Schoolgirls’ experience and appraisal of menstrual absorbents in rural Uganda: a cross-sectional evaluation of reusable sanitary pads

Abstract

BackgroundGovernments, multinational organisations, and charities have commenced the distribution of sanitary products to address current deficits in girls’ menstrual management. The few effectiveness studies conducted have focused on health and education outcomes but have failed to provide quantitative assessment of girls’ preferences, experiences of absorbents, and comfort. Objectives of the study were, first, to quantitatively describe girls’ experiences with, and ratings of reliability and acceptability of different menstrual absorbents. Second, to compare ratings of freely-provided reusable pads (AFRIpads) to other existing methods of menstrual management. Finally, to assess differences in self-reported freedom of activity during menses according to menstrual absorbent.MethodsCross-sectional, secondary analysis of data from the final survey of a controlled trial of reusable sanitary padand puberty education provision was undertaken. Participants were 205 menstruating schoolgirls from eight schools in rural Uganda. 72 girls who reported using the intervention-provided reusable pads were compared to those using existing improvised methods (predominately new or old cloth).ResultsSchoolgirls using reusable pads provided significantly higher ratings of perceived absorbent reliability across activities, less difficulties changing absorbents, and less disgust with cleaning absorbents. There were no significant differences in reports of outside garment soiling (OR 1.00 95%CI 0.51–1.99), or odour (0.84 95%CI 0.40–1.74) during the last menstrual period. When girls were asked if menstruation caused them to miss daily activities there were no differences between those using reusable pads and those using other existing methods. However, when asked about activities avoided during menstruation, those using reusable pads participated less in physical sports, working in the field, fetching water, and cooking.ConclusionsReusable pads were rated favourably. This translated into some benefits for self-reported involvement in daily activities, although reports of actual soiling and missing activities due to menstruation did not differ. More research is needed comparing the impact of menstrual absorbents on girls’ daily activities, and validating outcome measures for menstrual management research.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0260-7) contains supplementary material, which is available to authorized users.

Puberty and menstruation knowledge among young adolescents in low- and middle-income countries: a scoping review

“…Studies evaluating interventions relating to MHM included both hardware (Phillips-Howard et al 2016 ; Shah et al 2013 ) and software interventions (Afsari et al 2017a ; Djalalinia et al 2012 ; Haque et al 2014 ; Kapadia-Kundu et al 2014 ; Kheirollahi et al 2017 ; Moodi et al 2013 ; Nagaraj and Konapur 2016 ; Sharma et al 2015 ; Su and Lindell 2016 ). Two linked studies combined hardware and software interventions (Hennegan et al 2016 ; Montgomery et al 2016 ), and assessed the association with school attendance; there was no association between reusable pads and puberty education and school attendance (Hennegan et al 2016 ). Both education and provision of reusable sanitary pads were equally as effective in improving school attendance (Montgomery et al 2016 ).…”

Menstrual health management and schooling experience amongst female learners in Gauteng, South Africa: a mixed method study

“…However, the sustainability of the provision of pads (rather than alternative modern sanitary products) in terms of burden on waste disposal systems and environmental impact will need to be addressed. There have been promising efforts in other countries in the region to introduce menstrual cups in schools which are environmentally sustainable, cost effective, safe and have shown the best health outcomes [6,39,41]. The availability of menstrual cups is relatively new in South Africa and has largely had exposure amongst women (18-24 years).…”

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