Paul Montgomery|Julie Hennegan|Catherine Dolan|Maryalice Wu|Laurel Steinfield|Linda M. Scott
Menstruation and the Cycle of Poverty: A Cluster Quasi-Randomised Control Trial of Sanitary Pad and Puberty Education Provision in Uganda
University of Oxford|University of Oxford|SOAS University of London|University of London|Applied Technologies (United States)|University of Illinois Urbana-Champaign|Bentley University|Science Oxford|University of Oxford
poor menstrual knowledge access sanitary products proposed barriers menstrual health school attendance response interventions targeting needs seen increasing implementation public private sectors however limited assessment effectivenessassess impact providing reusable sanitary pads puberty education girls school attendance psychosocial wellbeing outcomesa cluster quasirandomised controlled trial conducted across 8 schools including 1124 girls rural uganda schools allocated one four conditions provision puberty education alone reusable sanitary pads alone puberty education reusable sanitary pads control intervention primary outcome school attendance secondary outcomes reflected psychosocial wellbeingat followup school attendance worsened girls across conditions perprotocol analysis revealed decline significantly greater control condition 052 95ci 026077 control schools 171 95ci 87255 greater drop attendance intervention school differences intervention conditions high rates school dropout transfer meant trial suffered substantial participant dropout intentiontotreat analyses using two different imputation strategies consistent main results mean differences 52 attendance bestcase 245 worstcase imputations results robust adjustments clustering impact interventions girls selfreported shame insecurity menstruationresults trial support hypothesised positive impact providing sanitary pads puberty education girls school attendance developing country context findings must interpreted caution light poor participant retention intervention fidelity attendance measures usedpan african clinical trials registry pactr201503001044408