Exploring the relationship between sanitation and mental and social well-being: A systematic review and qualitative synthesis

Sclar, Gloria D.; Penakalapati, Gauthami; Caruso, Bethany A.; Rehfuess, Eva; Garn, Joshua V.; Alexander, Kelly; Freeman, Matthew C.; Boisson, Sophie; Medlicott, Kate; Clasen, Thomas

doi:10.1016/j.socscimed.2018.09.016

Cited by 71 publications

(71 citation statements)

References 60 publications

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“…The use of 'worries' terminology in scale items was selected to best align with past qualitative reports and to prevent confusion which may arise in positively and negatively worded items using the same response options. [3,34] However, we acknowledge this may have been more likely to evoke anxieties than items asking about 'comfort' or having 'enough' of various resources. Feedback from enumerators suggested that girls in this study did not struggle with the nature of these items as the response options were in the affirmative direction for all questions.…”

Section: Discussionmentioning

confidence: 95%

Measuring menstrual hygiene experience: Development and validation of the Menstrual Practice Needs Scale (MPNS-36)

Hennegan¹,

Nansubuga²,

Smith³

et al. 2019

Preprint

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Objectives. This study describes the development and validation the Menstrual Practice Needs Scale (MPNS-36) which measures the extent to which females’ menstrual practices and environments meet their needs. Methods. A 54-item pool was developed following systematic-review of qualitative and quantitative studies and expert feedback. Item reduction and scale validation were undertaken using a cross-sectional survey of 538 menstruating schoolgirls in Soroti, Uganda. Test-retest reliability was assessed in a sub-sample of 52 girls two weeks after the first administration. Construct validity was tested through relationships with hypothesised correlates: confidence to manage menses, self-reported school absenteeism, and mental health symptoms. Results. The final MPNS-36 comprises 28 items applicable to all respondents, and 8 items capturing washing and drying experiences for those reusing menstrual materials. A four-factor solution for the core 28 items was the best fit for the data (RMSEA=0.028-0.029; CFI=0.961-0.964; TFI=0.957-0.959), supplemented by two factors for reuse (RMSEA=0.021-0.030; CFI=0.987-0.994; TFI=0.981-0.991). Subscale and total scores were calculated as mean scores to support accessibility for practitioners. Subscales were ‘material and home environment needs’ (11 items, α-ordinal=0.84), ‘transport and school environment needs’ (5-items, α-ordinal=0.73), ‘material reliability concerns’ (3-items, α-ordinal=0.55), ‘change and disposal insecurity’ (9-items, α-ordinal=0.80), ‘reuse needs’ (5-items, α-ordinal=0.76), and ‘reuse insecurity’ (3-items, α-ordinal=0.56). Relationships between subscales and hypothesised correlates supported validity. Home- and school-based items were more strongly associated with confidence to manage menstruation at home and school, respectively. Higher scores predicted not missing school during the last menstrual period (total score: OR=2.62, 95%CI=1.52-4.50). Test-retest reliability was moderate (total score: ICC(2,1)=0.69).Conclusions. The MPNS-36 demonstrated acceptable reliability and validity. It is the first measure to capture women and girls perceived menstrual hygiene and may be used across a range of study designs to assess menstrual needs. Future research should explore the suitability and sensitivity of the measure across contexts.

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Section: Discussionmentioning

confidence: 95%

Measuring menstrual hygiene experience: Development and validation of the Menstrual Practice Needs Scale (MPNS-36)

Hennegan¹,

Nansubuga²,

Smith³

et al. 2019

Preprint

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“…Inspection of bivariate correlations suggested that trade-offs may be made between the favourability of the location to change menstrual materials and the accessibility of disposal options, contributing to negative subscale correlations. The use of ‘worries’ terminology in scale items was selected to best align with past qualitative reports and to prevent confusion which may arise in positively and negatively worded items using the same response options 3 39. However, we acknowledge this may have been more likely to evoke anxieties than items asking about ‘comfort’ or having ‘enough’ of various resources.…”

Section: Discussionmentioning

confidence: 99%

Measuring menstrual hygiene experience: development and validation of the Menstrual Practice Needs Scale (MPNS-36) in Soroti, Uganda

Hennegan

Nansubuga²,

Smith³

et al. 2020

BMJ Open

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Strengths and limitations of this study► This study reports the development and validation of the Menstrual Practice Needs Scale (MPNS-36) and the conceptual justification for the measure. ► Measure development drew on systematic reviews and findings from studies of measurement challenges in menstrual health research across a range of contexts. ► The MPNS-36 sought to measure the degree to which the practices and environments used in managing menstrual bleeding meet respondents' needs. ► There were no existing validated measures of menstrual experience against which to demonstrate the convergent and divergent validity of the scale. ► The scale was tested among schoolgirls in Uganda, a single population and language, and requires further research on cross-cultural validity and use in other populations. AbStrACtObjective This study describes the development and validation of the Menstrual Practice Needs Scale (MPNS-36), which measures the extent to which respondents' menstrual practices and environments meet their needs.Methods A 54-item pool was developed following systematic review of qualitative and quantitative studies and expert feedback. Item reduction and scale validation were undertaken using a cross-sectional survey of 538 menstruating schoolgirls in Soroti, Uganda. Test-retest reliability was assessed in a subsample of 52 girls 2 weeks after the first administration. Construct validity was tested through relationships with hypothesised correlates: confidence to manage menses, self-reported school absenteeism and mental health symptoms.results The MPNS-36 comprises 28 items applicable to all respondents and 8 items capturing washing and drying experiences for those reusing menstrual materials. A four-factor solution for the core 28 items was the best fit for the data (root mean square error of approximation (RMSEA)=0.028-0.029; comparative fit index (CFI)=0.961-0.964; Tucker-Lewis index (TLI)=0.953-0.955), supplemented by two factors for reuse (RMSEA=0.021-0.030; CFI=0.987-0.994; TLI=0.981-0.991). Subscale and total scores were calculated as mean scores to support accessibility for practitioners. The subscales were 'material and home environment needs' (11 items, α ordinal =0.84), 'transport and school environment needs' (5 items, α ordinal =0.73), 'material reliability concerns' (3 items, α ordinal =0.55), 'change and disposal insecurity' (9 items, α ordinal =0.80), 'reuse needs' (5 items, α ordinal =0.76) and 'reuse insecurity' (3 items, α ordinal =0.56). Relationships between subscales and hypothesised correlates supported validity. Home-based and school-based items were more strongly associated with confidence to manage menstruation at home and school, respectively. Higher total scores indicated more positive experiences and were associated with greater odds of not missing school during the last menstrual period (OR=2.62, 95% CI 1.52 to 4.50). Test-retest reliability was moderate (total score: intraclass correlation coefficient, ICC (2,1) =0.69).Conclusions The MPNS-36 demonstrated acceptable reliabili...

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“…Two recent reports from the Bill and Melinda Gates Foundation on gender and sanitation noted that in-home CBS services provide women and girls with a private, safe space to use the toilet and manage menstruation and pregnancy 5 . By contrast, open defecation and public sanitation options expose women and girls to high risks of violence and harassment as they travel to defecation locations, often at night (Pommells et al, 2018;Sclar et al, 2018). CBS could contribute to multi-sector approaches to eradicate this type of violence and harassment.…”

Section: Protecting Women and Girlsmentioning

confidence: 99%

Taking Container-Based Sanitation to Scale: Opportunities and Challenges

Russel

Hughes²,

Roach

et al. 2019

Front. Environ. Sci.

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Container-Based Sanitation (CBS) has rapidly progressed from its inception less than a decade ago to its recent classification as a type of improved sanitation facility by the Joint Monitoring Programme. CBS in many ways represents a sustainable service, as it addresses the entire sanitation service chain; offers a variety of service-based business models; and is affordable to people living in marginalized and informal urban settlements. At the same time, CBS services which have been operating for a number of years have grown relatively slowly. Taking CBS to scale will require solving several diverse challenges, particularly the need for government mandates; regulation; and innovative financing. This paper presents the collective views of some of the world's leading CBS practitioners in an effort to summarize the potential, research gaps, and major challenges to scaling CBS.

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Exploring the relationship between sanitation and mental and social well-being: A systematic review and qualitative synthesis

Cited by 71 publications

References 60 publications

Measuring menstrual hygiene experience: Development and validation of the Menstrual Practice Needs Scale (MPNS-36)

Measuring menstrual hygiene experience: Development and validation of the Menstrual Practice Needs Scale (MPNS-36)

Measuring menstrual hygiene experience: development and validation of the Menstrual Practice Needs Scale (MPNS-36) in Soroti, Uganda

Taking Container-Based Sanitation to Scale: Opportunities and Challenges

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