A Ghanaian researcher is confronting menstrual stigma and poverty by developing evidence-based tools and policies to keep girls in school.

For years, menstruation in Ghanaian schools lived in the shadows—an untouchable subject that quietly derailed the education of countless girls. Classrooms lacked privacy. Toilets were inadequate or nonexistent. Teachers and students alike absorbed the message that the topic was shameful. The result was predictable: month after month, girls stayed home, surrendering precious days of learning to a problem no one wanted to name.

The pattern is as stark as it is solvable. In many schools, girls face a trifecta of barriers: stigma that silences, infrastructure that fails, and a marketplace that prices sanitary pads out of reach. When menstruation arrives, some students simply disappear from class. They fear ridicule if their clothes are stained. They worry about managing heavy bleeding without privacy. They endure pain with little support. And so they stay home—again and again—until the gaps in attendance accumulate into gaps in achievement.

Enter Mubarick Nungbaso Asumah, a Ghanaian nurse based in the United States and a PhD student at the University of Michigan studying maternal health and gender-based violence. Determined to replace euphemism with evidence, he went to schools and asked the unasked questions.

One survey reached 338 young women between the ages of 15 and 19. Roughly one in five reported missing school during their period. When asked why, they pointed to menstrual pain, fear of stained clothes, heavy bleeding, and self-stigmatization. Nearly all used some absorbent material; a vast majority used sanitary pads, others used cloth, and tissues. The conclusion was blunt: “Menstruation-related school absenteeism is considered high and could affect girls’ educational attainment,” the study found, urging the Ghana Education Service to treat the issue as a priority, particularly in public schools.

The problem, of course, is not uniquely Ghanaian. UNESCO estimates that in Kenya alone, about half of school-age girls lack access to sanitary pads. And globally, menstruation is a monthly reality for the 52 percent of women and girls of reproductive age—roughly 26 percent of the world’s population—who still confront taboos that make basic menstrual hygiene management hard to secure.

Asumah’s most consequential contribution has been methodological: he built a way to measure whether a school is actually ready to support menstruating students. Published in BMJ Open, his “readiness index” integrates what too often gets assessed in isolation—safe infrastructure, real privacy, trained staff, and workable waste-disposal systems—into a single, rigorous framework.

“For the first time,” Asumah explains, “authorities can classify schools by level of preparedness and target interventions accordingly.” The index did more than tidy up a messy policy debate; it gave governments and NGOs a replicable tool to move money and fix specific failures, fast. It also filled a glaring gap he first observed in Ghana’s Savannah Region, where policy talk was plentiful but standardized measurement didn’t exist. Without shared indicators, responses were piecemeal. The index imposed order and comparability—an evidence base where anecdotes once stood.

The model didn’t stay local. Researchers abroad began citing and adapting the index for their own school assessments. NGOs folded it into toolkits—some supported by UNICEF—and ministries used it to shape national strategies. Asumah’s qualitative research, published in the Pan African Medical Journal, pushed the field further by illuminating how secrecy, stigma, and cost combine to push girls out of school. Those insights soon appeared in studies well beyond West Africa—from investigations in Laos, to analyses in India, and work on migrant women in Europe. Rather than simply referencing his findings, scholars used his approach to structure their own. A 2023 study extended the lens to urban settings, rounding out a view that spans rural, peri-urban, and city schools.

The mark of serious research is not only citation but adoption. In the Savannah Region, schools began carving out private, hygienic spaces for girls to change pads. Teachers received training to talk about menstruation without judgment. SHEP (School Health Education Programme) coordinators used the research to normalize conversations and reduce absenteeism. Asumah himself has trained male teachers alongside SHEP staff, and he says the results are visible: fewer missed days, more confidence, and—crucially—less shame. Students testify that these changes restored dignity and allowed them to stay in school without fear.

Academic advances matter, but policy still decides who can afford a pad. In 2023, as Ghana rolled out the One District, One Factory industrialization push, Asumah and colleagues argued that sanitary pads should be deemed essential goods—taxed less, made cheaper, and produced locally. Their editorial urged the government to scrap the 20 percent import tariff and 12.5 percent VAT on pads, subsidize production, and guarantee wash facilities in all schools and workplaces. Not every recommendation has been enacted, but their agenda helped define the debate.

Momentum followed. In March, the government announced a $26 million program to distribute free sanitary pads to girls in primary and secondary schools, citing the harsh tradeoff many families face: food versus menstrual supplies. When pads are unaffordable, girls turn to rags, old cloth, paper—even leaves—raising infection risks and deepening the shame that keeps them out of class. The connection to absenteeism is direct and well-documented.

Progress has not been linear. When Asumah began assessing school readiness, baseline data were sparse and tools inconsistent, especially in Northern Ghana. He had to train data collectors, devise a new index, and navigate cultural sensitivities that can shut down honest discussion. He responded by recruiting female facilitators, engaging community leaders, and co-developing a practical guide for SHEP coordinators—so schools had a playbook rather than just a diagnosis. Limited resources and competing priorities slowed implementation, but the scaffolding is now in place to scale what works.

What distinguishes this work is its dual fidelity: to precision and to people. Asumah’s frameworks are rigorous enough to steer budgets and simple enough to translate into a private stall, a sealed bin, a teacher who knows what to say. That is how a metric becomes a lifeline. And that is how a long-silenced topic becomes a visible policy responsibility.

Menstruation shouldn’t be a reason to miss school—any day, in any district. Ghana’s recent moves suggest that the country is starting to agree. If the index continues to travel, if procurement follows the evidence, and if schools are held accountable for meeting a basic standard of dignity, the quiet crisis that has persisted for generations can finally be measured, managed, and ended.