Access to menstrual hygiene products through incentivised, community-based, peer-led sexual and reproductive health services before and during the COVID-19 pandemic: findings from the Yathu Yathu trial.
Access to menstrual hygiene products through incentivised, community-based, peer-led sexual and reproductive health services before and during the COVID-19 pandemic: findings from the Yathu Yathu trial.
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DOI：
10.1186/s12889-022-12915-5
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发表时间：
2022-03-21
影响因子：
4.5
通讯作者：
H A
中科院分区：
文献类型：
--
作者：
B H;M G;M P;A S;M S;S F;L M;L S;K S;M S;S F;R H;H A
获得负担得起和有效的经期卫生用品对少女和年轻妇女的经期健康至关重要。在这项混合方法分析中，我们使用了提供全面性健康和生殖健康（SRH）服务的规划的数据来描述获得MHP的情况以及与covid -19相关的关闭如何影响获得MHP；我们使用定性数据来了解AGYW在研究期间访问产品的体验。在2019年9月至2021年1月期间，我们使用了从10个Yathu Yathu中心常规收集的数据，这些中心为15-24岁的青少年和年轻人提供以社区为基础的同伴主导的性健康生殖健康服务。Hubs提供免费的MHP（主要是一次性卫生巾）服务。为了激励人们使用服务，Yathu Yathu内置了一个“忠诚”卡系统，允许个人通过使用服务获得积分，并使用这些积分兑换奖励。奖励包括品牌卫生巾、卫生棉条和可重复使用的卫生巾。我们描述了获得卫生巾和奖励MHP的情况，并使用逻辑回归来调查在2019冠状病毒病相关关闭之前（2019年9月- 2020年3月）和之后（2020年7月- 2021年1月）获得卫生巾和奖励产品的相关因素。焦点小组讨论探讨了通过中心提供MHP的可及性。在2019年9月至2021年1月期间，6374名AGYW访问了34116个中心，以获得SRH服务和/或兑换奖励。在这些访问中，AGYW访问了任何MHP，占30%。在covid - 19关闭之前，每月平均有17%的就诊是免费提供的一次性卫生巾，而在中心重新开放后，这一比例为34% （p < 0.001）。奖励访问的结果也类似。总体而言，6374 AGYW中有63%的用户至少将卫生巾作为服务收集一次。在covid - 19关闭之前，18-24岁的AGYW比青少年（15 - 17岁）更有可能获得服务垫。重新开放后，较老的AGYW的访问率较低。在中心关闭之前，接受过一些中等教育的AGYW对奖励MHP的吸收较高，但在中心重新开放后则没有。讨论显示，对于15-19岁的青少年，与covid -19相关的中心关闭需要恢复使用无效的材料来管理月经。通过Yathu Yathu提供的MHP为大量AGYW提供了获得这些产品的途径。枢纽对青春期女孩来说似乎尤为重要。应将以社区为基础、以同行为主导的中心视为为AGYW提供负担得起和有效的MHP的空间。
Access to affordable and effective menstrual hygiene products (MHP) is critical to the menstrual health of adolescent girls and young women (AGYW). In this mixed-methods analysis, we use data from a programme delivering comprehensive sexual and reproductive health (SRH) services to describe access to MHP and how COVID-19-related closures affected access to MHP; we use qualitative data to understand AGYW’s experience accessing products during the study. Between September 2019-January 2021, we used data routinely collected from ten Yathu Yathu hubs offering community-based, peer-led SRH services to adolescents and young people aged 15–24. Hubs offered free MHP (primarily disposable pads) as a service. To incentivise service access, a “loyalty” card system was embedded within Yathu Yathu, allowing individuals to gain points for services accessed and redeem rewards using these points. Branded pads, tampons and reusable pads were among available rewards. We describe access to service pads and to reward MHP, and use logistic regression to investigate factors associated with accessing pads and reward products before (Sept 2019-March 2020) and after (July 2020-Jan 2021) COVID-19-related closures. Focus group discussions explored accessibility of offering MHP through hubs. Between September 2019-January 2021, 6374 AGYW made 34,116 hub visits to access an SRH service and/or redeem a reward. At 30% of these visits, AGYW accessed any MHP. Before COVID19-closures, an average of 17% of monthly visits were for freely-available disposable pads compared to 34% after hubs reopened (p < 0.001). Results were similar for reward visits. Overall, 63% of 6374 AGYW collected pads as a service at least once. Prior to COVID19-closures, AGYW aged 18–24 were more likely to access service pads than adolescents (15–17-years). After reopening, access was lower among older AGYW. Prior to hub closures, uptake of reward MHP was higher among AGYW with some secondary education but not after reopening. Discussions revealed that, for adolescents aged 15–19, COVID-19-related hub closures required reverting to using ineffective materials to manage menstruation. Availability of MHP through Yathu Yathu provided a large number of AGYW with access to these products. Hubs seemed particularly important for adolescent girls. Community-based, peer-led hubs should be considered as spaces to provide AGYW access to affordable and effective MHP.
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3.7
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通讯作者：
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通讯作者：
Simwinga M