Menstrual hygiene and school absenteeism among Gambian schools: Preparatory phase for a RCT.

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Poor menstrual hygiene management among adolescent girls have been associated with school absenteeism and other health outcomes. Globally girls around the world have developed their own personal strategies to cope with menstruation. These vary greatly from country to country, individual's personal preferences, available resources, local traditions and cultural beliefs and knowledge or education. Some of the menstrual practices have been associated with different health outcomes (Bacterial vaginosis and urogenital infections)(9). Across the globe menstruation and its management also have important social and cultural implications which may in turn impact girl's lives. Absence from school, has been of particular interest to International organisations and research bodies working in this area such a WaterAid, the Water Research Commission and Plan International. These organizations report that in their experience girls' absence from school during menstruation can have both physical and psychological causes. A literature review we conducted in 2013 found there was good evidence that educational interventions can improve menstrual hygiene practices and reduce social restrictions but there was no quantitative evidence that improvements in menstrual knowledge and management methods reduce school absenteeism and urogenital infections. This work will contribute to increase the knowledge on the effectiveness of potentially scalable interventions to improve menstrual hygiene management, school attendance of Gambian schoolgirls and reduce urogenital infections.