Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya
Summary: Background: Access to menstrual hygiene products enables positive health for adolescent girls and young women (AGYW). Among AGYW in Nairobi, Kenya, this prospective mixed-methods study characterised menstrual health product-access challenges at two time points during the COVID-19 pandemic;...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022002127 |
| _version_ | 1811243820485967872 |
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| author | Shannon N. Wood Rachel Milkovich Mary Thiongo Meagan E. Byrne Bianca Devoto Grace Wamue-Ngare Michele R. Decker Peter Gichangi |
| author_facet | Shannon N. Wood Rachel Milkovich Mary Thiongo Meagan E. Byrne Bianca Devoto Grace Wamue-Ngare Michele R. Decker Peter Gichangi |
| author_sort | Shannon N. Wood |
| collection | DOAJ |
| description | Summary: Background: Access to menstrual hygiene products enables positive health for adolescent girls and young women (AGYW). Among AGYW in Nairobi, Kenya, this prospective mixed-methods study characterised menstrual health product-access challenges at two time points during the COVID-19 pandemic; assessed trajectories over the pandemic; and examined factors associated with product-access trajectories. Methods: Data were collected from an AGYW cohort in August–October 2020 and March–June 2021 (n=591). The prevalence of menstrual health product-access challenges was calculated per timepoint, with trajectories characterizing product-access challenges over time. Logistic regression models examined associations with any product-access challenge throughout the pandemic; multinomial and logistic regressions further assessed factors associated with trajectories. Qualitative data contextualize results. Findings: In 2020, 52·0% of AGYW experienced a menstrual health product-access challenge; approximately six months later, this proportion dropped to 30·3%. Product-access challenges during the pandemic were heightened for AGYW with secondary or lower education (aOR=2·40; p<0·001), living with parents (aOR=1·86; p=0·05), not the prime earner (aOR=2·27; p=0·05); and unable to meet their basic needs (aOR=2·25; p<0·001). Between timepoints, 38·0% experienced no product-access challenge and 31·7% resolved, however, 10·2% acquired a challenge and 20·1% experienced sustained challenges. Acquired product-access challenges, compared to no challenges, were concentrated among those living with parents (aOR=3·21; p=0·05); multinomial models further elucidated nuances. Qualitative data indicate deprioritization of menstrual health within household budgets as a contributor. Interpretation: Menstrual health product-access challenges are prevalent among AGYW during the pandemic; barriers were primarily financial. Results may reflect endemic product-access gaps amplified by COVID-specific constraints. Ensuring access to menstrual products is essential to ensure AGYW's health needs. Funding: This work was supported, in whole, by the Bill & Melinda Gates Foundation [010481]. |
| first_indexed | 2024-04-12T14:15:04Z |
| format | Article |
| id | doaj.art-1dbcc6c860e24b989e8df47aaf23f7fc |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-12T14:15:04Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-1dbcc6c860e24b989e8df47aaf23f7fc2022-12-22T03:29:45ZengElsevierEClinicalMedicine2589-53702022-07-0149101482Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, KenyaShannon N. Wood0Rachel Milkovich1Mary Thiongo2Meagan E. Byrne3Bianca Devoto4Grace Wamue-Ngare5Michele R. Decker6Peter Gichangi7Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Corresponding author at: Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 N. Wolfe Street Room E4009 Baltimore, MD 21205, USA.Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.International Centre for Reproductive Health-Kenya, Nairobi, Kenya.Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.Women's Economic Empowerment Hub, Kenyatta University, Nairobi, Kenya.; Department of Sociology, Gender and Development Studies, Kenyatta University, Nairobi, Kenya.Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.International Centre for Reproductive Health-Kenya, Nairobi, Kenya.; Technical University of Mombasa, Mombasa, Kenya.; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, BelgiumSummary: Background: Access to menstrual hygiene products enables positive health for adolescent girls and young women (AGYW). Among AGYW in Nairobi, Kenya, this prospective mixed-methods study characterised menstrual health product-access challenges at two time points during the COVID-19 pandemic; assessed trajectories over the pandemic; and examined factors associated with product-access trajectories. Methods: Data were collected from an AGYW cohort in August–October 2020 and March–June 2021 (n=591). The prevalence of menstrual health product-access challenges was calculated per timepoint, with trajectories characterizing product-access challenges over time. Logistic regression models examined associations with any product-access challenge throughout the pandemic; multinomial and logistic regressions further assessed factors associated with trajectories. Qualitative data contextualize results. Findings: In 2020, 52·0% of AGYW experienced a menstrual health product-access challenge; approximately six months later, this proportion dropped to 30·3%. Product-access challenges during the pandemic were heightened for AGYW with secondary or lower education (aOR=2·40; p<0·001), living with parents (aOR=1·86; p=0·05), not the prime earner (aOR=2·27; p=0·05); and unable to meet their basic needs (aOR=2·25; p<0·001). Between timepoints, 38·0% experienced no product-access challenge and 31·7% resolved, however, 10·2% acquired a challenge and 20·1% experienced sustained challenges. Acquired product-access challenges, compared to no challenges, were concentrated among those living with parents (aOR=3·21; p=0·05); multinomial models further elucidated nuances. Qualitative data indicate deprioritization of menstrual health within household budgets as a contributor. Interpretation: Menstrual health product-access challenges are prevalent among AGYW during the pandemic; barriers were primarily financial. Results may reflect endemic product-access gaps amplified by COVID-specific constraints. Ensuring access to menstrual products is essential to ensure AGYW's health needs. Funding: This work was supported, in whole, by the Bill & Melinda Gates Foundation [010481].http://www.sciencedirect.com/science/article/pii/S2589537022002127Menstrual healthCOVID-19Adolescent girls and young womenKenya |
| spellingShingle | Shannon N. Wood Rachel Milkovich Mary Thiongo Meagan E. Byrne Bianca Devoto Grace Wamue-Ngare Michele R. Decker Peter Gichangi Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya EClinicalMedicine Menstrual health COVID-19 Adolescent girls and young women Kenya |
| title | Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya |
| title_full | Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya |
| title_fullStr | Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya |
| title_full_unstemmed | Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya |
| title_short | Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya |
| title_sort | product access challenges to menstrual health throughout the covid 19 pandemic among a cohort of adolescent girls and young women in nairobi kenya |
| topic | Menstrual health COVID-19 Adolescent girls and young women Kenya |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022002127 |
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