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Use of menstrual cups among school girls: longitudinal observations nested in a randomised controlled feasibility study in rural western Kenya.

van Eijk, Anna ORCID: https://orcid.org/0000-0003-1635-1289, Laserson, Kayla F, Nyothach, Elizabeth, Oruko, Kelvin, Omoto, Jackton, Mason, Linda, Alexander, Kelly, Oduor, Clifford, Mohammed, Aisha, Eleveld, Alie, Ngere, Isaac, Obor, David, Vulule, John and Phillips-Howard, Penelope ORCID: https://orcid.org/0000-0003-1018-116X (2018) 'Use of menstrual cups among school girls: longitudinal observations nested in a randomised controlled feasibility study in rural western Kenya.'. Reproductive Health, Vol 15, Issue 1, p. 139.

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Abstract

BACKGROUND
A menstrual cup can be a good solution for menstrual hygiene management in economically challenged settings. As part of a pilot study we assessed uptake and maintenance of cup use among young school girls in Kenya.

METHODS
A total of 192 girls between 14 to 16 years were enrolled in 10 schools in Nyanza Province, Western Kenya; these schools were assigned menstrual cups as part of the cluster-randomized pilot study. Girls were provided with menstrual cups in addition to training and guidance on use, puberty education, and instructions for menstrual hygiene. During repeated individual visits with nurses, girls reported use of the menstrual cup and nurses recorded colour change of the cup.

RESULTS
Girls were able to keep their cups in good condition, with only 12 cups (6.3%) lost (dropped in toilet, lost or destroyed). Verbally reported cup use increased from 84% in the first 3 months (n = 143) to 96% after 9 months (n = 74). Colour change of the cup, as 'uptake' indicator of use, was detected in 70.8% of 192 participants, with a median time of 5 months (range 1-14 months). Uptake differed by school and was significantly higher among girls who experienced menarche within the past year (adjusted risk ratio 1.29, 95% CI 1.04-1.60), and was faster among girls enrolled in the second study year (hazard ratio 3.93, 95% CI 2.09-7.38). The kappa score comparing self-report and cup colour observation was 0.044 (p = 0.028), indicating that agreement was only slightly higher than by random chance.

CONCLUSIONS
Objective evidence through cup colour change suggests school girls in rural Africa can use menstrual cups, with uptake improving with peer group education and over time.

TRIAL REGISTRATION
ISRCTN17486946 . Retrospectively registered 09 December 2014.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health
WP Gynecology > WP 20 Research (General)
WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12978-018-0582-8
Depositing User: Stacy Murtagh
Date Deposited: 22 Aug 2018 14:31
Last Modified: 13 Sep 2019 14:16
URI: https://archive.lstmed.ac.uk/id/eprint/9186

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