IDEAS home Printed from https://ideas.repec.org/p/hal/psewpa/halshs-04590500.html

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: https://shs.hal.science/halshs-04590500v1/document
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. 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.
    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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Lucia Corno & Eliana La Ferrara & Alessandra Voena, 2025. "Female Genital Cutting and the Slave Trade," DISCE - Working Papers del Dipartimento di Economia e Finanza def138, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bennell, Paul, 2023. "The attainment of gender education equality: A preliminary assessment of country performance in sub-Saharan Africa," International Journal of Educational Development, Elsevier, vol. 98(C).
    2. Sen Chakraborty, Kritika & Villa, Kira M., 2024. "Teen parent trap? The education and labor implications of motherhood and fatherhood during the transition from adolescence to adulthood in Cebu, the Philippines," Economics & Human Biology, Elsevier, vol. 55(C).
    3. Baird, Sarah & Özler, Berk & Dell’Aira, Chiara & Parisotto, Luca & Us-Salam, Danish, 2025. "Therapy, mental health, and human capital accumulation among adolescent girls in Uganda," Journal of Development Economics, Elsevier, vol. 176(C).
    4. Langford, Rebecca & Panter-Brick, Catherine, 2013. "A health equity critique of social marketing: Where interventions have impact but insufficient reach," Social Science & Medicine, Elsevier, vol. 83(C), pages 133-141.
    5. Shan, Xiaoyue & Zölitz, Ulf, 2022. "Peers Affect Personality Development," CEPR Discussion Papers 17241, Centre for Economic Policy Research.
    6. Stephanie L. Martin & Jennifer K. Arney & Lisa M. Mueller & Edward Kumakech & Fiona Walugembe & Emmanuel Mugisha, 2013. "Using Formative Research to Design a Behavior Change Strategy to Increase the Use of Improved Cookstoves in Peri-Urban Kampala, Uganda," IJERPH, MDPI, vol. 10(12), pages 1-19, December.
    7. Mehmood, Sultan & Naseer, Shaheen & Chen, Daniel L., 2022. "Training Effective Altruism," TSE Working Papers 22-1390, Toulouse School of Economics (TSE).
    8. Aristide Houndetoungan & Cristelle Kouame & Michael Vlassopoulos, 2024. "Identifying Peer Effects in Networks with Unobserved Effort and Isolated Students," Papers 2405.06850, arXiv.org, revised Apr 2026.
    9. repec:bcp:journl:v:9:y:2025:i:11:p:4978-4990 is not listed on IDEAS
    10. Nyantakyi-Frimpong, Hanson & Colecraft, Esi K. & Awuah, Raphael Baffour & Adjorlolo, Leonard Kofi & Wilson, Mark L. & Jones, Andrew D., 2018. "Leveraging smallholder livestock production to reduce anemia: A qualitative study of three agroecological zones in Ghana," Social Science & Medicine, Elsevier, vol. 212(C), pages 191-202.
    11. Ferguson,Neil T. N. & Wolfe,Rebecca J. & Amine,Laila & Ramadi,Eric & Shahin,Lina, 2022. "Building Stability Between Host and Refugee Communities : Evidence from a TVET Program inJordan and Lebanon," Policy Research Working Paper Series 10101, The World Bank.
    12. Fujiy, Brian C. & Khanna, Gaurav & Toma, Hiroshi, 2025. "Cultural proximity and inter-firm trade," European Economic Review, Elsevier, vol. 179(C).
    13. Cortina Toro,Magdalena & Jimenez,Juan Miguel & Rozo Villarraga,Sandra Viviana, 2024. "Little Nomads : Economic and Social Impacts of Migration on Children," Policy Research Working Paper Series 10686, The World Bank.
    14. B. Haßler, 2022. "Reaching SDG4 By 2030: characteristics of interventions that can accelerate progress in the lowest-income countries," DECISION: Official Journal of the Indian Institute of Management Calcutta, Springer;Indian Institute of Management Calcutta, vol. 49(2), pages 189-194, June.
    15. Natalia Montinari & Matteo Ploner & Veronica Rattini, 2025. "Identity and Cooperation in Multicultural Societies: An Experimental Investigation," Papers 2507.02511, arXiv.org, revised Jan 2026.
    16. Catia Batista & Lara Bohnet & Jules Gazeaud & Julia Seither, 2025. "From destination to origin: experimental evidence on the international spillovers of migrant integration," Nova SBE Working Paper Series wp2503, Universidade Nova de Lisboa, Nova School of Business and Economics.
    17. Chaudhary, Latika & Dupraz, Yannick & Fenske, James, 2025. "A Century of Language Barriers to Migration in India," The Warwick Economics Research Paper Series (TWERPS) 1580, University of Warwick, Department of Economics.
    18. Evans David K. & Akmal Maryam & Jakiela Pamela, 2021. "Gender gaps in education: The long view," IZA Journal of Development and Migration, Sciendo & Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 12(1), pages 1-27, January.
    19. Simon Briole & Marc Gurgand & Éric Maurin & Sandra McNally & Jenifer Ruiz-Valenzuela & Daniel Santín, 2025. "The Making of Civic Virtues: A School-Based Experiment in Three Countries," American Economic Journal: Economic Policy, American Economic Association, vol. 17(3), pages 496-521, August.
    20. Freddi, Eleonora & Potters, Jan & Suetens, Sigrid, 2024. "The effect of brief cooperative contact with ethnic minorities on discrimination," Journal of Economic Behavior & Organization, Elsevier, vol. 222(C), pages 64-76.
    21. Damm, Anna Piil & Mattana, Elena & Nielsen, Helena Skyt & Rouland, Benedicte, 2021. "Academic achievement and wellbeing of dual language learners: Evidence from a busing program," Journal of Urban Economics, Elsevier, vol. 126(C).

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hal:psewpa:halshs-04590500. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: CCSD (email available below). General contact details of provider: https://hal.archives-ouvertes.fr/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.