Effect of a Multicomponent Intervention to Improve Menstrual Health and Hygiene and School Attendance Among Adolescent Girls in the Gambia (MEGAMBO Trial)

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health Pub Date : 2025-02-11 DOI:10.1016/j.jadohealth.2024.12.018

Vishna Shah M.Sc. , Wolf Schmidt Ph.D. , Bakary Sonko , Edrisa Sinjanka , Francois Mendy , Julie Hennegan Ph.D. , Penelope Phillips-Howard Ph.D. , Belen Torondel Ph.D.

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引用次数: 0

Abstract

Purpose

Evidence on the effect of menstrual health and hygiene (MHH) interventions on education is scarce. This trial assessed the effect of a multicomponent intervention on school attendance, urogenital health, and other wellbeing outcomes among schoolgirls in rural Gambia.

Methods

A cluster-randomised controlled trial was conducted between July 2019 and December 2020 in 50 villages across 2 regions of The Gambia, selecting one school per village. Using restricted randomisation, half of the villages received a 3-month NGO-led intervention, which included Peer education camps, Mother's outreach sessions, Community meetings and improving school water, sanitation, and hygiene (WASH). The other 25 villages received no intervention. The primary outcome was self-reported schoolgirls' absenteeism of at least one-day due to last period. Secondary outcomes included: urinary tract infections measured with symptoms and biochemical markers, reproductive tract infections symptoms, menstruation-related wellbeing, social support and knowledge, attitudes, and practices toward menstruation. All menstruating schoolgirls 13 years and older were eligible for outcome assessment. We analyzed data on an intention-to-treat basis.

Results

Outcome assessment included 3556 schoolgirls (1832 [51.5%] in the intervention group and 1724 [48.5%] in the control group). Self-reported school absenteeism was only slightly lower in the intervention arm than the control arm (15.6% vs. 17.1%, risk difference = −1.4%, 95% CI = −4.6%–1.9%). The intervention had no effect on urogenital health but had broad positive effects on menstrual knowledge, attitudes, wellbeing, and social support.

Discussion

The multicomponent MHH intervention had no effect on absence due to last period, but achieved improvements in MHH knowledge, experiences, and needs.

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多成分干预对改善冈比亚青春期女孩月经健康和卫生以及入学率的影响（MEGAMBO试验）。

目的：关于月经健康和卫生（MHH）干预对教育影响的证据很少。本试验评估了多组分干预对冈比亚农村女学生出勤率、泌尿生殖健康和其他福利结果的影响。方法：2019年7月至2020年12月，在冈比亚两个地区的50个村庄进行了一项整群随机对照试验，每个村庄选择一所学校。采用有限随机方法，一半的村庄接受了由非政府组织主导的为期3个月的干预，其中包括同伴教育营、母亲外展会议、社区会议和改善学校水、环境卫生和个人卫生（WASH）。其他25个村庄没有接受干预。主要结果是自我报告的女学生因上一次例假至少缺勤一天。次要结局包括：用症状和生化指标测量的尿路感染、生殖道感染症状、月经相关的健康状况、社会支持和知识、对月经的态度和实践。所有13岁及以上的经期女学生都有资格进行结果评估。我们以意向治疗为基础分析数据。结果：结果评估共纳入3556名女学生，其中干预组1832人（51.5%），对照组1724人（48.5%）。干预组自我报告的缺勤率仅略低于对照组（15.6% vs. 17.1%，风险差异= -1.4%,95% CI = -4.6%-1.9%）。干预对泌尿生殖健康没有影响，但对月经知识、态度、幸福感和社会支持有广泛的积极影响。讨论：多成分MHH干预对上一段时间缺勤没有影响，但在MHH知识、经验和需求方面取得了改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Adolescent Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

10.40

自引率

3.90%

发文量

526

审稿时长

46 days

期刊介绍： The Journal of Adolescent Health is a scientific publication dedicated to enhancing the health and well-being of adolescents and young adults. Our Journal covers a broad range of research topics, spanning from the basic biological and behavioral sciences to public health and policy. We welcome a variety of contributions, including original research papers, concise reports, literature reviews, clinical case reports, opinion pieces, and letters to the editor. We encourage professionals from diverse disciplines such as Anthropology, Education, Ethics, Global Health, Health Services Research, Law, Medicine, Mental and Behavioral Health, Nursing, Nutrition, Psychology, Public Health and Policy, Social Work, Sociology, and Youth Development to share their expertise and contribute to our mission of promoting adolescent health. Moreover, we value the voices of young individuals, family and community members, and healthcare professionals, and encourage them to submit poetry, personal narratives, images, and other creative works that provide unique insights into the experiences of adolescents and young adults. By combining scientific peer-reviewed research with creative expressions, our Journal aims to create a comprehensive understanding of the challenges and opportunities in adolescent and young adult health.