Objective:

To reassess the 'pad deficit' explanation for period-related school absenteeism in Ghana and evaluate perceptions of parents and teachers on the national free sanitary pad policy.

Approach:

• Methodology: A mixed-methods approach combining survey data from over 1,300 adolescent school girls and focus group discussions with teachers and parents.
• Data Analysis: Descriptive statistics and ordered logistic regression for quantitative data; thematic analysis for qualitative stakeholder views.

Key Findings:

• Menstrual discomfort is the most frequently cited reason for absenteeism among school girls.
• Inadequate sanitation conditions and limited access to sanitary products are also significant factors.
• Teachers and parents attribute absenteeism primarily to sanitary pad deficit.
• Regression results indicate menstrual discomfort has a greater impact on absenteeism than pad access or WASH infrastructure.

Interpretation:

Findings challenge the dominant sanitary pad deficit explanations of period-related absenteeism among school girls in low-income settings, highlighting the need for a broader approach that includes addressing menstrual discomfort and infrastructural issues.

Limitations:

• The study may not capture all contextual factors influencing absenteeism.
• Focus on a single country may limit generalizability to other contexts.

Conclusion:

An integrated, ecosystem-based response is necessary to effectively address period-related absenteeism among school girls, prioritizing menstrual discomfort alongside material access.