Factors associated with declining a menstrual cup among female students and their parents in Ugandan secondary schools: a cross-sectional study

Introduction A greater choice of menstrual products may improve menstrual health (MH). This study assessed factors associated with declining consent to receive a menstrual cup by parents and female students participating in a MH intervention trial in Ugandan schools.Methods We analysed baseline data...

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Main Authors: Helen A Weiss, Catherine Kansiime, Shamirah Nakalema, Levicatus Mugenyi, Mandikudza Tembo, Kate Andrews Nelson, Katherine A Thomas, Stephen Lagony, Alex Muleyi Mpaata, Sophie Belfield, Agnes Akech, Belen Torondel-Lopez
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Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/12/e087438.full
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author Helen A Weiss
Catherine Kansiime
Shamirah Nakalema
Levicatus Mugenyi
Mandikudza Tembo
Kate Andrews Nelson
Katherine A Thomas
Stephen Lagony
Alex Muleyi Mpaata
Sophie Belfield
Agnes Akech
Belen Torondel-Lopez
author_facet Helen A Weiss
Catherine Kansiime
Shamirah Nakalema
Levicatus Mugenyi
Mandikudza Tembo
Kate Andrews Nelson
Katherine A Thomas
Stephen Lagony
Alex Muleyi Mpaata
Sophie Belfield
Agnes Akech
Belen Torondel-Lopez
author_sort Helen A Weiss
collection DOAJ
description Introduction A greater choice of menstrual products may improve menstrual health (MH). This study assessed factors associated with declining consent to receive a menstrual cup by parents and female students participating in a MH intervention trial in Ugandan schools.Methods We analysed baseline data from a cluster-randomised trial evaluating the effectiveness of a multicomponent MH intervention among female students in 60 Ugandan secondary schools. Parental consent and student assent to receive a menstrual cup and training on its use was sought separately from consent from other trial activities. Random-effects logistic regression models were used to estimate adjusted OR (aOR) and 95% CIs for factors associated with (i) parents or guardians declining the cup and (ii) students declining the cup using hierarchical conceptual frameworks.Results The baseline trial population comprised 3705 post-menarchal students (mean age 15.6 (SD 0.9 years), of whom 2048 (55.3%) were day students. Among the parents of the 3635 participants aged <18 years, 1566 (43.1%) declined consent for their student to receive the cup. This was higher in Wakiso District than in Kalungu District (52.9% vs 8.0%, p<0.001). Parental decline of the cup differed by ethnicity, and this association varied between districts (p=0.004). Overall, 20.5% students declined the cup (Kalungu 21.1%, Wakiso 20.2%, p=0.62). Student decline of the cup was higher among day than boarding students (aOR=1.40, 95% CI 1.07 to 1.84), those with academic performance above the median score (aOR=1.29, 95% CI 1.01 to 1.65), those whose menstrual practice needs score was above the median (aOR=1.36, 95% CI 1.08 to 1.72) and those with more negative attitudes to MH (aOR=1.46, 95% CI 1.16 to 1.83).Conclusion Among Ugandan students and their parents, declining consent to receive a menstrual cup varied by district and ethnicity as well as academic performance and menstrual-related factors. A contextual understanding of the barriers for uptake of the menstrual cup is needed to guide future interventions.Trial registration number ISRCTN45461276.
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spelling doaj-art-ff08079238414cba94f5c812a072a1f22025-08-20T02:36:36ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-087438Factors associated with declining a menstrual cup among female students and their parents in Ugandan secondary schools: a cross-sectional studyHelen A Weiss0Catherine Kansiime1Shamirah Nakalema2Levicatus Mugenyi3Mandikudza Tembo4Kate Andrews Nelson5Katherine A Thomas6Stephen Lagony7Alex Muleyi Mpaata8Sophie Belfield9Agnes Akech10Belen Torondel-Lopez117 Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, London, UK4 MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Wakiso, Uganda5 WoMena Uganda, Kampala, Uganda1 Statistics, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda2 London School of Hygiene & Tropical Medicine, London, UK2 London School of Hygiene & Tropical Medicine, London, UK2 London School of Hygiene & Tropical Medicine, London, UK4 MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Wakiso, Uganda4 MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Wakiso, Uganda5 WoMena Uganda, Kampala, Uganda5 WoMena Uganda, Kampala, Uganda6 London School of Hygiene and Tropical Medicine, London, UKIntroduction A greater choice of menstrual products may improve menstrual health (MH). This study assessed factors associated with declining consent to receive a menstrual cup by parents and female students participating in a MH intervention trial in Ugandan schools.Methods We analysed baseline data from a cluster-randomised trial evaluating the effectiveness of a multicomponent MH intervention among female students in 60 Ugandan secondary schools. Parental consent and student assent to receive a menstrual cup and training on its use was sought separately from consent from other trial activities. Random-effects logistic regression models were used to estimate adjusted OR (aOR) and 95% CIs for factors associated with (i) parents or guardians declining the cup and (ii) students declining the cup using hierarchical conceptual frameworks.Results The baseline trial population comprised 3705 post-menarchal students (mean age 15.6 (SD 0.9 years), of whom 2048 (55.3%) were day students. Among the parents of the 3635 participants aged <18 years, 1566 (43.1%) declined consent for their student to receive the cup. This was higher in Wakiso District than in Kalungu District (52.9% vs 8.0%, p<0.001). Parental decline of the cup differed by ethnicity, and this association varied between districts (p=0.004). Overall, 20.5% students declined the cup (Kalungu 21.1%, Wakiso 20.2%, p=0.62). Student decline of the cup was higher among day than boarding students (aOR=1.40, 95% CI 1.07 to 1.84), those with academic performance above the median score (aOR=1.29, 95% CI 1.01 to 1.65), those whose menstrual practice needs score was above the median (aOR=1.36, 95% CI 1.08 to 1.72) and those with more negative attitudes to MH (aOR=1.46, 95% CI 1.16 to 1.83).Conclusion Among Ugandan students and their parents, declining consent to receive a menstrual cup varied by district and ethnicity as well as academic performance and menstrual-related factors. A contextual understanding of the barriers for uptake of the menstrual cup is needed to guide future interventions.Trial registration number ISRCTN45461276.https://bmjopen.bmj.com/content/14/12/e087438.full
spellingShingle Helen A Weiss
Catherine Kansiime
Shamirah Nakalema
Levicatus Mugenyi
Mandikudza Tembo
Kate Andrews Nelson
Katherine A Thomas
Stephen Lagony
Alex Muleyi Mpaata
Sophie Belfield
Agnes Akech
Belen Torondel-Lopez
Factors associated with declining a menstrual cup among female students and their parents in Ugandan secondary schools: a cross-sectional study
BMJ Open
title Factors associated with declining a menstrual cup among female students and their parents in Ugandan secondary schools: a cross-sectional study
title_full Factors associated with declining a menstrual cup among female students and their parents in Ugandan secondary schools: a cross-sectional study
title_fullStr Factors associated with declining a menstrual cup among female students and their parents in Ugandan secondary schools: a cross-sectional study
title_full_unstemmed Factors associated with declining a menstrual cup among female students and their parents in Ugandan secondary schools: a cross-sectional study
title_short Factors associated with declining a menstrual cup among female students and their parents in Ugandan secondary schools: a cross-sectional study
title_sort factors associated with declining a menstrual cup among female students and their parents in ugandan secondary schools a cross sectional study
url https://bmjopen.bmj.com/content/14/12/e087438.full
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