Menstrual stigma, hygiene, and human capital: experimental evidence from Madagascar

Menstrual stigma is pervasive in low- and middle-income countries, yet we know little about its consequences for girls’ human capital. In a field experiment in 140 schools in Madagascar (N=2,256), we evaluate a school hygiene program focused on reducing menstrual stigma through sanitation infrastructure, menstrual products, and teacher- and peer-led sensitization. The program generates substantial learning gains (0.15 SD) without improving attendance or health. The learning gains are instead explained by psychosocial mechanisms: reduced stigma, lower stress measured by heart rate, and a better school social climate. Our results suggest that menstruation can be a meaningful barrier to girls’ learning.