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

被引:0
作者
Shah, Vishna [1 ]
Schmidt, Wolf [1 ]
Sonko, Bakary [2 ]
Sinjanka, Edrisa [2 ]
Mendy, Francois [3 ]
Hennegan, Julie [4 ]
Phillips-Howard, Penelope [5 ]
Torondel, Belen [1 ]
机构
[1] London Sch Hyg & Trop Med, Dept Infect Dis, Environm Hlth Grp, London, England
[2] MRCG Keneba, Nutr Theme, Med Res Council Unit, Banjul, Gambia
[3] Nova Scotia Gambia Assoc NSGA, Banjul, Gambia
[4] Burnet Inst, Maternal Child & Adolescent Hlth Program, Melbourne, Australia
[5] Univ Liverpool Liverpool Sch Trop Med, Dept Clin Sci, Pembroke Pl, Liverpool, England
基金
英国医学研究理事会;
关键词
Menstruation; Menstrual health; Hygiene; School-based interventions; Toilet facilities; Gambia; Adolescent health; MANAGEMENT;
D O I
10.1016/j.jadohealth.2024.12.018
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
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. (c) 2025 Society for Adolescent Health and Medicine. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
引用
收藏
页码:879 / 888
页数:10
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