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Cost-Effectiveness and Cost–Benefit Analyses of Providing Menstrual Cups and Sanitary Pads to Schoolgirls in Rural Kenya

Babagoli, Masih A., Benshaul-Tolonen, Anja, Zulaika, Garazi, Nyothach, Elizabeth, Oduor, Clifford, Obor, David, Mason, Linda, Kerubo, Emily, Ngere, Isaac, Laserson, Kayla F., Tudor Edwards, Rhiannon and Phillips-Howard, Penelope ORCID: (2022) 'Cost-Effectiveness and Cost–Benefit Analyses of Providing Menstrual Cups and Sanitary Pads to Schoolgirls in Rural Kenya'. Women's Health Reports, Vol 3, Issue 1, pp. 773-784.

Babagoli et al 2022 CE and CB of menstrual cups and pads Kenya.pdf - Published Version
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Objective: To analyze the relative value of providing menstrual cups and sanitary pads to primary schoolgirls.

Design: Cost-effectiveness and cost–benefit analyses of three-arm single-site open cluster randomized controlled pilot study providing menstrual cups or sanitary pads for 1 year.

Participants: Girls 14–16 years of age enrolled across 30 primary schools in rural western Kenya.

Methods: Cost-effectiveness analysis was conducted based on the health effects (reductions in disability-adjusted life years [DALYs]) and education effects (reductions in school absenteeism) of both interventions. The health and education benefits were separately valued and compared with relative program costs.

Results: Compared with the control group, the cost of menstrual cups was estimated at $3,270 per year for 1000 girls, compared with $24,000 for sanitary pads. The benefit of the menstrual cup program (1.4 DALYs averted, 95% confidence interval [CI]: −4.3 to 3.1) was higher compared with a sanitary pad program (0.48 DALYs averted, 95% CI: −4.2 to 2.3), but the health effects of both interventions were not statistically significant likely due to the limited statistical power. Using point estimates, the menstrual cup intervention was cost-effective in improving health outcomes ($2,300/DALY averted). The sanitary pad intervention had a cost-effectiveness of $300/student-school year in reducing school absenteeism. When considering improvements in future earnings from reduced absenteeism, the sanitary pad program had a net benefit of +$68,000 (95% CI: −$32,000 to +$169,000).

Conclusions: The menstrual cup may provide a cost-effective solution for menstrual hygiene management in low-income settings. This study outlines a methodology for future analyses of menstrual hygiene interventions and highlights several knowledge gaps that need to be addressed.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
WA Public Health > Sanitation. Environmental Control > General Sanitation and Environmental Control > WA 670 General works
WP Gynecology > WP 20 Research (General)
WS Pediatrics > By Age Groups > WS 450 Puberty
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):
Depositing User: Jane Rawlinson
Date Deposited: 28 Sep 2022 09:54
Last Modified: 28 Sep 2022 09:54


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