A qualitative understanding of the effects of reusable sanitary pads and puberty education: Implications for future research and practice

Hennegan, Julie; Dolan, Catherine; Steinfield, Laurel; Montgomery, Paul

Abstract

BACKGROUND: The management of menstruation has come to the fore as a barrier to girls’ education attainment in
low income contexts. Interventions have been proposed and piloted, but the emerging nature of the field means
limited evidence is available to understand their pathways of effect.


// METHODS: This study describes and compares schoolgirls’ experiences of menstruation in rural Uganda at the
conclusion of a controlled trial of puberty education and sanitary pad provision to elucidate pathways of effect in
the interventions. Semi-structured interviews were undertaken with schoolgirls who participated in the
Menstruation and the Cycle of Poverty trial concurrent with the final set of quantitative surveys. A framework
approach and cross-case analysis were employed to describe and compare the experiences of 27 menstruating girls
across the four intervention conditions; education (n = 8), reusable sanitary pads (n = 8), education with reusable
sanitary pads (n = 6), and control (n = 5).


// RESULTS: Themes included: menstrual hygiene, soiling, irritation and infection, physical experience, knowledge of
menstruation, psychological, social and cultural factors, and support from others. Those receiving reusable pads
experienced improvements in comfort and reliability. This translated into reduced fears around garment soiling and
related school absenteeism. Other menstrual hygiene challenges of washing, drying and privacy remained
prominent. Puberty education improved girls’ confidence to discuss menstruation and prompted additional support
from teachers and peers.


// CONCLUSIONS: Findings have important implications for the development and evaluation of future interventions. Results
suggest the provision of menstrual absorbents addresses one core barrier to menstrual health, but that interventions
addressing broader needs such as privacy may improve effectiveness. Puberty education sessions should increase
attention to body awareness and include strategies to address a wider range of practical menstrual challenges, including
pain management. Interviews revealed possibilities for improving quantitative surveys in future research.

Citation

Hennegan, J., Dolan, C., Steinfield, L., & Montgomery, P. (2017). A qualitative understanding of the effects of reusable sanitary pads and puberty education: Implications for future research and practice. Reproductive Health, 14(78), https://doi.org/10.1186/s12978-017-0339-9

• Journal Article Type: Article
• Acceptance Date: Jun 12, 2017
• Online Publication Date: Jun 27, 2017
• Publication Date: Jun 27, 2017
• Deposit Date: Jul 7, 2017
• Publicly Available Date: Jul 26, 2017
• Journal: Reproductive Health
• Electronic ISSN: 1742-4755
• Publisher: BMC
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 78
• DOI: https://doi.org/10.1186/s12978-017-0339-9
• Keywords: Menstrual hygiene, Menstrual health, Adolescent girls, Education, Qualitative