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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BMJ Publishing Group
2024-12-01
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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. |
| format | Article |
| id | doaj-art-ff08079238414cba94f5c812a072a1f2 |
| institution | OA Journals |
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| language | English |
| publishDate | 2024-12-01 |
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| series | BMJ Open |
| 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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