A qualitative understanding of the effects of reusable sanitary pads and puberty education: Implications for future research and practice
Open accessAbstract
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. TRIAL REGISTRATION: Pan-African Clinical Trials Registry PACTR201503001044408.
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Written from the paper’s full text.
TL;DR
This qualitative follow-up to the Menstruation and the Cycle of Poverty trial compared 27 menstruating schoolgirls’ experiences across four intervention conditions in rural Uganda. It found reusable pads reduced soiling fears and menstrual-related absenteeism, while puberty education improved confidence and support, but washing, drying, privacy, and pain remained unmet challenges.
Key findings
- Among 27 interviewed girls (education n = 8, reusable pads n = 8, education plus pads n = 6, control n = 5), those receiving reusable AFRIpads reported improvements in comfort and reliability, translating into reduced fears of garment soiling and related school absenteeism; the trial had found the attendance drop was mitigated by a mean 17.1% (95% CI 8.7–25.5) by education or reusable pads.
- Menstrual hygiene challenges of washing, drying, and privacy remained prominent across conditions; girls hid drying absorbents, covered them with another cloth, and some used the provided 45-g Omo soap surprisingly sparingly, possibly stretching it over nine months.
- Puberty education improved girls’ confidence to discuss menstruation and prompted additional support from teachers and peers; girls in education conditions were more comfortable discussing menstruation in interviews.
- Menstrual pain and anxiety about menstrual variation were common across all conditions and caused school absences and disengagement; girls often did not reveal menstruation as the source of pain, sometimes receiving the wrong medication.
Methods
- Qualitative follow-up concurrent with final quantitative surveys of a quasi-randomised controlled trial in eight schools in Kamuli District, rural Uganda; semi-structured interviews were conducted with 27 menstruating girls aged 12–17 (Mean = 14.35, SD = 1.11), sampled across the four trial conditions.
- Interviews lasted approximately one hour at a private school location, with Lusoga translation by trained female research assistants; they were digitally recorded and transcribed, covering household dynamics, schooling, menstrual experiences and practices, support sources, reproductive health knowledge, and future ambitions.
- Analysis used a framework approach and cross-case analysis in NVivo 11, following five steps; themes included menstrual hygiene, soiling, irritation and infection, physical experience, knowledge of menstruation, psychological/social/cultural factors, and support.
Limitations
- Stated: the small sample was limited by available resources and time constraints; girls who had dropped out or were absent on interview days could not be selected; NGO staff assisted with translation and participant selection and may have introduced bias.
- Stated: there were insufficient funds for back-translation, four interviews had only English transcriptions, and self-report biases were evident, including girls’ greater ease reporting others’ menstrual difficulties rather than their own; the foreign interviewer may have further limited openness.
- Evident from the text: the study is confined to one rural Ugandan district and school-based sample, so findings may not be broadly generalizable; as a qualitative follow-up, it cannot by itself establish causal pathways, though it aims to elucidate them.
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Claims the paper makes
0 of 19 cited sources checked · 0 supported · 0 flagged
- Findingown data
All girls expressed fears of soiling.
“All girls expressed fears of soiling.”
Quote in the paperNot a substantial claim - Findingown data
Unreliable absorbents kept girls from school, particularly where girls were using old or found cloths.
“Unreliable absorbents kept girls from school, particularly where girls were using old or found cloths.”
Quote in the paperSubstantial claim - Findingown data
Most girls reported knowing others who struggled to find absorbents and thus stayed home.
“Most girls reported knowing others who struggled to find absorbents and thus stayed home.”
Quote in the paperSubstantial claim - Findingown data
At one pads-only school, girls regularly changed absorbents in the latrines, storing used AFRIpads or cloth in a black plastic bag placed into their schoolbag to take home and wash.
“at another school (pads-only condition) girls regularly changed absorbents in the latrines, storing used AFRIpads or cloth in a black plastic bag placed into their schoolbag to take home and wash.”
Quote in the paperNot a substantial claim - Findingown data
When girls lacked soap, most would discard the used cloths.
“When girls lacked soap most would discard the used cloths.”
Quote in the paperNot a substantial claim
- Findingown data
Most girls reported that soiling at school occurred on the first day of their menses when they were unprepared.
“most reported that soiling at school occurred on the first day of their menses when they were unprepared.”
Quote in the paperNot a substantial claim - Findingown data
Girls receiving AFRIpads felt they were superior to previous improvised absorbents in comfort and reliability.
“Girls receiving AFRIpads felt they were superior to previous improvised absorbents in comfort and reliability.”
Quote in the paperSubstantial claim - Findingown data
Genital irritation was reported across the whole sample.
“Genital irritation was reported across the whole sample.”
Quote in the paperNot a substantial claim - Findingown data
Privacy concerns around drying absorbents did not differ between those using cloth and those using AFRIpads.
“This did not differ between those using cloth, and those using AFRIpads.”
Quote in the paperNot a substantial claim - Findingown data
There were privacy concerns around drying absorbents.
“there were privacy concerns around drying absorbents.”
Quote in the paperNot a substantial claim - Findingown data
Cloth was the most common absorbent for girls who did not receive AFRIpads.
“Cloth was the most common absorbent for girls who did not receive AFRIpads.”
Quote in the paperNot a substantial claim - Findingown data
Girls with no absorbents were absent from school.
“Girls with no absorbents were absent.”
Quote in the paperSubstantial claim - Findingown data
Some girls were concerned about the AFRIpad moving or being visible.
“other girls were concerned about the pad moving or being visible.”
Quote in the paperNot a substantial claim - Findingown data
Some girls described a burning sensation when using the AFRIpads, associating it with wearing the pad for an extended time.
“Some girls’ described a burning sensation when using the AFRIpads, associating it with wearing the pad for an extended time.”
Quote in the paperNot a substantial claim - Findingown data
Providing AFRIpads reduced financial burden on girls.
“Providing AFRIpads also reduced financial burden on girls.”
Quote in the paperSubstantial claim - Findingown data
Going home to change absorbents was most common among those in education-only and control schools.
“Going home to change was most common among those in education-only and control schools.”
Quote in the paperNot a substantial claim - Findingown data
At one education-only school, a common bullying practice was to lock other students inside the latrines, compelling all girls interviewed at this school to return home to change.
“At one school (education-only), a common bullying practice was to lock other students inside the latrines, compelling all girls interviewed at this school to return home to change.”
Quote in the paperNot a substantial claim - Findingown data
Girls in pad-provision conditions used the small quantity of Omo soap provided surprisingly sparingly, possibly stretching the 45-g over nine months in some cases.
“Girls in pad-provision conditions used the small quantity of Omo soap provided surprisingly sparingly, possibly stretching the 45-g over nine months in some cases.”
Quote in the paperNot a substantial claim - Findingown data
Girls receiving education more freely discussed menstruation with the interviewers.
“girls receiving education more freely discussed menstruation with the interviewers”
Quote in the paperSubstantial claim - Findingown data
AFRIpads allowed girls to feel more confident that they would not soil garments during menses.
“the AFRIpads allowed girls to feel more confident that they would not soil garments during menses”
Quote in the paperSubstantial claim - Findingown data
Girls expressed little control over their body.
“Furthermore, girls expressed little control over their body.”
Quote in the paperSubstantial claim - Findingown data
Female teachers were an important source of information and support.
“Female teachers were an important source of information and support.”
Quote in the paperNot a substantial claim - Findingown data
Anxiety and embarrassment pervaded menstrual experiences across conditions.
“Anxiety and embarrassment pervaded menstrual experiences across conditions.”
Quote in the paperSubstantial claim - Findingown data
Where girls did not feel comfortable discussing menstruation with their mother, there was often an aunt, grandmother, or sister they talked to.
“Where girls did not feel comfortable to discuss menstruation with their mother there was often an aunt, grandmother, or sister they talked to.”
Quote in the paperNot a substantial claim - Findingown data
Menstrual cramping was a focal part of girls' experience across all conditions.
“Menstrual cramping was a focal part of girls’ experience across all conditions.”
Quote in the paperNot a substantial claim - Findingown data
Findings indicate that girls were under-informed about practical management and individual variations in menstruation.
“However, findings indicate that girls were under-informed about practical management and individual variations in menstruation.”
Quote in the paperSubstantial claim - Findingown data
Girls carried significant anxiety about soiling outer-garments and being embarrassed or teased.
“Girls carried significant anxiety about soiling outer-garments and being embarrassed or teased.”
Quote in the paperSubstantial claim - Findingown data
Girls expressed anxiety about variations in their menstrual patterns, which they feared were abnormal.
“Girls expressed anxiety about variations in their menstrual patterns, which they feared were abnormal.”
Quote in the paperNot a substantial claim - Findingown data
Girls often felt they could talk to a female teacher about menstrual issues.
“Girls often felt they could talk to a female teacher about menstrual issues.”
Quote in the paperNot a substantial claim - Findingown data
Most girls did not talk to fathers about menstruation.
“Most girls did not talk to fathers about menstruation.”
Quote in the paperNot a substantial claim - Findingown data
Many girls, across conditions, had experienced itching and abnormal discharge at least once.
“Many girls, across the conditions, had experienced itching and abnormal discharge at least once.”
Quote in the paperSubstantial claim - Findingown data
In contrast to some past studies, most girls in this study were aware of menstruation prior to menarche.
“In contrast to some past studies (e.g., [3, 16, 23]), we found that most girls were aware of menstruation prior to menarche.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [3] Mason L, Nyothach E, Alexander K, Odhiambo FO, Eleveld A, Vulule J, et al. ‘We keep it secret so no one should know’–A qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural Western Kenya. PLoS One. 2013;8(11):e79132. source
Not checked in the free run.
- cites [16] Tegegne TK, Sisay MM. Menstrual hygiene management and school absenteeism among female adolescent students in Northeast Ethiopia. BMC Public Health. 2014;14(1):1118. source
Not checked in the free run.
- cites [23] Ali TS, Rizvi SN. Menstrual knowledge and practices of female adolescents in urban Karachi, Pakistan. J Adolesc. 2010;33(4):531–41. source
Not checked in the free run.
- Findingown data
Across intervention conditions, girls were heavily reliant on external sources to tell them what was normal for their periods and what their management practices should look like.
“Across intervention conditions, girls were heavily reliant on external sources to tell them what was normal for their periods and what their management practises should look like.”
Quote in the paperSubstantial claim - Findingown data
Teasing was mostly attributed to boys.
“Teasing was mostly attributed to boys.”
Quote in the paperNot a substantial claim - Findingown data
Disparity between advice provided by family members or peers and information in the education sessions was a source of stress.
“Disparity between the advice provided by family members or peers and information in the education sessions was a source of stress.”
Quote in the paperNot a substantial claim - Findingown data
Debriefing sessions with local research assistants revealed that girls were expected to elongate labia prior to menarche, at which time labia were believed to become tougher and harder to elongate.
“Debriefing sessions with the local research assistants revealed that girls were expected to elongate labia prior to menarche at which time labia were believed to become tougher and harder to elongate.”
Quote in the paperNot a substantial claim- Rests on an assumption: The local research assistants' debriefing accurately reflects girls' expectations about labia elongation.
- Findingown data
The level of detail in information girls received from family varied.
“The level of detail in information girls’ received from family varied.”
Quote in the paperNot a substantial claim - Findingreasoning
The amount of cloth girls had available to use as absorbent dictated changing practices for some.
“The amount of cloth girls had available to use as absorbent dictated changing practices for some.”
Quote in the paperNot a substantial claim - Findingown data
Girls' reliance on others to provide funds for absorbents, soap and basins meant most expressed little control over their ability to manage menses.
“Girls’ reliance on others to provide funds for absorbents, soap and basins for washing meant most expressed little control over their ability to manage menses.”
Quote in the paperSubstantial claim - Findingreasoning
Many girls using AFRIpads or cloths returned home to change.
“Still, many girls using AFRIpads or cloths returned home to change.”
Quote in the paperNot a substantial claim - Findingown data
Girls in intervention schools reported greater ease discussing menstruation with peers, with some individual variation.
“Girls in the intervention schools reported greater ease discussing menstruation with peers, albeit with some individual variation.”
Quote in the paperSubstantial claim - Findingnone given
None of the schools provided soap or water basins fit for purpose (even if water was available at a reasonable distance).
“None of the schools provided soap or water basins fit for purpose (even if water was available at a reasonable distance).”
Quote in the paperSubstantial claim - Findingown data
Labia elongation emerged as an important cultural practice and avenue through which girls were informed about menstruation.
“Labia elongation emerged as an important cultural practice and avenue through which girls were informed about menstruation.”
Quote in the paperNot a substantial claim - Findingown data
In some instances, girls were told by family members to restrict their activities during menstruation, including not going to school or being around boys.
“In some instances, girls were told by family members to restrict their activities during menstruation, including not going to school or being around boys.”
Quote in the paperSubstantial claim - Findingown data
The education sessions informed girls otherwise (that they need not restrict activities during menstruation).
“The education sessions informed them otherwise.”
Quote in the paperSubstantial claim - Findingown data
Girls had more concerns about drying.
“Girls had more concerns about drying.”
Quote in the paperNot a substantial claim - Findingown data
Few girls whose parents regularly provided disposable pads and funds for painkillers expressed greater control and lower anxiety.
“Of notable exception were the few girls whose parents regularly provided disposable pads and funds for painkillers. These girls expressed greater control and lower anxiety.”
Quote in the paperNot a substantial claim - Findingown data
Exposure to the education prompted some girls to start discussions with caregivers about menstruation.
“Exposure to the education prompted some girls to start discussions with caregivers about menstruation.”
Quote in the paperNot a substantial claim - Findingown data
Although girls had been told menstruation would happen, most received little instruction on practical management.
“Although they had been told that menstruation would happen to them, most received little instruction on practical management.”
Quote in the paperSubstantial claim - Findingown data
Girls reported school absences and disengagement for themselves and others due to menstrual pain.
“They reported school absences and disengagement for themselves and others due to pain.”
Quote in the paperSubstantial claim - Findingown data
Menstrual pain and variations in menstrual experience cause significant distress.
“we found that menstrual pain and variations in menstrual experience cause significant distress”
Quote in the paperSubstantial claim - Findingown data
Other menstrual hygiene challenges of washing, drying and privacy remained prominent.
“Other menstrual hygiene challenges of washing, drying and privacy remained prominent.”
Quote in the paperSubstantial claim - Findingown data
Embarrassment and anxiety around menstruation was evident in girls' willingness to report others' struggles with menstruation and soiled garments, rather than their own.
“Embarrassment and anxiety around menstruation was evident in girls’ willingness to report others’ struggles with menstruation and soiled garments, rather than their own.”
Quote in the paperSubstantial claim - Findingown data
Providing pads did not address other challenges of managing menstruation such as washing and drying the reusable pads.
“Providing pads did not address other challenges of managing menstruation such as washing and drying the reusable pads.”
Quote in the paperSubstantial claim - Findingown data
Girls had received instructions from mothers, aunts, teachers and other girls to pull and elongate their labia minora.
“Girls had received instructions from mothers, aunts, teachers and other girls to ‘pull’ and elongate their labia minora.”
Quote in the paperNot a substantial claim - Findingown data
Interviews revealed that when girls dried absorbents outside they covered them with another cloth.
“Interviews revealed that when girls dried absorbents outside they covered them with another cloth.”
Quote in the paperSubstantial claim - Findingown data
Interviews confirmed that among this sample, inadequate absorbents were a source of school absence.
“Interviews confirmed that among this sample, inadequate absorbents were a source of school absence.”
Quote in the paperSubstantial claim - Findingnone given
School culture around latrine use dictated if girls felt comfortable to change absorbents there.
“School culture around latrine use dictated if girls felt comfortable to change absorbents there.”
Quote in the paperSubstantial claim - Findingown data
Girls in education conditions were more comfortable discussing menstruation in interviews.
“Girls in education conditions were also more comfortable discussing menstruation in interviews.”
Quote in the paperNot a substantial claim - Findingown data
Some girls reported burning sensations on extended AFRIpad use.
“Some girls reported burning sensations on extended AFRIpad use”
Quote in the paperNot a substantial claim - Findingown data
Education sessions provided girls with more practical knowledge than they had before, such as the importance of using cold water for washing.
“Education sessions provided girls with more practical knowledge than they had before, such as the importance of using cold water for washing.”
Quote in the paperSubstantial claim - Findingown data
Those receiving reusable pads experienced improvements in comfort and reliability.
“Those receiving reusable pads experienced improvements in comfort and reliability.”
Quote in the paperSubstantial claim - Findingown data
A number of girls reported that the intervention education session was the first time they received any demonstration of the use of absorbents.
“A number of girls reported that the intervention education session was the first time they received any demonstration of the use of absorbents.”
Quote in the paperSubstantial claim - Findingown data
Despite being aware of menstruation, many girls reflected on menarche with fear.
“Despite being aware of menstruation, many girls reflected on menarche with fear.”
Quote in the paperNot a substantial claim - Findingown data
Some girls had been told to keep clean but were not given formal instruction on absorbent use.
“For some, they had been told to “keep clean” but were not given any formal instruction on absorbent use.”
Quote in the paperNot a substantial claim - Findingown data
Menstruation presented a significant challenge to school attendance.
“We found that menstruation presented a significant challenge to school attendance”
Quote in the paperSubstantial claim - Findingown data
Most girls did not immediately tell care providers or friends about menarche even though they had been told menstruation would happen.
“Even though they had been told that menstruation would happen, most did not immediately tell care providers or friends about it.”
Quote in the paperNot a substantial claim - Premisecitation
Few high quality trials of menstrual health programs have been conducted.
“Programs seeking to improve menstrual health have been implemented, but few high quality trials have been conducted [7].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] Hennegan J, Montgomery P. Do menstrual hygiene management interventions improve education and psychosocial outcomes for women and girls in low and middle income countries? A Systematic Review. PLoS One. 2016;11(2):e0146985. source
Not checked in the free run.
- Premisecitation
The drop in attendance in control schools was mitigated by a mean 17.1% (95%CI 8.7-25.5) by provision of either education or reusable pads in intervention schools.
“This drop was mitigated by a mean 17.1% (95%CI 8.7–25.5) by the provision of either education or reusable pads in the intervention schools [11].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [11] Montgomery P, Hennegan J, Dolan C, Wu M, Steinfield L, Scott L. Menstruation and the cycle of poverty: a cluster quasi-randomised control trial of sanitary pad and puberty education provision in Uganda. PLoS One. 2016;11(2):e0166122. doi: 10.1371/journal.pone.0166122 . source
Not checked in the free run.
- Premisecitation
In the Menstruation and the Cycle of Poverty trial, the percentage of school days attended dropped substantially in control schools.
“The trial found that the percentage of school days attended dropped substantially in the control schools.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [11] Montgomery P, Hennegan J, Dolan C, Wu M, Steinfield L, Scott L. Menstruation and the cycle of poverty: a cluster quasi-randomised control trial of sanitary pad and puberty education provision in Uganda. PLoS One. 2016;11(2):e0166122. doi: 10.1371/journal.pone.0166122 . source
Not checked in the free run.
- Interpretationreasoning
Nevertheless, the education fell short in empowering girls to feel in control of their menstrual management.
“Nevertheless, the education fell short in empowering girls to feel in control of their menstrual management.”
Quote in the paperSubstantial claim - Interpretationreasoning
Social support from peers and teachers was an unmeasured driver of intervention effects.
“Across the interventions we found social support from peers and teachers to be an unmeasured driver of intervention effects.”
Quote in the paperSubstantial claim - Interpretationreasoning
Improvements in comfort and reliability from reusable pads translated into reduced fears around garment soiling and related school absenteeism.
“This translated into reduced fears around garment soiling and related school absenteeism.”
Quote in the paperSubstantial claim - Interpretationnone given
Support from peers, teachers and family were integral to girls' experience.
“Support from peers, teachers and family were integral to girls’ experience.”
Quote in the paperSubstantial claim - Interpretationown data
Other content in the education sessions such as practical suggestions about how to fix absorbents in underwear or use cold water for washing was beneficial for girls' menstrual management.
“Other content in the education sessions such as practical suggestions about how to fix absorbents in underwear or use cold water for washing was beneficial for girls’ menstrual management.”
Quote in the paperNot a substantial claim - Interpretationown data
Symptomatology suggested possible menstrual disorders in a couple of cases.
“Symptomatology suggested possible menstrual disorders in a couple of cases.”
Quote in the paperNot a substantial claim - Interpretationreasoning
This may explain the unexpected quantitative findings that those drying menstrual absorbents outside experienced poorer health (discharge and odour) outcomes [18].
“This may explain the unexpected quantitative findings that those drying menstrual absorbents (cloths or reusable pads) outside experienced poorer health (discharge and odour) outcomes [18].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [18] Hennegan J, Dolan C, Wu M, Scott L, Montgomery P. Measuring the prevalence and impact of poor menstrual hygiene management: a quantitative survey of schoolgirls in rural Uganda. BMJ Open. 2016;6:e012596. source
Not checked in the free run.
- Interpretationreasoning
The provision of reusable pads meant girls could direct precious funds spent on pads or cloths to other needs, a potential added benefit.
“Further, the provision of reusable pads meant that girls could direct precious funds spent on pads or cloths to other needs, a potential added benefit.”
Quote in the paperNot a substantial claim - Interpretationcitation
Girls' lack of understanding around vaginal discharge and health may be one source of the poor consistency between self-reported symptoms and laboratory-confirmed reproductive tract infections [21].
“Girls’ lack of understanding around vaginal discharge and health may be one source of the poor consistency between self-reported symptoms and laboratory-confirmed reproductive tract infections [21].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [21] Kerubo E, Laserson KF, Otecko N, Odhiambo C, Mason L, Nyothach E, et al. Prevalence of reproductive tract infections and the predictive value of girls’ symptom-based reporting: findings from a cross-sectional survey in rural western Kenya. Sex Transm Infect. 2016; doi: 10.1136/sextrans-2015-052371 . source
Not checked in the free run.
- Interpretationreasoning
The ingenuity of girls in one school to pool resources and make pads likely contributed to the education intervention effectiveness identified in this school.
“The ingenuity of the girls in one school to pool resources and make pads is testament to the importance of this issue in their lives and likely contributed to the education intervention effectiveness identified in this school.”
Quote in the paperNot a substantial claim - Interpretationown data
Provision of sanitary pads reduced fears of soiling outer garments allowing better school attendance.
“the provision of sanitary pads reduced fears of soiling outer garments allowing better school attendance”
Quote in the paperSubstantial claim - Interpretationreasoning
As a result, those in schools receiving the education intervention were more at ease discussing menstruation.
“As a result, those in schools receiving the education intervention were more at ease discussing menstruation.”
Quote in the paperSubstantial claim - Interpretationown data
Social support from peers and teachers was an important driver of effects across both conditions.
“Social support from peers and teachers was an important driver of effects across both conditions.”
Quote in the paperSubstantial claim
- May combine two claims. 29
- Classified as probably not a substantial claim. 14
May combine two claims.
Findingown dataSome girls reported a burning sensation when using AFRIpads, or heard that others experienced this.
“a few girls reported that they experienced a burning sensation, or heard that others experienced this”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFear of soiling often meant girls avoided standing in class to answer questions, and was a barrier to concentration.
“Fear of soiling often meant girls avoided standing in class to answer questions, and was a barrier to concentration.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataGirls who received AFRIpads felt these were reliable and experienced greater comfort, with some reporting soiling prior to but not after receiving AFRIpads.
“Girls’ who received AFRIpads felt these were reliable and experienced greater comfort as a result, with some reporting that they experienced soiling prior to, but not after, receiving AFRIpads.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataMost girls had access to soap, although for some this was inconsistent.
“Most girls had access to soap, although for some this was inconsistent.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataSoiling was a consistent problem for girls with poorer quality absorbents such as old cloth or underwear alone, prompting some to stay home on heavier days.
“Soiling was a consistent problem for girls with poorer quality absorbents such as old cloth or underwear alone, prompting some to stay home on the heavier days of their period.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAt one school, uniforms had changed colour in the past year, reducing girls' fears of soiling.
“At one school the uniforms had changed colour in the past year, reducing girls fears of soiling.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe provision of sanitary pads reduced fears of outer garment soiling, although did not address other menstrual hygiene challenges such as changing and drying the reusable pads.
“The provision of sanitary pads reduced fears of outer garment soiling, although did not address other menstrual hygiene challenges such as changing and drying the reusable pads.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe range of topics and ease of talking to the female teacher was greater in intervention conditions than control, where menstrual education at school was more limited.
“Notably, the range of topics and the ease of talking to the female teacher was greater in the intervention conditions than the control, where menstrual education at the school was more limited.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataGirls were conflicted about whether or not they should engage in labia elongation, and indicated the topic had been raised during questions in the education sessions.
“Girls were conflicted about whether or not they should engage in the practice, and indicated that the topic had been raised during questions in the education sessions.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAnxiety about menstrual pattern variations was similar across all conditions and did not seem affected by the education intervention.
“This was similar across all conditions, and did not seem to be affected by having received the education intervention.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataGirls were concerned that their bleeding was too heavy, although it was unclear to interviewers if bleeding was truly abnormal.
“In particular, girls were concerned that their bleeding was too heavy, although it was unclear to interviewers if bleeding was truly abnormal.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingnone givenNone of the interventions addressed the school facilities available for changing absorbents, which were similar across the schools.
“None of the interventions addressed the school facilities available for changing absorbents, which were similar across the schools.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAcross all schools, girls reported checking each other's skirts for leaks, talking about menstruation with others, and providing moral support.
“Across all schools, girls reported checking each other’s skirts for leaks, talking about menstruation with others, and providing moral support.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataWhile most girls reported positive experiences with teachers, some expressed that teachers of both sexes were not sensitive enough to menstrual issues.
“While most girls reported positive experiences with teachers, some expressed that teachers of both sexes were not sensitive enough to menstrual issues.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataRegardless of intervention condition, many girls had known about menstruation prior to menarche, although were given varying information by mothers, aunts, sisters, or peers.
“Regardless of intervention condition, many girls had known about menstruation prior to menarche, although were given varying information by mothers, aunts, sisters, or peers.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAlmost all girls experienced menstrual pain and identified this as a barrier to attendance and engagement in the classroom.
“Almost all girls experienced menstrual pain and identified this as a barrier to attendance and engagement in the classroom.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataPuberty education improved girls' confidence to discuss menstruation and prompted additional support from teachers and peers.
“Puberty education improved girls’ confidence to discuss menstruation and prompted additional support from teachers and peers.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataReceiving the pads-alone intervention did not appear to have the same impact on comfort discussing menstruation, and two girls from pad-only schools expressed fear to describe menstruation or use anatomical terms such as 'vagina'.
“Receiving the pads-alone intervention did not appear to have the same impact, and notably two girls from the pad-only schools expressed fear to describe menstruation or use anatomical terms such as ‘vagina’.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataMothers had often told girls about menstruation and provided money for cloth or painkillers, consistent across conditions.
“Mother’s had often told girls about menstruation and provided money for cloth or painkillers. This was consistent across conditions.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataMost girls washed their absorbents at home and felt comfortable doing so.
“Most girls washed their absorbents at home and felt comfortable doing so.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingreasoningEducation was successful in improving understanding and comfort with menstruation, but more practical information was needed.
“Education was successful in improving understanding and comfort with menstruation, but more practical information was needed.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationQualitative research provides a trial process evaluation by exploring mechanisms of impact, implementation, and study context.
“Furthermore, in fulfilling these functions qualitative research serves to provide a trial process evaluation by exploring mechanisms of impact in the trial, implementation, and study context [10].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10] Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: medical research council guidance. BMJ. 2015;350:h1258. source
Not checked in the free run.
May combine two claims.
PremisecitationThere were no significant differences in attendance between intervention conditions, nor between psychosocial wellbeing outcomes including shame and insecurity during menstruation, at the conclusion of the trial.
“There were no significant differences in attendance between the intervention conditions, nor between psychosocial wellbeing outcomes, including shame and insecurity during menstruation, when compared at the conclusion of the trial.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [11] Montgomery P, Hennegan J, Dolan C, Wu M, Steinfield L, Scott L. Menstruation and the cycle of poverty: a cluster quasi-randomised control trial of sanitary pad and puberty education provision in Uganda. PLoS One. 2016;11(2):e0166122. doi: 10.1371/journal.pone.0166122 . source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationConsequences of inadequate menstrual management extend beyond the classroom to health, dignity, psychosocial wellbeing, employment, and participation in society.
“Consequences of inadequate menstrual management have been suggested to extend beyond the classroom to health, dignity, psychosocial wellbeing, employment, and participation in society [3, 4].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [3] Mason L, Nyothach E, Alexander K, Odhiambo FO, Eleveld A, Vulule J, et al. ‘We keep it secret so no one should know’–A qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural Western Kenya. PLoS One. 2013;8(11):e79132. source
Not checked in the free run.
- cites [4] Phillips-Howard PA, Otieno G, Burmen B, Otieno F, Odongo F, Odour C, et al. Menstrual needs and associations with sexual and reproductive risks in rural Kenyan females: a cross-sectional behavioral survey linked with HIV prevalence. J Women’s Health. 2015;24(10):801–11. source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationQualitative methods after a trial can explore reasons for findings, explain variations in effectiveness, examine underlying theory, and generate further questions or hypotheses.
“Lewin and colleagues [8]. suggest four broad ways qualitative methods can be employed after a trial to enhance evaluation: to explore reasons for the findings; to explain variations in effectiveness across the sample; to examine underlying theory, and; to generate further questions or hypotheses.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] Lewin S, Glenton C, Oxman AD. Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ. 2009;339:b3496. source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationQualitative research conducted alongside effectiveness trials is valuable.
“Across disciplines there is increasing recognition of the value of qualitative research conducted alongside effectiveness trials [8, 9].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [8] Lewin S, Glenton C, Oxman AD. Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ. 2009;339:b3496. source
Not checked in the free run.
- cites [9] O'Cathain A, Thomas KJ, Drabble SJ, Rudolph A, Hewison J. What can qualitative research do for randomised controlled trials? A systematic mapping review. BMJ Open. 2013;3(6):e002889. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataInterviews were conducted in a private location on school grounds.
“Members of the research team (JH, LS) interviewed girls over approximately one hour at a private location on the school grounds.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataThe provision of reliable absorbents in the intervention addressed soiling and fears of soiling, and meant girls could more easily attend school during menses.
“The provision of reliable absorbents in the intervention addressed soiling and fears of soiling, and meant girls could more easily attend school during menses.”
Quote in the paperSubstantial claim- Rests on an assumption: The AFRIpads provided in the intervention were reliable absorbents.
May combine two claims.
Interpretationown dataProvision of menstrual absorbents addresses one core barrier to menstrual health, but interventions addressing broader needs such as privacy may improve effectiveness.
“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.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataCross-case matrices were generated to compare between trial conditions.
“Following the framework analysis, cross-case matrices were generated to compare between the trial conditions.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
InterpretationreasoningThis awareness may have been due to the widespread practice of labia elongation and/or the presence of the trial.
“This may have been due to the widespread practice of labia elongation and/or the presence of the trial.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenLusoga translations were provided by trained female research assistants from the partner NGO.
“Lusoga translations were provided by trained female research assistants from the partner NGO.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningThe burning sensations may have reflected an interaction with labia elongation or hygiene.
“which may have reflected an interaction with labia elongation or hygiene.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenTheme and sub-theme coding was reviewed and discussed among the study authors.
“Theme and sub-theme coding was reviewed and discussed among the study authors (JH CD LS PM).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationFramework analysis followed five steps described by Spencer and colleagues.
“Framework analysis followed the five steps described by Spencer and colleagues [14].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [14] Spencer L, Ritchie J, O’Connor W, Morrell G, Ormston R. Analysis in practice. In: Ritchie J, Lewis J, Mcnaughton-Nicholls C, Ormston R, editors. Qualitative research practice. 2nd ed; 2014.
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataNotes from school facility assessments, field notes and debrief sessions with project research assistants were consulted to contextualise interviews.
“In addition to interview transcripts, notes from school facility assessments, field notes and debrief sessions with the project research assistants were consulted to contextualise interviews.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningThe burning sensations may also have been symptomatic of a reproductive-tract or sexually transmitted infection.
“This may also have been symptomatic of a reproductive-tract or sexually transmitted infection.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationThose using AFRIpads may have been able to change faster, as indicated in quantitative findings, facilitating some girls to change at school in those conditions.
“Those using AFRIpads may have been able to change faster, as indicated in quantitative findings, [17] facilitating some girls to change at school in those conditions.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [17] Hennegan J, Dolan C, Wu M, Scott L, Montgomery P. Schoolgirls’ experience and appraisal of menstrual absorbents in rural Uganda: a cross-sectional evaluation of reusable sanitary pads. Reprod Health. 2016;13:143–55. source
Not checked in the free run.
May combine two claims.
InterpretationreasoningThe education intervention addressed some of this deficit, and provided an opportunity for girls to ask questions and initiate conversations with friends and other support sources.
“The education intervention addressed some of this deficit, and provided an opportunity for girls to ask questions and initiate conversations with friends and other support sources.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningResults are consistent with the quantitative findings from the trial in suggesting that both education and pads were effective interventions to address some menstrual needs and reduce menstrual-related absenteeism.
“Results are consistent with the quantitative findings from the trial in suggesting that both education and pads were effective interventions to address some menstrual needs and reduce menstrual-related absenteeism.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationSemi-structured interviews covered topics drawn from interviews undertaken in pilots preceding the trial, with additions to capture more detail around menstrual experience and trial implementation.
“Semi-structured interviews covered a range of topics drawn from interviews undertaken in pilots preceding the trial, [12, 13] with additions to capture more detail around menstrual experience and trial implementation”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [12] Scott L, Montgomery P, Steinfield L, Dolan C, Dopson S. Sanitary pad acceptability and sustainability study. Oxford: University of Oxford; 2013. source
Not checked in the free run.
- cites [13] Dolan CS, Ryus CR, Dopson S, Montgomery P, Scott L. A blind spot in girls’ education: menarche and its webs of exclusion in Ghana. J Int Dev. 2013;26(5):643–57. source
Not checked in the free run.
The paper relies on this without support.
Menstruation is a neglected but significant obstacle to girls' education.
“Among these, menstruation has emerged as a neglected but significant obstacle to education.”
The paper relies on this without support.
Menstrual health is severely under-researched.
“Menstrual health is severely under-researched.”
The paper relies on this without support.
Menstrual pain remains a challenge worldwide.
“Menstrual pain remains a challenge worldwide.”
The paper relies on this without support.
Providing pain relief medications to girls in LMICs would be ethically challenging and difficult to implement without the risk of harm.
“Providing pain relief medications to girls in LMICs would be ethically challenging and difficult to implement without the risk of harm.”
The paper relies on this without support.
The AFRIpads provided in the intervention were reliable absorbents.
“The provision of reliable absorbents in the intervention addressed soiling and fears of soiling”
The paper relies on this without support.
The local research assistants' debriefing accurately reflects girls' expectations about labia elongation.
“Debriefing sessions with the local research assistants revealed that girls were expected to elongate labia prior to menarche”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Lack of knowledge about MHM was a source of anxiety among the girls in this study, and this can lead to inadequate menstrual hygiene management (e.g. to predict onset of next period).
“Lack of knowledge about MHM was a source of anxiety among the girls in this study, and this can lead to inadequate menstrual hygiene management (e.g. to predict onset of next period) [19, 27, 28].”
From Menstrual health and school absenteeism among adolescent girls in Uganda (MENISCUS): a feasibility study (2018) · cites this paper as [19]
The Results (Knowledge of menstruation) report limited practical instruction and stress from conflicting advice; the Discussion (Main findings) says girls were under-informed about menstrual management. The Discussion (Implications for research) also says girls were often unprepared on the first day of menstruation, but it does not establish that lack of knowledge caused difficulty predicting the next period. The indexed passages provide no page numbers. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPrevious studies in LMIC show that menstruation is a cause of distress to many girls and a barrier to school attendance, including a recent qualitative study among school girls in rural Uganda.
“The qualitative findings support previous studies in LMIC showing that menstruation is a cause of distress to many girls, and a barrier to school attendance [3, 18], including a recent qualitative study among school girls in rural Uganda [19].”
From Menstrual health and school absenteeism among adolescent girls in Uganda (MENISCUS): a feasibility study (2018) · cites this paper as [19]
The finding that higher levels of sanitation according to existing criteria were not strongly associated with more positive perceptions of the menstrual management environment is consistent with studies of girls in schools reporting that girls may avoid using sanitation facilities due to stigma around menstruation and fears for privacy, and with women's sanitation-related stress.
“However, this finding is consistent with studies of girls’ in schools, which have reported that girls may avoid using sanitation facilities due to stigma around menstruation and fears for privacy [2,12,13], and women’s sanitation-related stress [16,17].”
Survey items did not capture other sources of distress such as access to resources needed to manage menstruation, concerns around soiling and odor, or stigma and taboos associated with menstruation identified in existing literature.
“survey items did not capture other sources of distress such as access to resources needed to manage menstruation, concerns around soiling and odor, or stigma and taboos associated with menstruation identified in existing literature [2,5,8].”
These findings seem inconsistent with high reports of stress associated with menstrual management in studies amongst school girls in sub-Saharan Africa and among adult women in India.
“These findings seem inconsistent with high reports of stress associated with menstrual management in studies amongst school girls in sub-Saharan Africa [2,5,13,34], and among adult women in India [16,18,35].”
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“in the development of interventions, and in their evaluation [5, 6].”
BackgroundProcess evaluation of complex interventions: Medical Research Council guidance
Moore, G. F., Audrey, S., Barker, M., Bond, L., Bonell, C., Hardeman, W., Moore, L., O'Cathain, A., Tinati, T., Wight, D., et al. (2015) · BMJ · doi:10.1136/bmj.h1258 · Cited by 6,204 · cited 1× · see citing works
“these functions qualitative research serves to provide a trial process evaluation by exploring mechanisms of impact in the trial, implementation, and study context [10].”
BackgroundLewin, S., Glenton, C., & Oxman, A. D. (2009) · BMJ · doi:10.1136/bmj.b3496 · Cited by 678 · see citing works
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Hawe, P. (2015) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031912-114421 · Cited by 607 · cited 1× · see citing works
“in the development of interventions, and in their evaluation [5, 6].”
BackgroundNonsteroidal anti-inflammatory drugs for dysmenorrhoea
Marjoribanks, J., Ayeleke, R. O., Farquhar, C. M., & Proctor, M. L. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001751.pub3 · Cited by 573 · see citing works
A systematic review of the health and social effects of menstrual hygiene management
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“More research is needed on the relationships between irritation, infection, and menstrual management [19, 20].”
BackgroundDas, P., Baker, K. K., Dutta, A., Swain, T., Sahoo, S., Das, B. S., Panda, B., Nayak, A., Bara, M., Bilung, B., et al. (2015) · PLOS ONE · doi:10.1371/journal.pone.0130777 · Cited by 441 · cited 1× · see citing works
“More research is needed on the relationships between irritation, infection, and menstrual management [19, 20].”
BackgroundWhat can qualitative research do for randomised controlled trials? A systematic mapping review
O'Cathain, A., Thomas, K. J., Drabble, S. J., Rudolph, A., & Hewison, J. (2013) · BMJ Open · doi:10.1136/bmjopen-2013-002889 · Cited by 438 · see citing works
A Time for Global Action: Addressing Girls’ Menstrual Hygiene Management Needs in Schools
Sommer, M., Caruso, B. A., Sahin, M., Calderon, T., Cavill, S., Mahon, T., & Phillips-Howard, P. A. (2016) · PLOS Medicine · doi:10.1371/journal.pmed.1001962 · Cited by 435 · see citing works
Mason, L., Nyothach, E., Alexander, K., Odhiambo, F. O., Eleveld, A., Vulule, J., Rheingans, R., Laserson, K. F., Mohammed, A., & Phillips-Howard, P. A. (2013) · PLoS ONE · doi:10.1371/journal.pone.0079132 · Cited by 375 · cited 3× · see citing works
“A similar finding was noted by Mason and colleagues [3], and did not appear to be impacted by the intervention.”
BackgroundResultTegegne, T. K., & Sisay, M. M. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-1118 · Cited by 342 · cited 1× · see citing works
“, [3, 16, 23]), we found that most girls were aware of menstruation prior to menarche.”
BackgroundHennegan, J., & Montgomery, P. (2016) · PLOS ONE · doi:10.1371/journal.pone.0146985 · Cited by 333 · cited 1× · see citing works
“Programs seeking to improve menstrual health have been implemented, but few high quality trials have been conducted [7].”
BackgroundSelf-citationvan Teijlingen, E. (2006) · Sociological Research Online · doi:10.1177/136078040601100108 · Cited by 218 · see citing works
What can qualitative research do for randomised controlled trials? A systematic mapping review
O’Cathain, A., Thomas, K. J., Drabble, S. J., Rudolph, A., & Hewison, J. (2013) · Trials · doi:10.1186/1745-6215-14-s1-o52 · Cited by 198 · see citing works
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“other strategies, such as stretching or heat, which could also be suggested in education [27].”
BackgroundMenstrual knowledge and practices of female adolescents in urban Karachi, Pakistan
Ali, T. S., & Rizvi, S. N. (2010) · Journal of Adolescence · doi:10.1016/j.adolescence.2009.05.013 · Cited by 187 · cited 1× · see citing works
“, [3, 16, 23]), we found that most girls were aware of menstruation prior to menarche.”
BackgroundSommer, M., Ackatia-Armah, N., Connolly, S., & Smiles, D. (2015) · Compare: A Journal of Comparative and International Education · doi:10.1080/03057925.2013.871399 · Cited by 169 · see citing works
Hennegan, J., Dolan, C., Wu, M., Scott, L., & Montgomery, P. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-012596 · Cited by 160 · cited 1× · see citing works
“This may explain the unexpected quantitative findings that those drying menstrual absorbents (cloths or reusable pads) outside experienced poorer health (discharge and odour) outcomes [18].”
BackgroundSelf-citationCrichton, J., Okal, J., Kabiru, C. W., & Zulu, E. M. (2013) · Health Care for Women International · doi:10.1080/07399332.2012.740112 · Cited by 147 · cited 1× · see citing works
“[22] found that girls in Nairobi were unaware pharmaceutical options existed.”
BackgroundMontgomery, P., Hennegan, J., Dolan, C., Wu, M., Steinfield, L., & Scott, L. (2016) · PLOS ONE · doi:10.1371/journal.pone.0166122 · Cited by 132 · see citing works
Self-citationPhillips-Howard, P. A., Otieno, G., Burmen, B., Otieno, F., Odongo, F., Odour, C., Nyothach, E., Amek, N., Zielinski-Gutierrez, E., Odhiambo, F., et al. (2015) · Journal of Women's Health · doi:10.1089/jwh.2014.5031 · Cited by 119 · cited 1× · see citing works
“Consequences of inadequate menstrual management have been suggested to extend beyond the classroom to health, dignity, psychosocial wellbeing, employment, and participation in society [3, 4].”
BackgroundA blind spot in girls education: menarche and its webs of exclusion in Ghana
Dolan, C. S., Ryus, C. R., Dopson, S., Montgomery, P., & Scott, L. (2014) · Journal of International Development · doi:10.1002/jid.2917 · Cited by 114 · cited 1× · see citing works
“Semi-structured interviews covered a range of topics drawn from interviews undertaken in pilots preceding the trial, [12, 13] with additions to capture more detail around menstrual experience and trial implementation (see Table 1 for broad guide).”
BackgroundSelf-citationMILLS, J. S., & White, R. (1987) · Elsevier eBooks · doi:10.1016/b978-0-408-11810-1.50017-9 · Cited by 83 · see citing works
Hennegan, J., Dolan, C., Wu, M., Scott, L., & Montgomery, P. (2016) · Reproductive Health · doi:10.1186/s12978-016-0260-7 · Cited by 61 · cited 1× · see citing works
“Those using AFRIpads may have been able to change faster, as indicated in quantitative findings, [17] facilitating some girls to change at school in those conditions.”
MethodSelf-citationHilber, A. M., Kenter, E., Redmond, S. M. S., Merten, S., Bagnol, B., Low, N. N., & Garside, R. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.11.032 · Cited by 55 · cited 1× · see citing works
“While studies have suggested that vaginal practices such as labia elongation may be a source of agency, [24] this did not appear to be the case in this study where social pressure and fear pervaded.”
BackgroundKerubo, E., Laserson, K. F., Otecko, N., Odhiambo, C., Mason, L., Nyothach, E., Oruko, K. O., Bauman, A., Vulule, J., Zeh, C., et al. (2016) · Sexually Transmitted Infections · doi:10.1136/sextrans-2015-052371 · Cited by 40 · cited 1× · see citing works
“Girls’ lack of understanding around vaginal discharge and health may be one source of the poor consistency between self-reported symptoms and laboratory-confirmed reproductive tract infections [21].”
BackgroundSanitary Pad Acceptability and Sustainability Study - Long Report
Scott, L., Montgomery, P., Steinfeld, L., Dolan, C., & Dopson, S. (2013) · doi:10.35648/20.500.12413/11781/ii161 · Cited by 13 · see citing works
Self-citationSanitary Pad: Acceptability and Sustainability Study
Scott, L. M., Montgomery, P., Steinfield, L. A., Dolan, C. S., Dopson, S., & Hecimovich, J. (2013) · SOAS Research Online (SOAS University of London) · Cited by 12 · see citing works
Self-citationUNESCO, G. R. (2015) · doi:10.54676/myfz9834 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Miiro, G., Rutakumwa, R., Nakiyingi-Miiro, J., Nakuya, K., Musoke, S., Namakula, J., Francis, S., Torondel, B., Gibson, L. J., Ross, D. A., et al. (2018) · BMC Women's Health · doi:10.1186/s12905-017-0502-z · Cited by 297 · see citing works
“Published on UNESCO HIV and Health Education Clearinghouse (https://hivhealthclearinghouse.unesco.org) Menstrual health and school absenteeism among adolescent girls in Uganda (MENISCUS): A feasibility study 2018.”
ResultInfluentialvan Eijk, A. M., Jayasinghe, N., Zulaika, G., Mason, L., Sivakami, M., Unger, H. W., & Phillips‐Howard, P. A. (2021) · PLoS ONE · doi:10.1371/journal.pone.0257610 · Cited by 101 · see citing works
“Some studies did not report the percentage of complaints, but noted that these complaints were associated with wearing the same RMP for an extended duration [26] or with inadequate cleaning or drying [42,60].”
BackgroundShah, V., Nabwera, H., Sonko, B. J., Bajo, F., Faal, F., Saidykhan, M., Jallow, Y., Keita, O., Schmidt, W., & Torondel, B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19063337 · Cited by 96 · see citing works
“These findings support previous studies in LMICs that show menstruation is a barrier to school attendance [25,27,46,47].”
ResultChirgwin, H., Cairncross, S., Zehra, D., & Waddington, H. S. (2021) · Campbell Systematic Reviews · doi:10.1002/cl2.1194 · Cited by 97 · see citing works
Puberty Education in a Global Context: Knowledge Gaps, Opportunities, and Implications for Policy
Crockett, L. J., Deardorff, J., Johnson, M. M., Irwin, C. E., & Petersen, A. C. (2019) · Journal of Research on Adolescence · doi:10.1111/jora.12452 · Cited by 68 · see citing works
Evans, R. L., Harris, B., Onuegbu, C. M., & Griffiths, F. E. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-057204 · Cited by 86 · see citing works
Shannon, A. K., Meléndez‐Torres, G. J., & Hennegan, J. M. (2020) · Culture Health & Sexuality · doi:10.1080/13691058.2020.1718758 · Cited by 61 · see citing works
“Reusable sanitary pads needed to be washed and dried which presented ongoing challenges (Hennegan et al. 2017; Shah et al. 2013; Stopford 2011; WoMena 2017).”
BackgroundMethodInfluentialSelf-citationA novel banana fiber pad for menstrual hygiene in India: a feasibility and acceptability study
Achuthan, K., Muthupalani, S., Kolil, V. K., Bist, A., Sreesuthan, K., & Sreedevi, A. (2021) · BMC Women s Health · doi:10.1186/s12905-021-01265-w · Cited by 62 · see citing works
“In alignment with past works, [43] the workshops were a new experience for most women who had no access to information on MHM as well as knowledge on the origin or destiny of disposable pads.”
BackgroundHennegan, J. M., & Sol, L. (2019) · Culture Health & Sexuality · doi:10.1080/13691058.2019.1580768 · Cited by 51 · see citing works
“…in secrecy; limited social support from parents, teachers and peers; poor access to clean absorbent materials; and inadequate physical infrastructure to support changing and cleaning absorbents and the body (Hennegan et al. 2017; Rheinl€ander et al. 2018; Caruso et al. 2013; Sommer et al. 2014).”
BackgroundSelf-citationTeachers' Perceptions and Experiences of Menstrual Cycle Education and Support in UK Schools
Brown, N., Williams, R., Bruinvels, G., Piasecki, J., & Forrest, L. J. (2022) · Frontiers in Global Women s Health · doi:10.3389/fgwh.2022.827365 · Cited by 45 · see citing works
“Alongside greater information and resources needed to support adolescent girls to confidently care for their bodies (18), an open and safe environment, free from stigma and psychological distress are also important aspects in achieving positive menstrual health.”
BackgroundKumbeni, M. T., Ziba, F. A., Apenkwa, J., & Otupiri, E. (2021) · BMC Women s Health · doi:10.1186/s12905-021-01418-x · Cited by 44 · see citing works
“These findings are not surprising because most girls feel the sanitary pad is superior to cloth and therefore they are more comfortable using sanitary pad while in school without the fear of staining themselves and being teased [21].”
BackgroundHennegan, J., Zimmerman, L., Shannon, A. K., Exum, N. G., OlaOlorun, F., Omoluabi, E., & Schwab, K. J. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15050905 · Cited by 38 · see citing works
“Qualitative studies in sub-Saharan Africa have noted the stress girls experience in changing their menstrual materials, with many citing safety and privacy concerns as reasons to avoid attending school or changing menstrual absorbents at school [2,10].”
BackgroundResultInfluentialSelf-citationHennegan, J. M. (2020) · Springer eBooks · doi:10.1007/978-981-15-0614-7_47 · Cited by 31 · see citing works
“Seemingly intuitive community programs or policies often fail to have the anticipated results and can risk unintended harms (Hennegan 2017).”
BackgroundSelf-citationDrivers of menstrual material disposal and washing practices: A systematic review
Robinson, H. J., & Barrington, D. (2021) · PLoS ONE · doi:10.1371/journal.pone.0260472 · Cited by 32 · see citing works
“Hennegan et al, 2017 [50] Uganda Lower-middle Girls in school 27 students (female, aged 12–17, across 8 schools)”
BackgroundTshomo, T., Gurung, M. S., Shah, S., Cuesta, J. G., Maes, P., Wangdi, R., & Tobden, J. (2021) · Frontiers in Reproductive Health · doi:10.3389/frph.2021.703978 · Cited by 45 · see citing works
Menstrual health and hygiene among Indigenous Australian girls and women: barriers and opportunities
Krusz, E., Lansbury, N., Barrington, D., Creamer, S., Anders, W., King, M., Martin, H., & Hennegan, J. M. (2019) · BMC Women s Health · doi:10.1186/s12905-019-0846-7 · Cited by 33 · see citing works
Self-citationFoster, J., & Montgomery, P. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189766 · Cited by 39 · see citing works
“Therefore, provision of superior absorbents and cost-effective menstrual hygiene products can reduce fears of soiling outer garments allowing better school attendance [11].”
BackgroundSelf-citationAnaba, E. A., Udofia, E. A., Manu, A., Daniels, A. A., & Aryeetey, R. (2022) · BMC Women s Health · doi:10.1186/s12905-022-01670-9 · Cited by 31 · see citing works
“However, effective management of reusable menstrual materials, especially reusable cloth/pads, remains a challenge for many women [6].”
BackgroundAlam, M., Sultana, F., Hunter, E. C., WINCH, P. J., UNICOMB, L. E., Sarker, S., Mahfuz, M. T., Al‐Masud, A., Rahman, M. M., & Luby, S. P. (2022) · BMC Public Health · doi:10.1186/s12889-022-13478-1 · Cited by 34 · see citing works
“school were shaped by common language and education around menstruation, as well as encouragement from teachers and peers, which led to their ease and confidence in managing menstruation [18].”
BackgroundThe menstrual cycle and football: The experiences of African women football players
Mkumbuzi, N. S., Dlamini, S. B., Chibhabha, F., Govere, F. M., & Manda‐Taylor, L. (2021) · Science and Medicine in Football · doi:10.1080/24733938.2021.2005252 · Cited by 30 · see citing works
“alternative sanitary products is similar to findings reported in other low-income cohorts (Hennegan et al. 2017).”
ResultMunro, A. K., Keep, M., Hunter, E. C., & Hossain, S. Z. (2022) · Women s Health · doi:10.1177/17455065211070666 · Cited by 29 · see citing works
Biodegradable sanitary napkins — a sustainable approach towards menstrual and environmental hygiene
Panjwani, M. H., Rapolu, Y., Chaudhary, M., Gulati, M., Razdan, K., Dhawan, A., & Sinha, V. R. (2023) · Biomass Conversion and Biorefinery · doi:10.1007/s13399-023-04688-7 · Cited by 32 · see citing works
“The practice of controlling menstrual bleeding using traditional methods frequently results in fungal infections and recurrent infections that put women at risk for urinary tract infections, vaginal infections, cervical cancer, and infertility [13].”
Systematic Review on Sanitary Pads and Female Health
Woo, J., Kim, S., Kim, H., Jeong, K. S., Kim, E., & Ha, E. (2019) · Ewha Medical Journal · doi:10.12771/emj.2019.42.3.25 · Cited by 27 · see citing works
Mehjabeen, D., Hunter, E. C., Mahfuz, M. T., Mobashara, M., Rahman, M. M., & Sultana, F. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191610140 · Cited by 25 · see citing works
Ahmed, M. S., Yunus, F. M., Hossain, M. B., Sarker, K. K., & Khan, S. (2021) · Adolescents · doi:10.3390/adolescents1030025 · Cited by 20 · see citing works
“This creates adverse schooling experiences and can lead to absenteeism from school [39].”
BackgroundMahfuz, M. T., Sultana, F., Hunter, E. C., Jahan, F., Akand, F., Khan, S., Mobashhara, M., Rahman, M. M., Alam, M., UNICOMB, L. E., et al. (2021) · Global Health Action · doi:10.1080/16549716.2021.1955492 · Cited by 24 · see citing works
“USA [34,35] England [36] Australia [37] Swaziland [25] Uganda [5] Peru [38] Thailand [39] Malaysia [40]”
BackgroundSwe, Z. Y., Mon, N. O., Than, K. K., Azzopardi, P. S., Kennedy, E. C., Davis, J., Burns, L. J., & Hennegan, J. M. (2022) · Frontiers in Reproductive Health · doi:10.3389/frph.2022.893266 · Cited by 18 · see citing works
Self-citationTembo, M., Weiss, H. A., Larsson, L. S., Bandason, T., Redzo, N., Dauya, E., Nzanza, T., Ishumael, P., Gweshe, N., Ndlovu, P., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-067897 · Cited by 13 · see citing works
Method, A., Hassan, J., Assenga, O., Kamugisha, P., Kawishe, T., Luchagura, F., Msaka, P., Singu, M., & Bintabara, D. (2024) · PLOS Global Public Health · doi:10.1371/journal.pgph.0002842 · Cited by 23 · see citing works
Mapping the health outcomes of menstrual inequity: a comprehensive scoping review
García-Egea, A., Pujolar-Díaz, G., Hüttel, A. B., Holst, A. S., Jacques‐Aviñó, C., & Medina‐Perucha, L. (2025) · Reproductive Health · doi:10.1186/s12978-025-02103-0 · Cited by 11 · see citing works
“A qualitative study shows that the disparities between information provided by family and peers, compared to the information received in an educational intervention is a source of stress (Table 5) for adolescent girls in Uganda [104].”
InfluentialGarcía-Egea, A., Holst, A. S., Jacques‐Aviñó, C., Bueno, C. M., Berenguera, A., Vicente‐Hernández, M. M., Valls-Llobet, C., Pinzón-Sanabria, D., Pujolar-Díaz, G., & Medina‐Perucha, L. (2024) · Reproductive Health · doi:10.1186/s12978-023-01730-9 · Cited by 13 · see citing works
Kolil, V. K., & Achuthan, K. (2024) · Scientific Reports · doi:10.1038/s41598-024-72122-7 · Cited by 11 · see citing works
“Studies have shown that RSPs are acceptable, effective, and can have a positive impact on MHM, especially in resource-poor settings 17,47 .”
BackgroundShrestha, S., Shrestha, S., Ito, Y., Kobayashi, Y., Nishida, K., Kazama, F., & Malla, R. (2021) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2021.100 · Cited by 9 · see citing works
“To date, healthcare interventions have received little attention (Hennegan et al. 2017) and have never been enlisted as a facility required for comfortable MM in school policies and strategies.”
BackgroundInfluentialUnderstanding autistic youths’ menstrual product preferences and caregivers’ product choices
Lundy, K. M., Fischer, A. J., Illapperuma-Wood, C. R., & Schultz, B. K. (2024) · Autism · doi:10.1177/13623613241275280 · Cited by 9 · see citing works
“Nevertheless, reusable menstrual products can increase cleaning and care demands for people living in low-or middle-income countries (LMICs) that lack access to affordable and sustainable water, sanitation, and hygiene (WASH) systems (Hennegan et al., 2017; Madami & Period, 2022).”
Ubochi, N. E., Chinweuba, U. A., Iheanacho, N. P., et al. (2023) · Pan African Medical Journal · doi:10.11604/pamj.2023.45.47.39675 · Cited by 7 · see citing works
“further substantiated this claim, it stated, that “the sociocultural context has a great influence on menstrual experiences, manifesting in strict behavioural expectations to conceal menstruation and limiting the provision of menstrual materials" [30].”
BackgroundKara, Ş. (2021) · Industria Textila · doi:10.35530/it.072.04.1795 · Cited by 6 · see citing works
Progressive Approach of SAPs in Disposable Hygiene Industry
Tuteja, J., & Vyas, A. (2023) · Springer eBooks · doi:10.1007/978-981-99-1102-8_8 · Cited by 6 · see citing works
Blood flows: mapping journeys of menstrual waste in Blantyre, Malawi
Roxburgh, H., Magombo, C., Kaliwo, T., Tilley, E., Hampshire, K., Oliver, D. M., & Quilliam, R. S. (2021) · Cities & Health · doi:10.1080/23748834.2021.1916330 · Cited by 6 · see citing works
“Household economics undoubtedly plays a crucial role; pads can be expensive relative to the average income, and therefore women who are poorer or have less control over household expenditures may be more likely to use old cloth (Hennegan et al .”
InfluentialArcuri, A. G., Veludo‐de‐Oliveira, T. M., & Larsen, G. (2026) · Marketing Theory · doi:10.1177/14705931251414808 · Cited by 5 · see citing works
“Moreover, even in the Global South where healthcare, contraceptives, and menstrual supplies may have previously been available via public services, the furthering of the colonial project of capitalism mean that they are increasingly available only via the marketplace thus exacerbating (non)consumption (Hennegan et al.…”
InfluentialBehera, M. R., Dehury, R. K., Behera, D., & Panda, B. (2024) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2024.101804 · Cited by 8 · see citing works
Assefa, G. M., Stulz, V. M., Mengie, G., Atnafe, L., Gezahegn, W., Smet, E., & Muluneh, M. D. (2025) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2025.233 · Cited by 4 · see citing works
SAMARA, A. A., Hanton, T., Thakar, R., Jauniaux, E. R. M., & Khalil, A. A. (2025) · Frontiers in Global Women s Health · doi:10.3389/fgwh.2025.1483938 · Cited by 4 · see citing works
Nalini, Y. C., Gaonkar, S., Anjusha, I. B., & Basavarajegowda, A. (2022) · BLDE University Journal of Health Sciences · doi:10.4103/bjhs.bjhs_2_22 · Cited by 3 · see citing works
Knowledge and peer support for increase Menstrual Hygiene Management (MHM) in adolescents
Armini, N. K. A., Setyani, A., Nastiti, A. A., & Triharini, M. (2023) · Healthcare in Low-resource Settings · doi:10.4081/hls.2023.11193 · Cited by 5 · see citing works
Dodroe, K. B., Wampande, L. N., Nishimwe, A., Mukinisha, M., & Schurer, J. M. (2025) · PLOS Global Public Health · doi:10.1371/journal.pgph.0004152 · Cited by 5 · see citing works
“In three surveys, schoolgirls perceived reusable pads as less costly, more reliable, less difficult to change and less disgusting while cleaning [28–30].”
Towards Menstrual Equity: A Review of Sustainable Solutions in Menstrual Hygiene Management
Sarkar, A., & Gehlawat, M. (2025) · Preventive Medicine Research & Reviews · doi:10.4103/pmrr.pmrr_231_24 · Cited by 3 · see citing works
Buser, J. M., Kumakech, E., August, E. T., Rana, G., Gray, R., Auma, A. G., Jacobson‐Davies, F. E., Endale, T., Pebolo, P. F., & Smith, Y. R. (2024) · Women s Health · doi:10.1177/17455057241285193 · Cited by 3 · see citing works
“57,77,78 Iyer and Aggleton explored teachers’ views of appropriate sex education and found that teachers express negative attitudes toward young people’s sexual activity and are not neutral delivery mechanisms in schools.”
BackgroundKeeping African Girls in School with Better Sanitary Care
Tofaris, E., & Dolan, C. (2018) · doi:10.35648/20.500.12413/11781/ii307 · Cited by 3 · see citing works
Self-citationBisimirwe, C., Maombi, S., Nabuki, S., Mubelelwa, L., Llosa, A. E., & Palacios, L. (2025) · Research Square · doi:10.21203/rs.3.rs-6938601/v1 · Cited by 3 · see citing works
The Effectiveness of Different Cleaning Methods on the Microbial Load of Reusable Menstrual Pads
Rajah, A. S., Yunusa, U., Tijjani, T. F., Tukuntawa, A. S., & Abdullahi, S. O. (2024) · UMYU Journal of Microbiology Research (UJMR) · doi:10.47430/ujmr.2492.024 · Cited by 2 · see citing works
“Additionally, managing menstruation effectively and hygienically can be a significant challenge, especially in low-income settings (Hennegan et al ., 2017).”
García-Egea, A., López‐Jiménez, T., Jacques‐Aviñó, C., et al. (2024) · Gaceta Sanitaria · doi:10.1016/j.gaceta.2024.102415 · Cited by 2 · see citing works
Foster, J., & Montgomery, P. (2021) · Research Square · doi:10.21203/rs.3.rs-306469/v1 · Cited by 2 · see citing works
“Therefore, provision of superior absorbents and cost-effective menstrual hygiene products can reduce fears of soiling outer garments allowing better school attendance [9].”
BackgroundSelf-citationVenetis, M. K., Shields, A. N., Rawat, M., & Seth, J. (2022) · Western Journal of Communication · doi:10.1080/10570314.2022.2141072 · Cited by 1 · see citing works
Nguegang, F., & Kum, F. V. (2024) · Journal of Behavioral and Experimental Economics · doi:10.1016/j.socec.2024.102302 · Cited by 3 · see citing works
Social Entrepreneurship Initiatives Addressing Period Poverty: Mapping Strategies and Outcomes
Tohit, N. F. M., Rashid, S. A. Z. A., Fakuradzi, W. F. S. W. A., Zaidi, N. A. A., & Haque, M. (2025) · Bangladesh Journal of Medical Science · doi:10.3329/bjms.v24i1.78607 · Cited by 1 · see citing works
“Studies have shown that access to affordable menstrual products can significantly reduce school absenteeism among girls, thereby promoting educational attainment and gender equality 32,33 .”
Just 4U™: Reusable Period Pants Alongside an Ovulatory Menstrual Health Literacy Program
Roux, K., Roux, F., Hendriks, J., et al. (2024) · Youth · doi:10.3390/youth4040111 · Cited by 1 · see citing works
La copa menstrual, una alternativa de higiene femenina. Revisión de la literatura
Prado-Galarza, M., William Andrés Doncel, C., Oscar Olmedo Mosquera, B., & Guarnizo-Tole, M. (2020) · Revista chilena de obstetricia y ginecología · doi:10.4067/s0717-75262020000100099 · Cited by 1 · see citing works
Knowledge on Sanitary Practices and Waste Management Among Sherubtse College GirlsPreprint
Nepal, T. K., Wangmo, S., Gurung, M. L. N., Yangchen, K., Dema, U., & Wangmo, D. (2021) · Preprints.org · doi:10.20944/preprints202102.0479.v1 · Cited by 1 · see citing works
“So, they mostly rely on reusable cloth pads which they wash and use again [11].”
BackgroundKumbeni, M. T., Ziba, F. A., Apenkwa, J., & Otupiri, E. (2021) · Research Square · doi:10.21203/rs.3.rs-146221/v1 · Cited by 1 · see citing works
“These ndings are not surprising because most girls feel the sanitary pad is superior to cloth and therefore they are more comfortable using sanitary pad while in school without the fear of staining themselves and being teased [21].”
BackgroundMenstrual health among school adolescent girls
Mishra, L. (2019) · International Journal of Advance Research in Nursing · doi:10.33545/nursing.2019.v2.i1.c.1
“Data presented in this paper are part of a larger study among both girls and boys, which focused on both menstrual practices and safe male circumcision (MENISCUS: Menstrual Hygiene and Safe Male Circumcision Promo-tion in Bhubaneswarn Schools).”
BackgroundInfluentialKhodakarami, B., Refaei, M., Faradmal, J., et al. (2020) · Current Women s Health Reviews · doi:10.2174/1573404816999200420111101
‘Blooming’: A Design Concept for Period Poverty in Rural Areas of China
Zeng, J., Liu, B., Sun, X. S., & Wu, J. (2021) · Lecture notes in computer science · doi:10.1007/978-3-030-77077-8_31
Rethinking Impact: Applying the Gender Lens
Initiative, T. I. (2019) · doi:10.35648/20.500.12413/11781/ii336
Recipes For Impact: Feed, Thinking, Nourish, Change
Initiative, T. I. (2018) · doi:10.35648/20.500.12413/11781/ii323
Impact of Menstrual Distress During Menstruation to Promote Coping Strategies
Karmakar, M., Panduragan, S. L., Said, F. M., & Poddar, S. (2023) · Advances in medical diagnosis, treatment, and care (AMDTC) book series · doi:10.4018/978-1-6684-5088-8.ch012
Exploration of Various Issues Associated with Sustainable use of Sanitary Napkins
Singh, P. (2023) · Journal of Applied Science and Education (JASE) · doi:10.54060/jase.v3i1.26
Menstrual Health Experiences of Adolescents in Institutional Care
Gupta, K., & Patel, S. J. (2023) · Institutionalised Children Explorations and Beyond · doi:10.1177/23493003231198572 · Cited by 1 · see citing works
Bhandari, K., Dahal, R., & Paudel, Y. R. (2024) · International Journal of Health Sciences and Research · doi:10.52403/ijhsr.20240516
Sari, N. P., Utama, B. I., & Amir, A. (2024) · Journal La Medihealtico · doi:10.37899/journallamedihealtico.v5i4.1454
“According to Elledge et al. (2018) and Hennegan et al. (2017), disposal of used sanitary pads is also included in these actions.”
BackgroundGender Equality Narratives by Zimbabwean Women: Education, Employment and Entrepreneurship
Muringani, B., & Hapazari, J. (2024) · Gender and Cultural Studies in Africa and the Diaspora · doi:10.1007/978-3-031-66917-0_10
Spiller, E., Blackwell, A., Ayella, C., Mansi, E., & Falb, K. (2025) · International Journal of Educational Development · doi:10.1016/j.ijedudev.2025.103264
Menstrual inequities and menstrual justice: A scoping review of social work literature
Bell, K., Cash, B., Moorhead, B., Boetto, H., & Ivory, N. J. (2025) · International Social Work · doi:10.1177/00208728251360602
“…where author location differed from the country of the research entirely, where the authors of a Kenyan-based study originated from the United States (Winter et al., 2022), and research conducted in Uganda was led by authors originating from the United Kingdom and USA (Hennegan et al., 2017).”
InfluentialRazavi, D., Cummings, H., Labonté, J. M., Kapiriri, L., & Sohani, S. (2026) · Reproductive Health · doi:10.1186/s12978-026-02319-8
“MHM interventions have been implemented in a variety of contexts, including in many African nations [Ghana [11], Ethiopia [12], Kenya [13, 14], Malawi [15], Uganda [16–19], and Zimbabwe [20, 21], the Middle East [22, 23], South Asia [24, 25], and the Caribbean [26].”
Gaihre, S., Dangal, B., Ghimire, U., Matheson, R., Parkar, S., Archana, K. C., & Paudyal, P. (2026) · Critical Public Health · doi:10.1080/09581596.2025.2612639
Bisimirwe, C., Maombi, S., Nabuki, S., Mubelelwa, L., Llosa, A. E., & Palacios, L. (2026) · npj Women s Health · doi:10.1038/s44294-026-00136-9 · Cited by 3 · see citing works
Chatterjee, J. (2026) · Social enterprise journal · doi:10.1108/sej-05-2025-0103 · Cited by 1 · see citing works
The role of sanitary pads in school achievement in low-income settings
Patel, A., Axinn, W. G., & Ghimire, D. J. (2026) · Social Science Research · doi:10.1016/j.ssresearch.2026.103395
Chouhan, P. (2026) · International Journal of Nursing Education and Research · doi:10.52711/2454-2660.2026.00051
- Authors
- Hennegan, J., Dolan, C., Steinfield, L., & Montgomery, P.
- Affiliations
- University of Oxford (GB)
- SOAS University of London (GB)
- Bentley University (US)
- Corresponding author
- Hennegan, Julie
- Venue
- Reproductive Health
- Published
- 2017-06-27
- Volume
- 14
- Issue
- 1
- Pages
- 78-78
- ISSN
- 1742-4755 (ISSN-L)
- PMC
- PMC5488479
- OpenAlex
- W2724127469
- Semantic Scholar
- 00f02c1fb3f34772ace682ac08ed33c31c1df181
- Cited by
- 83
- References
- 29
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 13 · 2023: 8 · 2022: 12 · 2021: 18 · 2020: 5 · 2019: 6 · 2018: 4
- FWCI
- 3.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Reproductive Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- SOAS Research Online (SOAS University of London) (acceptedVersion)
- SOAS Research Online (SOAS University of London) (acceptedVersion, other-oa)
- SOAS Research Online (SOAS University of London) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
- Funders
- Economic and Social Research Council (ES/I034145/1)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- menstrual hygiene, puberty education, female students, menstrual health, school absenteeism, privacy, menstrual pain management, women's education, rural Uganda
- MeSH terms
- Adolescent, Education, Female, Humans, Menstruation, Uganda, Hygiene Products, Reproductive Health
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