A qualitative understanding of the effects of reusable sanitary pads and puberty education: implications for future research and practice.
A qualitative understanding of the effects of reusable sanitary pads and puberty education: implications for future research and practice.
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DOI：
10.1186/s12978-017-0339-9
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发表时间：
2017-06-27
影响因子：
3.4
通讯作者：
Montgomery P
中科院分区：
文献类型：
--
作者：
Hennegan J;Dolan C;Steinfield L;Montgomery P
月经管理已成为低收入环境下女孩获得教育的障碍。已经提出并试行了干预措施，但该领域的新兴性质意味着可获得的证据有限，无法了解其影响途径。这项研究描述并比较了乌干达农村地区女学生在青春期教育和提供卫生巾的对照试验结束时的月经经历，以阐明干预措施的影响途径。在进行最后一套定量调查的同时，对参加月经和贫困周期试验的女学生进行了半结构化访谈。采用框架分析和交叉病例分析的方法，描述和比较27名月经女孩在4种干预条件下的经历：教育(n=8)、可重复使用卫生巾(n=8)、使用可重复使用卫生巾教育(n=6)和对照(n=5)。主题包括：月经卫生、污垢、刺激和感染、身体体验、月经知识、心理、社会和文化因素，以及来自他人的支持。那些接受可重复使用的垫子的人在舒适性和可靠性方面都得到了改善。这意味着人们对衣服弄脏和相关缺课的担忧有所减少。洗涤、烘干和隐私方面的其他月经卫生挑战仍然突出。青春期教育提高了女孩讨论月经的信心，并促使老师和同龄人提供额外的支持。研究结果对未来干预措施的发展和评估具有重要影响。结果表明，提供月经吸收剂解决了月经健康的一个核心障碍，但解决更广泛需求的干预措施，如隐私，可能会提高有效性。青春期教育课程应该增加对身体意识的关注，并包括应对更广泛的实际月经挑战的战略，包括疼痛管理。访谈揭示了在未来研究中改进量化调查的可能性。泛非临床试验注册PACTR201503001044408
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. 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). 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. 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. Pan-African Clinical Trials Registry PACTR201503001044408