The study will evaluate the effectiveness of the JFL program for reducing stigma and adolescent absenteeism.
The sample includes 140 schools in 3 rural districts in Madagascar. Randomization is at the school level, stratifying by (i) whether the school has functional infrastructure providing access to water at baseline; (ii) whether the school is primary or secondary; and (iii) the number of girls in the school aged 12 or greater. The treatment arms are:
(1) JFL (structured sessions) + Base Treatment (35 schools): receive the JFL program where JFLs are trained, and run structured classroom sessions about menstrual hygiene and WASH, plus the “base treatment” (described below).
(2) JFL (organic) + Base Treatment (35 schools): receive the JFL program where JFLs are trained, and are encouraged to have informal conversations with their peers about menstrual hygiene and WASH, plus the “base treatment”.
(3) Base treatment (35 schools). Only receive base treatment before endline, and receive JFL program after endline data collection.
(4) Control (35 schools). Receive no interventions.
The “base treatment”, delivered to groups (1), (2) and (3), includes (i) the construction of WASH infrastructure at schools, (ii) a voucher system providing access to reusable menstrual pads from local providers, (iii) the creation of “WASH committees” at the school level involving students and parents, and (iv) teacher training on WASH subjects.
There will also be district-wide interventions targeting girls and parents of all schools (treatment and control), including (i) a local newspaper encouraging positive WASH behaviors, (ii) training of local seamstresses to make menstrual pads, (iii) community-level celebrations of WASH-related world days.
In addition to primary data collection through baseline, midline and endline surveys, we will carry out unannounced spot-checks in schools during the first and second academic year of the program, with 5 spot checks per school, and 1 school-level survey at endline. These spot-checks will involve a roll-call in classrooms carried out by enumerators to provide a reliable measure of absenteeism at the school and individual level. The main primary data collection are a baseline (July-September 2021), midline (after 1 year) and endline (early 2023), using surveys of the teenage girls attending the targeted schools at baseline, as well as their parents.