Julie Hennegan1, Deborah Jordan Brooks2, Kellogg J Schwab1, G J Melendez-Torres3. 1. The Water Institute, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America. 2. The John Sloan Dickey Center for International Understanding and Department of Government, Dartmouth College, Hanover, New Hampshire, United States of America. 3. Peninsula Technology Assessment Group, College of Medicine and Health, University of Exeter, Exeter, United Kingdom.
Abstract
BACKGROUND: The lack of established measurement tools in the study of menstrual health and hygiene has been a significant limitation of quantitative studies to date. However, there has been limited exploration of existing measurement to identify avenues for improvement. METHODS: We undertook two linked systematic reviews of (1) trials of menstrual health interventions and their nested studies in low- and middle-income countries, (2) studies developing or validating measures of menstrual experiences from any location. Systematic searching was undertaken in 12 databases, together with handsearching. We iteratively grouped and audited concepts measured across included studies and extracted and compared measures of each concept. RESULTS: A total of 23 trials, 9 nested studies and 22 measure development studies were included. Trials measured a range of outcomes including menstrual knowledge, attitudes, and practices, school absenteeism, and health. Most measure validation studies focused on assessing attitudes towards menstruation, while a group of five studies assessed the accuracy of women's recall of their menstrual characteristics such as timing and cycle length. Measures of menstrual knowledge, attitudes, beliefs and restrictions were inconsistent and frequently overlapped. No two studies measured the same menstrual or hygiene practices, with 44 different practices assessed. This audit provides a summary of current measures and extant efforts to pilot or test their performance. CONCLUSIONS: Inconsistencies in both the definition and operationalisation of concepts measured in menstrual health and hygiene research should be addressed. To improve measurement, authors should clearly define the constructs they aim to measure and outline how these were operationalised for measurement. Results of this audit indicate the need for the development and validation of new measures, and the evaluation of the performance of existing measures across contexts. In particular, the definition and measurement of menstrual practices, knowledge, attitudes, norms and restrictions should be addressed. REVIEW PROTOCOL REGISTRATION: CRD42018089884.
BACKGROUND: The lack of established measurement tools in the study of menstrual health and hygiene has been a significant limitation of quantitative studies to date. However, there has been limited exploration of existing measurement to identify avenues for improvement. METHODS: We undertook two linked systematic reviews of (1) trials of menstrual health interventions and their nested studies in low- and middle-income countries, (2) studies developing or validating measures of menstrual experiences from any location. Systematic searching was undertaken in 12 databases, together with handsearching. We iteratively grouped and audited concepts measured across included studies and extracted and compared measures of each concept. RESULTS: A total of 23 trials, 9 nested studies and 22 measure development studies were included. Trials measured a range of outcomes including menstrual knowledge, attitudes, and practices, school absenteeism, and health. Most measure validation studies focused on assessing attitudes towards menstruation, while a group of five studies assessed the accuracy of women's recall of their menstrual characteristics such as timing and cycle length. Measures of menstrual knowledge, attitudes, beliefs and restrictions were inconsistent and frequently overlapped. No two studies measured the same menstrual or hygiene practices, with 44 different practices assessed. This audit provides a summary of current measures and extant efforts to pilot or test their performance. CONCLUSIONS: Inconsistencies in both the definition and operationalisation of concepts measured in menstrual health and hygiene research should be addressed. To improve measurement, authors should clearly define the constructs they aim to measure and outline how these were operationalised for measurement. Results of this audit indicate the need for the development and validation of new measures, and the evaluation of the performance of existing measures across contexts. In particular, the definition and measurement of menstrual practices, knowledge, attitudes, norms and restrictions should be addressed. REVIEW PROTOCOL REGISTRATION: CRD42018089884.
Authors: Mahbub-Ul Alam; Farhana Sultana; Erin C Hunter; Peter J Winch; Leanne Unicomb; Supta Sarker; Mehjabin Tishan Mahfuz; Abdullah Al-Masud; Mahbubur Rahman; Stephen P Luby Journal: BMC Public Health Date: 2022-06-02 Impact factor: 4.135
Authors: Julie Hennegan; Funmilola M OlaOlorun; Sani Oumarou; Souleymane Alzouma; Georges Guiella; Elizabeth Omoluabi; Kellogg J Schwab Journal: Sex Reprod Health Matters Date: 2021-12
Authors: Lucy C Wilson; Kate H Rademacher; Julia Rosenbaum; Rebecca L Callahan; Geeta Nanda; Sarah Fry; Amelia C L Mackenzie Journal: Sex Reprod Health Matters Date: 2021-12
Authors: Julie Hennegan; Justine N Bukenya; Simon P S Kibira; Petranilla Nakamya; Fredrick E Makumbi; Natalie G Exum; Kellogg J Schwab Journal: BMJ Open Date: 2022-07-01 Impact factor: 3.006