ROBERT SIEGEL, HOST:
In poor countries across Africa and Asia, once girls reach puberty, more and more of them start missing classes. When researchers ask these girls why, many say it's because they have their period. A new study suggests some very simple things might help the girls stay in school. NPR's Nurith Aizenman reports.
NURITH AIZENMAN, BYLINE: Marni Sommer is a professor at Columbia University who was among the first social science researchers to look into the impact of menstruation on girls in poor countries. For a while, she was one of the only ones.
MARNI SOMMER: When I started doing this in 2004, it was a pretty lonely world.
AIZENMAN: But not anymore. The work that she and other pioneers have done suggested that girls are having difficulty managing their periods, and it could be affecting their education. Now research on this issue has become hot.
SOMMER: So menstruation for sure is having its moment. It's a lot more fun to be looking at this issue as this groundswell of interest has arisen.
AIZENMAN: Those early studies were generally in-depth surveys of girls, mostly across Africa. The girls reported a range of concerns about their periods.
SOMMER: Fear, shame, embarrassment, you know, impact on feelings of confidence.
AIZENMAN: In a lot of cases, they said they don't have access to products like pads and tampons, toilets at school, even basic information. It makes going to class a challenge.
SOMMER: It's like the straw that breaks the camel's back, you know? There are many things making going to school difficult, and it's one more thing.
AIZENMAN: Compared to boys, a much larger share of girls in poor countries drop out of high school. Enter Paul Montgomery, a professor at Oxford University who wanted to see what might help. He decided to test two options - bringing in a community health worker to give girls a one-time hour-and-15-minute lecture...
PAUL MONTGOMERY: We took a standardized education package that teaches girls about puberty and then, more specifically, how to handle periods when they arrive.
AIZENMAN: ...Or offering girls free menstrual pads.
MONTGOMERY: The sort that are locally made from local materials.
AIZENMAN: He and his colleagues recruited more than 1,100 girls aged 10 to 13 in rural Uganda and divided them into groups. Some got pads. Some got the education. Some got both. Some got none. Their results, just out in the journal PLOS ONE...
MONTGOMERY: I mean what we've shown here is that compared to doing nothing, we can make a substantial difference by a simple intervention.
AIZENMAN: Over roughly two years as the girls got older and started to get their periods, their attendance rates dropped across the board, but that dip was a lot lower for girls who got either the pads or the education or both. We're talking a difference of 17 percentage points.
MONTGOMERY: This is a really substantial improvement.
AIZENMAN: But Montgomery says there are a lot of caveats that point to the challenges of a study like this. So many girls drop out or transfer in that region of Uganda that the researchers ended up losing track of about 40 percent of the girls. Also, more than half of those who were left didn't end up getting their periods. They might have been younger than they seemed.
MONTGOMERY: I mean one of the difficulties is actually knowing the age of the girls where many of them don't know their own age.
AIZENMAN: Marni Sommer at Columbia says all this means we still can't conclude that programs like this will work for girls. We're going to need more studies with larger sample sizes. But she's also got mixed feelings about the whole effort to prove that helping girls with their periods boosts attendance.
SOMMER: I don't want a lot of people implementing huge projects that they evaluate and decide don't work and sort of it gets thrown out the window - the whole issue - when in fact maybe you're just asking the wrong questions.
AIZENMAN: Maybe the bigger impact is on girls' concentration in the classroom, and maybe, she says, helping girls manage their periods is worth it for its own sake. Nurith Aizenman, NPR News.
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