Gbogbo Sitsofe, Axame Wisdom Kudzo, Wuresah Israel, Gbogbo Emmanuel, Klutse Priscilla, Hayibor Fred, Kugbey Nuworza, Imakando Mercy Monde, Doku Victor Christian Korley, Hennegan Julie, Baiden Frank E, Binka Fred, Danso-Appiah Anthony
University of Health and Allied Sciences, Ho, Ghana.
University of Environment and Sustainable Development, Somanya, Ghana.
BMJ Open. 2025 May 21;15(5):e094613. doi: 10.1136/bmjopen-2024-094613.
Poor menstrual health and unmet menstrual needs influence several aspects of adolescent girls' lives, including their educational outcomes. However, evidence on menstrual health needs and educational outcomes among these vulnerable girls living in countries across sub-Saharan Africa (SSA) is fragmented and inconclusive. The systematic review aims to explore the association between menstrual health needs and educational outcomes among adolescent girls (10-19 years) living in SSA.
Studies (published and unpublished) will be identified from relevant electronic databases including PubMed, CINAHL, ScienceDirect, Google Scholar and LILACS without language restriction from January 2012 to December 2024. A comprehensive set of search terms and their alternate terms, together with the names of countries in sub-Saharan Africa, will be used for running the searches. We will also search Scopus, Web of Science, African Index Medicus, HINARI, African Journals Online, Academic Search Premier, MedRXIV, ProQuest, EBSCO Open Dissertations and reference lists of relevant studies. We will contact experts, identified through authorship of key publications in menstrual health research and recommendations from established research networks, for potentially relevant unpublished studies. All retrieved articles from the electronic databases and grey literature will be collated and deduplicated using Endnote and exported to Rayyan QCRI. The pre-defined eligibility criteria will be followed to screen papers for inclusion in the review. The flow of studies will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Given the anticipated volume of literature to be reviewed, at least two reviewers will independently select studies, extract data and assess the quality of the included studies for risk of bias using the Robbins-E risk of bias assessment tool. Any disagreements will be resolved through discussion between the reviewers. The Joanna Briggs Institute's Sumari Software will be used for citation management. Binary outcomes will be estimated using pooled proportions (for non-comparative studies) and odds ratio (OR) or risk ratio (RR) (for comparative studies), reported with their 95% CIs. The mean difference (MD) will be used for reporting continuous outcomes with their 95% CIs. In the case where different instruments have been used to report means, we will employ standardised mean difference (SMD). Heterogeneity will be assessed graphically for overlapping CIs and statistically using the I statistic, and if heterogeneity is detected to be high (>50%), subgroup analysis will be performed to assess the impact of such variation.
While ethical approval is not required for the systematic review methodology itself, appropriate data sharing agreements and confidentiality protocols will be followed when collecting unpublished data from experts. The findings from this review will be published in a peer-reviewed journal and presented at relevant conferences. Also, the findings will be communicated to local stakeholders (eg, adolescent girls, parents/guardians, school authorities) in appropriate formats and languages to support translation into policy and practice to improve menstrual health and hygiene and education for adolescent girls in sub-Saharan Africa.
CRD42024565296.
月经健康状况不佳和未满足的月经需求会影响少女生活的多个方面，包括她们的教育成果。然而，关于撒哈拉以南非洲（SSA）各国这些弱势女孩的月经健康需求和教育成果的证据零散且尚无定论。本系统评价旨在探讨生活在SSA的10至19岁少女月经健康需求与教育成果之间的关联。
将从包括PubMed、CINAHL、ScienceDirect、谷歌学术和LILACS在内的相关电子数据库中检索2012年1月至2024年12月期间发表和未发表的研究，无语言限制。将使用一套全面的检索词及其替代词，以及撒哈拉以南非洲各国的名称进行检索。我们还将检索Scopus、科学网、非洲医学索引、HINARI、非洲期刊在线、学术搜索大全、MedRXIV、ProQuest、EBSCO开放学位论文以及相关研究的参考文献列表。我们将联系通过月经健康研究的关键出版物的作者身份以及既定研究网络的推荐确定的专家，获取可能相关的未发表研究。将使用Endnote对从电子数据库和灰色文献中检索到的所有文章进行整理和去重，并导出到Rayyan QCRI。将遵循预先定义的纳入标准筛选论文以纳入本评价。将使用系统评价和Meta分析的首选报告项目（PRISMA）流程图报告研究流程。鉴于预期要审查的文献量，至少两名评审员将独立选择研究、提取数据并使用Robbins-E偏倚风险评估工具评估纳入研究的偏倚风险质量。任何分歧将通过评审员之间的讨论解决。将使用乔安娜·布里格斯研究所的Sumari软件进行文献管理。二元结局将使用合并比例（用于非比较性研究）和比值比（OR）或风险比（RR）（用于比较性研究）进行估计，并报告其95%置信区间。均值差（MD）将用于报告连续性结局及其95%置信区间。在使用不同工具报告均值的情况下，我们将采用标准化均值差（SMD）。将通过图形评估重叠置信区间来评估异质性，并使用I统计量进行统计学评估，如果检测到异质性较高（>50%），将进行亚组分析以评估这种变异的影响。
虽然系统评价方法本身不需要伦理批准，但在从专家收集未发表数据时，将遵循适当的数据共享协议和保密协议。本评价的结果将发表在同行评审期刊上，并在相关会议上展示。此外，将以适当的格式和语言将结果传达给当地利益相关者（如少女、父母/监护人、学校当局），以支持转化为政策和实践，改善撒哈拉以南非洲少女的月经健康和卫生以及教育状况。
PROSPERO注册号：CRD42024565296。
