Department of Global Health and Development, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
Biomedical Research and Training Institute, Harare, Zimbabwe.
BMJ Open. 2023 Mar 9;13(3):e067897. doi: 10.1136/bmjopen-2022-067897.
While integral to women's physical and mental well-being, achieving good menstrual health (MH) remains a challenge for many women. This study investigated the effectiveness of a comprehensive MH intervention on menstrual knowledge, perceptions and practices among women aged 16-24 years in Harare, Zimbabwe.
A mixed-methods prospective cohort study with pre-post evaluation of an MH intervention.
Two intervention clusters in Harare, Zimbabwe.
Overall, 303 female participants were recruited, of whom 189 (62.4%) were seen at midline (median follow-up 7.0; IQR 5.8-7.7 months) and 184 (60.7%) were seen at endline (median follow-up 12.4; IQR 11.9-13.8 months). Cohort follow-up was greatly affected by COVID-19 pandemic and associated restrictions.
The MH intervention provided MH education and support, analgesics, and a choice of menstrual products in a community-based setting to improve MH outcomes among young women in Zimbabwe.
Effectiveness of a comprehensive MH intervention on improving MH knowledge, perceptions, and practices among young women over time. Quantitative questionnaire data were collected at baseline, midline, and endline. At endline, thematic analysis of four focus group discussions was used to further explore participants' menstrual product use and experiences of the intervention.
At midline, more participants had correct/positive responses for MH knowledge (adjusted OR (aOR)=12.14; 95% CI: 6.8 to 21.8), perceptions (aOR=2.85; 95% CI: 1.6 to 5.1) and practices for reusable pads (aOR=4.68; 95% CI: 2.3 to 9.6) than at baseline. Results were similar comparing endline with baseline for all MH outcomes. Qualitative findings showed that sociocultural norms, stigma and taboos around menstruation, and environmental factors such as limited access to water, sanitation and hygiene facilities affected the effect of the intervention on MH outcomes.
The intervention improved MH knowledge, perceptions and practices among young women in Zimbabwe, and the comprehensive nature of the intervention was key to this. MH interventions should address interpersonal, environmental and societal factors.
NCT03719521.
尽管良好的月经健康（MH）对女性的身心健康至关重要，但许多女性仍难以实现这一目标。本研究旨在调查一项综合性 MH 干预措施对津巴布韦哈拉雷 16-24 岁女性的月经知识、观念和实践的影响。
采用前瞻性队列研究设计，对 MH 干预措施进行前后评估。
津巴布韦哈拉雷的两个干预集群。
共招募了 303 名女性参与者，其中 189 名（62.4%）在随访中期（中位数随访时间为 7.0；IQR 为 5.8-7.7 个月），184 名（60.7%）在随访末期（中位数随访时间为 12.4；IQR 为 11.9-13.8 个月）。由于 COVID-19 大流行及其相关限制，队列随访受到了很大影响。
MH 干预措施在社区环境中提供 MH 教育和支持、镇痛药以及选择月经产品，以改善津巴布韦年轻女性的 MH 结局。
随着时间的推移，全面的 MH 干预措施对改善年轻女性的 MH 知识、观念和实践的有效性。在基线、随访中期和随访末期收集定量问卷数据。在随访末期，采用 4 个焦点小组讨论的主题分析进一步探讨了参与者对月经产品的使用情况和对干预措施的体验。
在随访中期，与基线相比，更多的参与者在 MH 知识（调整后的比值比（aOR）=12.14；95%置信区间：6.8 至 21.8）、观念（aOR=2.85；95%置信区间：1.6 至 5.1）和可重复使用垫的使用（aOR=4.68；95%置信区间：2.3 至 9.6）方面有正确/积极的反应。与基线相比，所有 MH 结局在随访末期的结果均相似。定性研究结果表明，社会文化规范、对月经的污名化和禁忌、以及环境因素（如获得水、卫生和卫生设施的机会有限）影响了干预措施对 MH 结局的影响。
该干预措施提高了津巴布韦年轻女性的 MH 知识、观念和实践水平，干预措施的全面性是关键。MH 干预措施应解决人际、环境和社会因素。
NCT03719521。
