Menstrual health intervention and school attendance in Uganda (MENISCUS-2): a pilot intervention study

What is it about?

Many girls and women have challenges in managing their menstrual health and hygiene. The aim of this study was to test the feasibility and acceptability of multi-component menstrual health intervention in Uganda. The intervention addresses individual, behavioural and environmental barriers to good menstrual health and school attendance. It included 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 (WASH) facilities. The study took place in two secondary schools in Uganda, and 473 participants were enrolled and followed for 9 months (232 girls and 218 boys). Baseline and endline quantitative surveys were conducted, with individual and group interviews conducted at endline. School attendance was assessed using self-completed daily diaries among 100 female students. The study showed that the intervention was acceptable and feasible to deliver, and there were substantial reported improvements in menstrual knowledge, practices and attitudes. For example, 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 impact of the intervention on improving menstrual-related school absenteeism. Overall, this study showed that the multi-component MHM intervention was acceptable and feasible to deliver, and potentially effective in improving menstruation knowledge and management. A larger study with a control group is needed to evaluate rigorously the intervention effects on MHM and school attendance.

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