want to study the effects of this intervention on worker’s well-being, health, and productivity, and whether such an intervention would yield a positive return if financed by the factories. We furthermore want to shed light on how common health taboos, such as those still surrounding menstrual health in many countries, affect the effectiveness of health interventions in providing health information, behaviour change and health technology adoption.

External Link(s)

Registration Citation

Citation

Czura, Kristina, Andreas Menzel and Martina Miotto. 2018. "Menstrual Health and Worker Productivity in the Bangladeshi Garment Sector." AEA RCT Registry. November 16. https://doi.org/10.1257/rct.3298-2.0

Former Citation

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Experimental Details

Interventions

Intervention(s)

We are testing the effectiveness of free Menstrual health classes, and of access to free sanitary pads, in improving MHM management, worker well-being, and work absenteeism.

Intervention Start Date

2018-10-08

Intervention End Date

2019-06-30

Primary Outcomes

Primary Outcomes (end points)

Work Absenteeism (measured through factory HR records at individual worker level)
Adoption of pads (measured both through surveys, through administrative data from pad distribution, and at those factory where available, purchases from factory shop).
Self-reported well-being (surveys).
Willingness to pay for sanitary pads.
Perceived taboos around menstruation.

Primary Outcomes (explanation)

Self-reported well-being: Individual survey questions and additive index from survey questions.
Willingness to pay for sanitary pads: Through Becker -de Groot Mechanism.
Perceived taboos around menstruation: Elicited through incentivised survey questions (monetary reward of mentioning modal extend of taboo as reported by others in survey). E.g. can a women cook during her period, go to mosque, go to bazaar....

Secondary Outcomes

Secondary Outcomes (end points)

Reported difficulty of working and achieving targets during period (survey based).
Worker Turnover (measured through factory HR records at individual worker level).
Menstrual Health Care Knowledge of Workers.

Secondary Outcomes (explanation)

Menstrual Health Care Knowledge of Workers: E.g. measured through question at baseline and follow-up survey, "Should washed cloth used during menstruation be dried in the sunlight?"

Experimental Design

We implement at 2x2 Design of our two basic interventions - menstrual health classes, and access to free pads - with 1000 workers in the initial phase (250 workers in each cell).

The treatments will be assigned at the worker level, randomisation will be stratified at factory level.

Subject to funding, the project will be scaled up to 2000 workers in total.

Experimental Design Details

Phase 1: 1000 Female Workers (Sewing Operators) across 3-5 factories near Dhaka, Bangladesh
(Factories in that area typically have anything between 200 and 10,000 workers. We focus on sewing workers, which typically make up at least half of the work-force, and are usually more than 80% female).

2x2 Design: 250 workers attend one hour long MHM sessions provided by local NGO, 250 get access to free pads over 5-6 months, distributed 2 times weekly at known times at a known place in the factory, 250 get access to both, and 250 to none (control group).
Randomisation stratified at factory level.

Cross-Randomised to basic design:
- Weekly sms reminders on good MHM health to 500 workers
- Every distribution date at each factory will at 50% of days be staffed by male distribution worker, and at other 50% by female distribution worker.
- 50% of MHM sessions will stress ability of sanitary pads to better absorb liquids (blood) compared to traditional remedies (cloth, paper), reducing the danger of "embarrassing" leakage. Other 50% will remain with core-message of health benefits of using sanitary pads.

Randomization Method

At computer in office.

Randomization Unit

Individual workers

Was the treatment clustered?

Experiment Characteristics

Sample size: planned number of clusters

1000 workers (in Phase 1)
1000 workers (in Phase 2)

Sample size: planned number of observations

1000 workers (in Phase 1) 1000 workers (in Phase 2)

Sample size (or number of clusters) by treatment arms

250 workers controls, 250 workers attending MHM classes, 250 worker getting access to free pads, 250 worker getting access to both MHM classes and free pads.

Minimum detectable effect size for main outcomes (accounting for sample design and clustering)

We have good data on worker absenteeism of the same kind we plan to collect during our experiment on our sample worker. We assume that inluding the planned Phase 2 of the project (which will be largely identical to Phase 1), we will eventually have had 2000 workers in combined sample. If we assume we have on average 10 monthly absenteeism observations per worker, and use the empirical mean absenteeism rate (3.2%), its standard deviation (7.6%), and intra-worker correlation (0.23), a sample of 2000 workers will allow to detect a reduction of 18% in absenteeism with power 80%, and 21% with power 90% (two-sided tests).

Supporting Documents and Materials

IRB