title: Sanitary pad interventions for girls' education in Ghana: a pilot study.
abstract: BACKGROUND
  Increased education of girls in developing contexts is associated with a number of important positive health, social, and economic outcomes for a community. The event of menarche tends to coincide with girls' transitions from primary to secondary education and may constitute a barrier for continued school attendance and performance. Following the MRC Framework for Complex Interventions, a pilot controlled study was conducted in Ghana to assess the role of sanitary pads in girls' education.
  
  
  METHODS
  A sample of 120 schoolgirls between the ages of 12 and 18 from four villages in Ghana participated in a non-randomized trial of sanitary pad provision with education. The trial had three levels of treatment: provision of pads with puberty education; puberty education alone; or control (no pads or education). The primary outcome was school attendance.
  
  
  RESULTS
  After 3 months, providing pads with education significantly improved attendance among participants, (lambda 0.824, F = 3.760, p<.001). After 5 months, puberty education alone improved attendance to a similar level (M = 91.26, SD = 7.82) as sites where pads were provided with puberty education (Rural M = 89.74, SD = 9.34; Periurban M = 90.54, SD = 17.37), all of which were higher than control (M = 84.48, SD = 12.39). The total improvement through pads with education intervention after 5 months was a 9% increase in attendance. After 3 months, providing pads with education significantly improved attendance among participants. The changes in attendance at the end of the trial, after 5 months, were found to be significant by site over time. With puberty education alone resulting in a similar attendance level.
  
  
  CONCLUSIONS
  This pilot study demonstrated promising results of a low-cost, rapid-return intervention for girls' education in a developing context. Given the considerable development needs of poorer countries and the potential of young women there, these results suggest that a large-scale cluster randomized trial is warranted.
  
  
  BACKGROUND
  Pan African Clinical Trials Registry PACTR201202000361337.
authors.affiliation: Centre for Evidence Based Intervention, University of Oxford, Oxford, Oxfordshire, United Kingdom. paul.montgomery@spi.ox.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Montgomery
authors.forename: Caitlin R
authors.initials: CR
authors.lastname: Ryus
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Dolan
authors.forename: Sue
authors.initials: S
authors.lastname: Dopson
authors.forename: Linda M
authors.initials: LM
authors.lastname: Scott
mesh_terms: D002648:Child; D002947:Cities / Q000706:statistics & numerical data; D004493:Education / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005843:Geography; D005869:Ghana; D006293:Health Promotion / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D006920:Hygiene; D008598:Menstruation; D010865:Pilot Projects; D011627:Puberty; D012424:Rural Population / Q000706:statistics & numerical data; D012574:Schools / Q000706:statistics & numerical data; D013997:Time Factors