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Menstrual Stigma, Hygiene, and Human Capital: Experimental Evidence from Madagascar

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  • Karen Macours

    (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École nationale des ponts et chaussées - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École nationale des ponts et chaussées - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

  • Julieta Vera Rueda

    (UCL - University College London [UCL])

  • Duncan Webb

    (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École nationale des ponts et chaussées - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École nationale des ponts et chaussées - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

Abstract

This paper presents results from an RCT in 140 schools in Madagascar that targets both hygiene practices and menstrual stigma. First, we show that a bundle of interventions (sanitation infrastructure, menstrual products, and teacher sensitization) leads to substantial (0.15 SD) improvements in learning tests and school marks, without affecting attendance or health. These learning benefits appear to be driven by reduced stress and an improved psychosocial environment in treatment schools, where girls' heart rate at endline is lower (-0.12 SD), severe bullying is less common (-0.08 SD), and a measure of network integration is higher (+0.24 SD). Second, we evaluate the additional effect of nominating and coaching "young girl leaders" - school girls willing to speak out against menstrual stigma - to spread positive messages about hygiene and menstruation. The combined program generates substantial improvements in hygiene knowledge and behavior (0.33-0.56 SD) and in menstrual stigma (0.74 SD), and the Young Girl Leader component significantly increases the impact on all of these dimensions.

Suggested Citation

  • Karen Macours & Julieta Vera Rueda & Duncan Webb, 2024. "Menstrual Stigma, Hygiene, and Human Capital: Experimental Evidence from Madagascar," PSE Working Papers halshs-04590500, HAL.
    • Handle: RePEc:hal:psewpa:halshs-04590500
    Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-04590500v1
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    References listed on IDEAS

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    1. Aboud, Frances E. & Singla, Daisy R., 2012. "Challenges to changing health behaviours in developing countries: A critical overview," Social Science & Medicine, Elsevier, vol. 75(4), pages 589-594.
    2. Katy Bergstrom & Berk Özler, 2023. "Improving the Well-Being of Adolescent Girls in Developing Countries," The World Bank Research Observer, World Bank, vol. 38(2), pages 179-212.
    3. David K Evans & Fei Yuan, 2022. "What We Learn about Girls’ Education from Interventions That Do Not Focus on Girls," The World Bank Economic Review, World Bank, vol. 36(1), pages 244-267.
    4. Sule Alan & Ceren Baysan & Mert Gumren & Elif Kubilay, 2021. "Building Social Cohesion in Ethnically Mixed Schools: An Intervention on Perspective Taking," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(4), pages 2147-2194.
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