Reducing menstrual stigma to improve girls’ schooling outcomes in Madagascar

About 26% of the world’s population gets their period every month, yet menstruation is still widely stigmatized across the world (UNICEF, 2018). For adolescent girls living in poverty, this social stigma leads to discrimination and harassment which may have a direct negative impact on their school attendance and performance as well as on their mental health. A lack of relevant information in discussions can lead to physical risks for their reproductive health.

**In Madagascar, and more particularly in rural areas, menstruation has been identified as an obstacle to girls’ schooling. On the one hand, poor access to suitable infrastructure and menstrual products can make it difficult for girls to participate in social, educational and economic activities during menstruation. **On the other hand, the prevalence of social stigma and the resulting internalization of constraints may also limit their participation outside periods of menstruation.

To tackle the issue, the NGO CARE has designed the “Young Girl Leaders” program, which aims to identify adolescent girls ready to denounce harmful stigma and defend menstrual health in their school.

The Paris School of Economics (PSE) proposes to evaluate the “Young Girl Leaders” program in three districts of the Amoron’i Mania region, to rigorously determine whether reducing stigma and encouraging discussion of stigmatized topics can have an impact on increasing girls’ ability and willingness to attend school. In each school, 3 to 6 adolescent girls will be selected, trained, and given information on optimal menstrual practices before being encouraged to discuss menstruation in an open and positive manner with their peers.

Studies have proven the effectiveness of peers and ambassadors in changing social norms in schools (Levy Paluck et al., 2020). This new study aims to test whether this approach is effective in the presence of stigma and taboo subjects, where little prior evidence exists.

To measure the program’s effectiveness on absenteeism and dropout, the Paris School of Economics will conduct a randomized controlled trial in 140 schools (private and public, primary and secondary).

• 70 schools will receive the Young Leaders program and the baseline WASH intervention
• 35 schools will receive only the baseline WASH intervention
• 35 schools will be the control group

The “Young Girl Leaders” program aims to initiate a social norm shift that would lift the ban on talking about menstruation and remove the social stigma. The program is also expected to increase returns from WASH interventions.

The results of this evaluation will inform the design and scaling up of similar interventions in Madagascar (and beyond), so that a much broader set of schools and adolescent girls will benefit from this program.