NOVAFRICA Working Paper: Menstrual Stigma, Hygiene, and Human Capital: Experimental Evidence from Madagascar
New research examines how menstrual hygiene interventions can improve girls’ learning outcomes in rural Madagascar. Evidence from a field experiment shows that the programme increased learning, with the gains linked to reduced menstrual stigma, lower stress, and a more supportive school environment.
“Menstrual Stigma, Hygiene, and Human Capital: Experimental Evidence from Madagascar”
Karen Macours – Paris School of Economics, and INRAE
Julieta Vera Rueda – Paris School of Economics
Duncan Webb – Nova School of Business and Economics, and NOVAFRICA
Abstract
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.
