eBASE, effective basic services:Menstrual Hygiene Management – trial

The project

The MHM intervention consists of a range of complementary activities designed to support improved MHM practices in schools and local communities. This includes the construction or renovation of improved toilet facilities for over girls, providing access to period products and MHM educational materials to over 20,000 girls, establishing MHM clubs within schools, training teachers as MHM leaders and community engagement activities. These activities will be implemented in 40 schools and local communities within 4 education priority regions of Cameroon (East, Far North, North West and South West). 

Why are we rolling out this intervention?

The intervention has previously been piloted in 15 schools across three regions of Cameroon in 2021 – 22. The pilot study found that: 

1. The intervention showed promise in improving the attendance rates of menstruating girls. The attendance rate in participating schools showed a small increase over the course of the pilot, and the intervention was received enthusiastically by participating schools 
2. There was encouraging evidence that the intervention can be feasible to deliver on a larger scale. There were some challenges with intervention delivery during the pilot (specifically, delays and partial delivery of some components). However, the key elements of the intervention were ultimately delivered as planned, and the experiences of the pilot created valuable lessons learned to improve delivery for a future trial.
3. The intervention was ready to be scaled further and evaluated in a full trial.
4. The current trial provides an opportunity to extend the preliminary evidence obtained from the pilot and provide causal evidence on the extent to which a comprehensive MHM intervention can influence the attendance and attainment of adolescent schoolgirls as well as change attitudes and knowledge of boys, teachers and community members. 

How are we evaluating it?

The impact evaluation is designed as a two-arm cluster randomised control efficacy trial, with secondary schools as the unit of randomisation and pupils as the unit of analysis.

The trial employs setting-level randomisation because some components of the intervention (e.g., toilet construction/​renovation and teacher MHM training) cannot be restricted to a subset of students. Moreover, setting-level randomisation prevents the risk of potential spillover effects associated with individual-level randomisation within schools. A total of 20 schools in 4 regions (80 schools in total) have been recruited to participate in the trial.