Girls’ poor ability to manage menstrual health (MH) imposes barriers to education and general wellbeing in developing countries. This paper presents the results of 2-year cluster randomized controlled trial on the impact of multipronged intervention facilitating MH in Bangladesh: the Ritu trial. We randomized 149 schools from one rural district, into three groups; i) receiving a school program (sanitation facilities, teacher trainings and MH module for school curriculum); ii) a school program and a household program (parental education and MH visual booklet); iii) a control group. The primary beneficiaries are schoolgirls in grades 6 until 8, age 11-15. The program ran for 2 years, and we measured medium term impacts on school attendance as our primary and a set of socio-psychological outcomes as our secondary outcomes. We used three sources of school attendance data: information from administrative records; self-reported survey data and observational data from someone from the research team appearing on randomly selected dates at the school recording attendance.
We find significant treatment effects in both treatment arms. The Ritu trial significantly reduced school absence rates and reduced the likelihood of dropping out of school before grade 8. The program also improved subjective wellbeing during menses, but this did not translate into an improvement of general wellbeing or mental health. We find little evidence that the additional household program generated larger effects than the school program alone – which is important for programming purposes given the substantial additional costs of the household intervention. Even though MH programs are becoming more popular, there is limited supporting evidence for having such programs in place. We are the first to show significant results of an MH program on school absence rates and other secondary outcomes, using a rigorous randomized approach.