Effect of a Multicomponent Intervention to Improve Menstrual Health and Hygiene and School Attendance Among Adolescent Girls in the Gambia (MEGAMBO Trial)

Shah, Vishna, Schmidt, Wolf, Sonko, Bakary, Sinjanka, Edrisa, Mendy, Francois, Hennegan, Julie, Phillips-Howard, Penelope ORCID: https://orcid.org/0000-0003-1018-116X and Torondel, Belen (2025) 'Effect of a Multicomponent Intervention to Improve Menstrual Health and Hygiene and School Attendance Among Adolescent Girls in the Gambia (MEGAMBO Trial)'. Journal of Adolescent Health. (In Press)

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Abstract

Purpose
Evidence on the effect of menstrual health and hygiene (MHH) interventions on education is scarce. This trial assessed the effect of a multicomponent intervention on school attendance, urogenital health, and other wellbeing outcomes among schoolgirls in rural Gambia.

Methods
A cluster-randomised controlled trial was conducted between July 2019 and December 2020 in 50 villages across 2 regions of The Gambia, selecting one school per village. Using restricted randomisation, half of the villages received a 3-month NGO-led intervention, which included Peer education camps, Mother's outreach sessions, Community meetings and improving school water, sanitation, and hygiene (WASH). The other 25 villages received no intervention. The primary outcome was self-reported schoolgirls' absenteeism of at least one-day due to last period. Secondary outcomes included: urinary tract infections measured with symptoms and biochemical markers, reproductive tract infections symptoms, menstruation-related wellbeing, social support and knowledge, attitudes, and practices toward menstruation. All menstruating schoolgirls 13 years and older were eligible for outcome assessment. We analyzed data on an intention-to-treat basis.

Results
Outcome assessment included 3556 schoolgirls (1832 [51.5%] in the intervention group and 1724 [48.5%] in the control group). Self-reported school absenteeism was only slightly lower in the intervention arm than the control arm (15.6% vs. 17.1%, risk difference = −1.4%, 95% CI = −4.6%–1.9%). The intervention had no effect on urogenital health but had broad positive effects on menstrual knowledge, attitudes, wellbeing, and social support.

Discussion
The multicomponent MHH intervention had no effect on absence due to last period, but achieved improvements in MHH knowledge, experiences, and needs.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WA Public Health > WA 4 Works on general hygiene
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.jadohealth.2024.12.018
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	13 Mar 2025 11:19
Last Modified:	13 Mar 2025 11:19
URI:	https://archive.lstmed.ac.uk/id/eprint/26181

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