Water, Sanitation and Hygiene Conditions in Kenyan Rural Schools: Are Schools Meeting the Needs of Menstruating Girls?

Alexander, Kelly; Oduor, Clifford; Nyothach, Elizabeth; Laserson, Kayla F.; Nyaguara, Amek; Eleveld, Alie; Mason, Linda; Rheingans, Richard; Beynon, Caryl; Mohammed, Aisha; Ombok, Maurice; Obor, David; Odhiambo, Frank; Quick, Robert; Phillips-Howard, Penelope A.

doi:10.3390/w6051453

Cited by 71 publications

(91 citation statements)

References 32 publications

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“…In this area, girls have little access to hygienic menstrual products,3 23 24 36 and are frequently exposed to sexual harms,3 22–24 reflected in the rapid increase in HIV and herpes simplex virus type 2 (HSV-2) prevalence in girls between 13 and 18 years of age from ∼1% to 12.8% and 9% to 40%, respectively 22…”

Section: Methodsmentioning

confidence: 99%

“…There were 71 primary schools within the HDSS area in Gem District; 62 agreed to participate,36 five of which were ineligible (enrolled in another study, or missed eligible class years). Of the 57 remaining schools, 30 fulfilled the WASH eligibility criteria consisting of a separate girls' toilet block present, water present at spot-check, and a pupil–latrine ratio<70:1.…”

Section: Methodsmentioning

confidence: 99%

“…The 30 eligible schools were matched in triplicate by the trial statistician based on the pupil–latrine ratio obtained from a baseline WASH study 36. Prior to a community randomisation ceremony, attended by all head teachers and District Education Officers (DEO), allocation assignments were sealed in three identical opaque envelopes by a non-involved administrator.…”

Section: Methodsmentioning

confidence: 99%

“…Household-level characteristics and socioeconomic status (SES) were obtained using the existing HDSS data 42. School-level characteristics on size and WASH were collected through unannounced spot-checks at baseline, and twice per term over the study 36. Participants were provided with adapted monthly calendars,14 to self-record daily school attendance and menstruation.…”

Section: Methodsmentioning

confidence: 99%

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Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya

et al. 2016

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ObjectivesConduct a feasibility study on the effect of menstrual hygiene on schoolgirls' school and health (reproductive/sexual) outcomes.Design3-arm single-site open cluster randomised controlled pilot study.Setting30 primary schools in rural western Kenya, within a Health and Demographic Surveillance System.ParticipantsPrimary schoolgirls 14–16 years, experienced 3 menses, no precluding disability, and resident in the study area.Interventions1 insertable menstrual cup, or monthly sanitary pads, against ‘usual practice’ control. All participants received puberty education preintervention, and hand wash soap during intervention. Schools received hand wash soap.Primary and secondary outcome measuresPrimary: school attrition (drop-out, absence); secondary: sexually transmitted infection (STI) (Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoea), reproductive tract infection (RTI) (bacterial vaginosis, Candida albicans); safety: toxic shock syndrome, vaginal Staphylococcus aureus.ResultsOf 751 girls enrolled 644 were followed-up for a median of 10.9 months. Cups or pads did not reduce school dropout risk (control=8.0%, cups=11.2%, pads=10.2%). Self-reported absence was rarely reported and not assessable. Prevalence of STIs in the end-of-study survey among controls was 7.7% versus 4.2% in the cups arm (adjusted prevalence ratio (aPR) 0.48, 0.24 to 0.96, p=0.039), 4.5% with pads (aPR=0.62; 0.37 to 1.03, p=0.063), and 4.3% with cups and pads pooled (aPR=0.54, 0.34 to 0.87, p=0.012). RTI prevalence was 21.5%, 28.5% and 26.9% among cup, pad and control arms, 71% of which were bacterial vaginosis, with a prevalence of 14.6%, 19.8% and 20.5%, per arm, respectively. Bacterial vaginosis was less prevalent in the cups (12.9%) compared with pads (20.3%, aPR=0.65, 0.44 to 0.97, p=0.034) and control (19.2%, aPR=0.67, 0.43 to 1.04, p=0.075) arm girls enrolled for 9 months or longer. No adverse events were identified.ConclusionsProvision of menstrual cups and sanitary pads for ∼1 school-year was associated with a lower STI risk, and cups with a lower bacterial vaginosis risk, but there was no association with school dropout. A large-scale trial on menstrual cups is warranted.Trial registrationISRCTN17486946; Results

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya

et al. 2016

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“…Sub-optimal WASH conditions in schools may hinder girls' ability to concentrate in class or attend school when menstruating, leading to, at worst, a greater likelihood that girls will drop out of school completely [139].…”

Section: Implementation In Developing Countriesmentioning

confidence: 99%

Economic Analysis and Feasibility of Rainwater Harvesting Systems in Urban and Peri-Urban Environments: A Review of the Global Situation with a Special Focus on Australia and Kenya

Amos

Rahman

Gathenya

2016

Water

112

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Rainwater harvesting (RWH) plays an important role in increasing water security for individuals and governments. The demand for tools to enable technical and economic analysis of RWH systems has led to a substantial body of research in the recent past. This paper focuses on the economic aspects of domestic RWH in urban and peri-urban environments. In this regard, key issues are identified and discussed including quality and quantity of harvested water, the water demand profile, the scale of installation, interest rates, the period of analysis, real estate value, and the water-energy-food nexus. Kenya and Australia are used as reference points having different economies and opposing RWH policies. It has been found that the previous studies on financial aspects of RWH systems often had conflicting results. Most of the economic analyses have ignored the full benefits that a RWH system can offer. In view of the varying and conflicting results, there is a need to standardize the methods of economic analysis of RWH systems.

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Role of institutional quality on women's empowerment—A case of highly gender unequal Asian countries

Qaiser

Rehman

Arshed

2023

Poverty & Public Policy

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Equal access to rights and opportunities for women and men is one of the indicators of women's empowerment. Classical economic growth models ignored gender differences in the labor force, but the literature now acknowledges the merits of equal participation of both genders in economic activities. This study investigates the determinants of gender equality as an instrument of women's empowerment. This study focused on Asian countries with a high gender gap in several domains. This lag in women's empowerment is hypothesized to be due to low‐quality institutions. The data for this investigation is compiled from World Development Indicators, Global Gender Gap reports, the Polity IV project, World Governance Indicators, and Human Development Reports. The Panel Feasible Generalized Least Squares results show that female unemployment and good governance tend to increase the gender gap in Asian countries, while Human Development Index, trade openness and democracy reduce the gender gap. This quantitative assessment is instrumental for policymakers in socially empowering women on equal terms with men in Asia.

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Water, Sanitation and Hygiene Conditions in Kenyan Rural Schools: Are Schools Meeting the Needs of Menstruating Girls?

Abstract: Water, sanitation and hygiene (WASH) programs in African schools have received increased attention, particularly around the potential impact of poor menstrual

Cited by 71 publications

References 32 publications

Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya

Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya

Economic Analysis and Feasibility of Rainwater Harvesting Systems in Urban and Peri-Urban Environments: A Review of the Global Situation with a Special Focus on Australia and Kenya

Role of institutional quality on women's empowerment—A case of highly gender unequal Asian countries

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