MRC International Statistics & Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
Biomedical Research and Training Institute, Harare, Zimbabwe.
BMC Health Serv Res. 2022 Mar 30;22(1):421. doi: 10.1186/s12913-022-07818-5.
Despite being fundamental to the health and well-being of women, menstrual health is often overlooked as a health priority and access to menstrual health education, products, and support is limited. Consequently, many young women are unprepared for menarche and face challenges in accessing menstrual health products and support and in managing menstruation in a healthy and dignified way. In this paper, we examine the acceptability of a comprehensive menstrual health and hygiene (MHH) intervention integrated within a community-based sexual and reproductive health (SRH) service for young people aged 16-24 years in Zimbabwe called CHIEDZA.
We conducted focus group discussions, that included participatory drawings, with CHIEDZA healthcare service providers (N = 3) and with young women who had attended CHIEDZA (N = 6) between June to August 2020. Translated transcripts were read for familiarisation and thematic analysis was used to explore acceptability. We applied Sekhon's thematic framework of acceptability that looks at seven key constructs (affective attitudes, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy). Data from FGDs and meeting minutes taken during the study time period were used to triangulate a comprehensive understanding of MHH intervention acceptability.
The MHH intervention was acceptable to participants as it addressed the severe prevailing lack of access to menstrual health education, products, and support in the communities, and facilitated access to other SRH services on site. In addition to the constructs defined by Sekhon's thematic framework, acceptability was also informed by external contextual factors such as sociocultural norms and the economic environment. Providers highlighted the increased burden in their workload due to demand for MHH products, and how sociocultural beliefs around insertable menstrual products compromising virginity can negatively affect acceptability among young people and community members.
MHH interventions are acceptable to young women in community-based settings in Zimbabwe as there is great unmet need for comprehensive MHH support. The integration of MHH in SRH services can serve as a facilitator to female engagement with SRH services. However, it is important to note that contextual external factors can affect the implementation and acceptability of integrated SRH and MHH services within communities.
Registry: Clinicaltrials.gov, Registration Number: NCT03719521 , Registration Date: October 25, 2018.
尽管月经健康对女性的健康和福祉至关重要，但它往往被忽视，不是健康优先事项，获得月经健康教育、产品和支持的机会有限。因此，许多年轻女性对初潮毫无准备，在获得月经健康产品和支持以及以健康和有尊严的方式管理月经方面面临挑战。本文研究了在津巴布韦开展的一项名为 CHIEDZA 的以社区为基础的性健康和生殖健康（SRH）服务中综合月经健康和卫生（MHH）干预措施的接受程度。
我们于 2020 年 6 月至 8 月期间，对 CHIEDZA 医疗服务提供者（n=3）和参加 CHIEDZA 的年轻女性（n=6）进行了焦点小组讨论，包括参与式绘图。翻译后的记录经过熟悉化处理，采用主题分析法探讨接受程度。我们采用 Sekhon 的可接受性主题框架，该框架着眼于七个关键结构（情感态度、负担、伦理性、干预一致性、机会成本、感知效果和自我效能）。来自 FGD 和研究期间会议记录的数据被用于三角测量，以全面了解 MHH 干预措施的接受程度。
MHH 干预措施是可以被接受的，因为它解决了社区中严重缺乏月经健康教育、产品和支持的问题，并促进了现场获得其他 SRH 服务。除了 Sekhon 主题框架定义的结构外，可接受性还受到外部社会文化规范和经济环境等因素的影响。提供者强调由于对 MHH 产品的需求增加，他们的工作量增加了负担，以及围绕可插入式月经产品会影响贞操的社会文化信仰如何会对年轻人和社区成员的接受程度产生负面影响。
在津巴布韦以社区为基础的环境中，MHH 干预措施是可以被年轻女性接受的，因为她们对全面的 MHH 支持有很大的需求。将 MHH 纳入 SRH 服务可以促进女性参与 SRH 服务。然而，需要注意的是，外部环境因素可能会影响社区内综合 SRH 和 MHH 服务的实施和接受程度。
Clinicaltrials.gov，注册号：NCT03719521，注册日期：2018 年 10 月 25 日。
