In the struggle to figure out how to get more girls in poor countries in school, there are a zillion strategies. Building more schools. Offering free school lunches, or sacks of grain to families of girls with perfect attendance for a month. Iodine supplements so that fetal girls don’t suffer iodine deficiency (which seems to retard their mental development more than it does boys’). Deworming, so that kids are stronger and healthier and miss less school.  In recent years, there also have been increasing suggestions that one of the reasons girls in Africa and Asia miss school is that they have trouble managing menstruation. The idea is that they don’t have decent sanitary products and so stay home during their periods and then get further and further behind and finally drop out. It’s considered an indelicate topic and so there’s not much discussion of this — and my attempts at interviews have sometimes horrified my interpreters — but my impression is that there’s something there. I’ve heard this from a number of development organizations, and Camfed helps girls with sanitation supplies and finds it helps keep girls in school. Other groups have also been trying this strategy.  But Emily Oster, an economist at University of Chicago, pointed me to this study that casts doubt on the effectiveness of this approach. It seems to be a well-conducted, randomized study in Nepal, and it found that high school girls welcomed help (a menstrual cup, in this case). But they didn’t miss any less school during their periods, and this study suggested that the main reason they stayed away was cramps.  So what’s going on? I know a number of you readers out there have worked in development in poor countries — what do you think? Would giving out pads be a cost-effective way to get more girls in school? Is this study indicative of something strange about Nepal? One of the problems in the field of economics is that everybody wants to be the first to do a study on something, but nobody wants to do the drudgery of replicating other people’s studies — yet that’s what we need to know what’s going on. Helping girls manage menstruation is something that Sheryl and I suggest in our book, and so I’m curious whether that was just wishful thinking or whether it seems a genuinely cost-effective approach to those of you out there in the field.
Does menstruation keep girls out of school in poor countries, and can help managing their periods reduce drop-out rates.