Effect of Hygiene and Menstrual Hygiene Interventions on Learning and Psychosocial Wellbeing in Madagascar

Summary

A previous study in schools in rural Madagascar found that a bundle of hygiene-focused interventions substantially improved girls' learning outcomes. This study disentangles the effects of physical infrastructure (latrines, handwashing basins) from other intervention components (peer sensitization and free sanitary pad distribution) in a cluster-randomized trial across 140 secondary schools in the Amoron'i Mania region. The trial originally measured learning and psychosocial wellbeing outcomes and was prospectively registered with the AEA RCT Registry (AEARCTR-0014423). The study team is now also collecting secondary health biomarker outcomes (e.g., salivary cortisol and blood-based C-reactive protein) and is registering those health biomarker endpoints with ClinicalTrials.gov.

Conditions

• Urinary Tract Infections
• Malnutrition
• Inflammation
• Stress
• Menstrual Hygiene

Interventions

BEHAVIORAL

Peer leadership/sensitization + sanitary pads

Young Girl Leaders program, teacher sensitization, WASH competition, free sanitary pad vouchers

OTHER

School infrastructure

Construction of latrines and handwashing basins

Sponsors & Collaborators

• Paris School of Economics

  collaborator OTHER

• Laboratoire d'Analyses Médicales Malagasy (LA2M)

  collaborator UNKNOWN

• Consultant Associates

  collaborator UNKNOWN

• Care International

  collaborator UNKNOWN

• University of California Santa Cruz

  lead OTHER

Principal Investigators

• Audrie Lin, PhD, MPH · University of California Santa Cruz

• Karen Macours, PhD · Paris School of Economics

• Duncan Webb, PhD · Nova School of Business and Economics

• Mariachiara Iannuzzi, MS · Paris School of Economics

• Oscar M Díaz, MS · Paris School of Economics

• William Amedanou, MS · Paris School of Economics

• Juliet Ellenbach, BS · University of California Santa Cruz

• Eliane Z Ralison · Consultant Associates

• Andry M Andrianarivelo, MD · Laboratoire d'Analyses Médicales Malagasy

• Ianja I Razanadrakoto, MD · Laboratoire d'Analyses Médicales Malagasy

• Tantely J Ramontalambo, MD · Laboratoire d'Analyses Médicales Malagasy

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

FACTORIAL

Eligibility

Min Age

11 Years

Max Age

21 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-10-01

Primary Completion

2026-08-31

Completion

2026-12-31

Countries

• Madagascar

Study Locations