Menstrual health intervention and school attendance in Uganda (MENISCUS-2): a pilot intervention study
Loading...
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Open
Abstract
Achieving good menstrual health and hygiene
(MHH) is a public health challenge and there is little
evidence to inform interventions. The aim of this study was
to pilot test an intervention to improve MHH and school
attendance in Uganda, in preparation for a future cluster-randomised
trial.
Design Longitudinal study with preāpost evaluation of a
pilot intervention.
Setting Two secondary schools in Entebbe, Uganda.
Participants Of the 473 eligible students in secondary
2 (S2) at baseline, 450 (95.1%; 232 girls and 218 boys)
consented/assented. 369 students (188 girls; 81.0%; and
181 boys; 83.0%) participated in the endline survey.
Intervention The intervention comprised training teachers
to improve delivery of government guidelines for puberty
education, training in use of a menstrual kit and pain
management, a drama skit, provision of analgesics and
improvements to school water and sanitation hygiene
facilities.
Primary and secondary outcome measures Feasibility
and acceptability of delivering the intervention. Baseline
and endline quantitative surveys were conducted, with
qualitative interviews conducted at endline. School
attendance was assessed using self-completed
daily
diaries among a nested cohort of 100 female students.
Results There were high levels of uptake of the individual
and behavioural intervention components (puberty
education, drama skit, menstrual hygiene management
(MHM) kit and pain management). The proportion of girls
reporting anxiety about next period decreased from 58.6%
to 34.4%, and reported use of effective pain management
increased from 76.4% to 91.4%. Most girls (81.4%)
reported improved school toilet facilities, which improved
their comfort managing menstruation. The diary data and
qualitative data indicated a potential intervention impact
on improving menstrual-related
school absenteeism.
Conclusions The pilot study showed that the
multicomponent MHM intervention was acceptable and
feasible to deliver, and potentially effective in improving
menstruation knowledge and management. A cluster-randomised
trial is needed to evaluate rigorously the
intervention effects on MHM and school attendance.
Description
Keywords
Menstrual health, School attendance, Uganda, Study
Citation
Kansiime C, Hytti L, Nalugya R, et al. Menstrual health intervention and school attendance in Uganda (MENISCUS-2): a pilot intervention study. BMJ Open 2020;10:e031182. doi:10.1136/ bmjopen-2019-031182