Menstrual Stigma and Girls’ Outcomes: An RCT Intervention among Schoolgirls in Nigeria

Working with a local non-profit organsation known as Girls Count Initiative we provide participants in the study with varying exposure to free pad distribution & information, anti-stigma training, and belief correction. We analyse the effects of these intervention on
girls' well-being, menstrual-related behaviour, and academic outcomes.

In collaboration with Girls Count Initiative – a women-focused, registered non-profit organization in Nigeria – we plan to implement a randomised menstrual health intervention (RCT) targeting 880 girls across 60 schools in Ibadan, Nigeria. The pool of schools comprises of both mixed and single sex public schools located in two urban and three peri-urban local government areas of Ibadan, Oyo state. In mixed schools, all interventions / data collections will take place exclusively for girls only. The experiment comprises the following three treatment groups and one control group:

Treatment 1 (T1 Base): Taking place across 15 schools, this treatment will offer free disposable pads and MHM information. The sanitary pads comprise up to three packs of sanitary pads for personal use that will last for up to three months. The MHM information intervention entails a 30 to 40-minute training on menstrual health and hygiene. This training explains the concept of menstruation to girls and teaches them how to manage blood flow and keep themselves clean and healthy during menstruation. We anticipate that these interventions will lift the (short-run) budget and knowledge constraints facing girls during menstruation. This treatment overcomes the budgetary and informational constraints.

Treatment 2 (T2 Base plus anti-stigma): This group comprises 15 schools; participants will be offered free disposable pads, MHM information (like in T1) plus an additional anti-stigma training. The anti-stigma training is a facilitator-led workshop that identifies the local and cultural roots of period stigma in the immediate environment where the participants are situated. The anti-stigma training is a 30 to 40 minutes facilitator-led and interactive workshop that allows girls to talk about the local and cultural roots, causes, and consequences of menstrual stigma. It encourages girls to be vulnerable and to open up on their challenges and experiences during menstruation. The instructor is trained to provide a listening ear to each participant and is encouraged to share her own experiences navigating through menstruation when they were younger. All facilitators are specifically trained by a local youth counselling psychologist. All facilitators (trainers) are women who are fluent in English and the local language(s). We expect that the anti-stigma training will address internal menstrual-related stigma and fear. This treatment overcomes the budgetary and informational constraints as well as psychosocial constraints emerging from self-restraint.

Treatment 3 (T3 Base plus anti-stigma plus norm correction): Taking place across 15 schools, participants will be offered free disposable pads, MHM information, anti-stigma training (like in T2) plus a norm correction. The norm correction aims at confronting girls’ personal attitudes and second-order beliefs (descriptive norms among their peers) during the data collection in t2 with the true level of attitudes measured in t1. During the interview process of t2 we reveal to girls the true fraction of their peers that endorse open communication on menstruation and other possible behaviours during menstruation, before we ask again about their personal attitudes and behaviours. Hence, we test whether the correction of possibly misperceived public norms will significantly address attitudes regarding menstruation and stigma any differently than in the treatment arm T2. This treatment overcomes the budgetary, informational and psychosocial constraints, and correct possibly misperceived social norms. Therefore, T3 aims at addressing both self-restraint and publicity avoidance.
Control: offers free sanitary kits at the end of the study.

2025-02-11

2025-02-26

Menstrual Stigma, subjective wellbeign, personal beliefs, social norms, pad adoption, speaking to others, Willingness to speak, private demand for information, public demand for information, giving,avoidance behaviour, school attendance, Academic performance measured by cognition tests, maths and english tests)

see PAP

Knowledge of Menstrual health, career aspiration, academic aspiration, and learning effort (teacher ratings of students commitment to classroom learning)

see PAP

The study targets 880 school girls across 60 schools in Ibadan, Nigeria. We aim to carefully disentangle the separate effects on a wide range of outcomes: behavioural outcomes and wellbeing, as well as academic outcomes . The randomized intervention comprises three treatment arms and a control:

Treatment 1: Base: offers free disposable pads, and MHM information
Treatment 2: Base plus anti-stigma: offers free disposable pads, MHM information plus an anti-stigma training
Treatment 3: Base plus anti-stigma plus norms: offers free disposable pads, MHM information, an anti-stigma training plus a norm correction
Control: offers free sanitary kits at the end of the study (delayed treatment).
The longitudinal RCT contains three waves of data collection at the individual schoolgirl level: t0 is the baseline, t1 is measured shortly after the intervention, t2 is measured 2-4 months after the intervention.

In collaboration with Girls Count Initiative – a women-focused, registered non-profit organization in Nigeria – we plan to implement a randomised menstrual health intervention (RCT) targeting 880 girls across 60 schools in Ibadan, Nigeria. The pool of schools comprises of both mixed and single sex public schools located in two urban and three peri-urban local government areas of Ibadan, Oyo state. In mixed schools, all interventions / data collections will take place exclusively for girls only. The experiment comprises the following three treatment groups and one control group:

Treatment 1 (T1 Base): Taking place across 15 schools, this treatment will offer free disposable pads and MHM information. The sanitary pads comprise up to three packs of sanitary pads for personal use that will last for up to three months. The MHM information intervention entails a 30 to 40-minute training on menstrual health and hygiene. This training explains the concept of menstruation to girls and teaches them how to manage blood flow and keep themselves clean and healthy during menstruation. We anticipate that these interventions will lift the (short-run) budget and knowledge constraints facing girls during menstruation. This treatment overcomes the budgetary and informational constraints.

Treatment 2 (T2 Base plus anti-stigma): This group comprises 15 schools; participants will be offered free disposable pads, MHM information (like in T1) plus an additional anti-stigma training. The anti-stigma training is a facilitator-led workshop that identifies the local and cultural roots of period stigma in the immediate environment where the participants are situated. The anti-stigma training is a 30 to 40 minutes facilitator-led and interactive workshop that allows girls to talk about the local and cultural roots, causes, and consequences of menstrual stigma. It encourages girls to be vulnerable and to open up on their challenges and experiences during menstruation. The instructor is trained to provide a listening ear to each participant and is encouraged to share her own experiences navigating through menstruation when they were younger. All facilitators are specifically trained by a local youth counselling psychologist. All facilitators (trainers) are women who are fluent in English and the local language(s). We expect that the anti-stigma training will address internal menstrual-related stigma and fear. This treatment overcomes the budgetary and informational constraints as well as psychosocial constraints emerging from self-restraint.

Treatment 3 (T3 Base plus anti-stigma plus norm correction): Taking place across 15 schools, participants will be offered free disposable pads, MHM information, anti-stigma training (like in T2) plus a norm correction. The norm correction aims at confronting girls’ personal attitudes and second-order beliefs (descriptive norms among their peers) during the data collection in t2 with the true level of attitudes measured in t1. During the interview process of t2 we reveal to girls the true fraction of their peers that endorse open communication on menstruation and other possible behaviours during menstruation, before we ask again about their personal attitudes and behaviours. Hence, we test whether the correction of possibly misperceived public norms will significantly address attitudes regarding menstruation and stigma any differently than in the treatment arm T2. This treatment overcomes the budgetary, informational and psychosocial constraints, and correct possibly misperceived social norms. Therefore, T3 aims at addressing both self-restraint and publicity avoidance.
Control: offers free sanitary kits at the end of the study.

systematic random sampling

Randomization is at school level

Yes

60 schools

The sample comprises of 14 girls in some schools and 15 in others reaching a total of 880 participants

15 schools in Treatment 1: Base: offers free disposable pads, and MHM information
15 schools in Treatment 2: Base plus anti-stigma: offers free disposable pads, MHM information plus an anti-stigma training
15 schools in Treatment 3: Base plus anti-stigma plus norms: offers free disposable pads, MHM information, an anti-stigma training plus a norm correction
15 schools in the Control group: offers free sanitary kits at the end of the study (delayed treatment).