scholarly journals Effects of sanitary pad distribution and reproductive health education on upper primary school attendance and reproductive health knowledge and attitudes in Kenya: a cluster randomized controlled trial

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Karen Austrian ◽  
Beth Kangwana ◽  
Eunice Muthengi ◽  
Erica Soler-Hampejsek
Keyword(s):  
Randomized Controlled Trial ◽  
Reproductive Health ◽  
Primary School ◽  
School Attendance ◽  
Controlled Trial ◽  
Gender Norms ◽  
Primary Grade ◽  
Randomized Controlled ◽  
Knowledge And Attitudes ◽  
Cluster Randomized

Abstract Background Adolescent girls’ risk of school dropout and reproductive health (RH) challenges may be exacerbated by girls’ attitudes toward their bodies and inability to manage their menstruation. We assessed effects of sanitary pad distribution and RH education on girls in primary grade 7 in Kilifi, Kenya. Methods A cluster randomized controlled trial design was used. Eligible clusters were all non-boarding schools in three sub-counties in Kilifi County that had a minimum of 25 girls enrolled in primary grade 7. 140 primary schools, 35 per arm, were randomly assigned to one of four study arms: (1) control; (2) sanitary pad distribution; (3) RH education; or (4) both sanitary pad distribution and RH education. Outcomes were school attendance, school engagement, RH knowledge and attitudes, gender norms, and self-efficacy. For outcomes measured both at baseline and endline, difference-in-differences (DID) models were estimated and for outcomes without baseline data available, analysis of covariance models were used. Results The study enrolled 3489 randomly selected girls in primary grade 7, with a mean age of 14.4 (SD 1.5). Girls in arms 2 and 4 received on average 17.6 out of 20 packets of sanitary pads and girls in arms 3 and 4 participated on average in 21 out of 25 RH sessions. Ninety-four percent of the baseline sample was interviewed at the end of the intervention with no differential attrition by arm. There was no evidence of an effect on primary school attendance on arm 2 (coefficient [coef] 0.37, 95% CI − 0.73, 1.46), arm 3 (coef 0.14, 95% CI − 0.99, 1.26) or arm 4 (coef 0.58, 95% CI − .37, 1.52). There was increased positive RH attitudes for girls in arm 3 (DID coef. 0.63, 95% CI 0.40–0.86) and arm 4 (DID coef. 0.85, 95% CI 0.64, − 1.07). There was also an increase in RH knowledge, gender norms and self-efficacy in arms 3 and 4. Conclusions The findings suggest that neither sanitary pad distribution nor RH education, on their own or together, were sufficient to improve primary school attendance. However, as the RH education intervention improved RH outcomes, the evidence suggests that sanitary pad distribution and RH education can be positioned in broader RH programming for girls. Trial registration: ISRCTN, ISRCTN10894523. Registered 22 August 2017—Retrospectively registered, http://www.isrctn.com/ISRCTN10894523

scholarly journals Effects of sanitary pad distribution and reproductive health education on primary school attendance and reproductive health knowledge and attitudes in Kenya: a cluster randomized controlled trial

2021 ◽  
Author(s):  
Karen Austrian ◽  
Beth Kangwana ◽  
Eunice N. Muthengi ◽  
Erica Soler-Hampejsek
Keyword(s):  
Randomized Controlled Trial ◽  
Health Education ◽  
Reproductive Health ◽  
Primary School ◽  
School Attendance ◽  
Controlled Trial ◽  
Primary Grade ◽  
Randomized Controlled ◽  
Knowledge And Attitudes ◽  
Cluster Randomized

Abstract Background: Adolescent girls’ risk of school dropout and reproductive health (RH) challenges may be exacerbated by girls’ attitudes toward their bodies and inability to manage their menstruation. We assessed effects of sanitary pad distribution and RH education on girls in primary grade 7 in Kilifi, Kenya in 2017-18.Methods: A cluster randomized controlled trial design was used. Eligible clusters were all non-boarding schools in three sub-counties in Kilifi County that had a minimum of 25 girls enrolled in primary grade 7. 140 primary schools, 35 per arm, were randomly assigned to one of four study arms: 1) control (standard government provision of pads and health education); 2) sanitary pad distribution; 3) RH education; or 4) both sanitary pad distribution and RH education. Outcomes were school attendance, school engagement, RH knowledge and attitudes, gender norms, and self-efficacy. For outcomes measured both at baseline and endline, difference-in-differences (DID) models were estimated and for outcomes without baseline data available, analysis of covariance models were used. Results: The study enrolled 3,489 randomly selected girls in primary grade 7. Girls in arms 2 and 4 received on average 17.5 out of 20 packets of sanitary pads and girls in arms 3 and 4 participated on average in 21 out of 25 RH sessions. Ninety-four percent of the baseline sample was interviewed at the end of the intervention with no differential attrition by arm. There was no evidence of an effect on primary school attendance on arm 2 (coefficient [coef] 0.37, 95% CI -0.73, 1.46), arm 3 (coef 0.14, 95% CI -0.99, 1.26) or arm 4 (coef 0.58, 95% CI -.37, 1.52). There was increased positive RH attitudes for girls in arm 3 (DID coef. 0.63, 95% CI 0.40, 0.86) and arm 4 (DID coef. 0.85, 95% CI 0.64, -1.07). There was also an increase in RH knowledge, gender norms and self-efficacy in arms 3 and 4.Conclusions: The findings suggest that neither sanitary pad distribution nor RH education, on their own or together, were sufficient to improve primary school attendance. However, as the RH education intervention improved RH outcomes, the evidence suggests that sanitary pad distribution and RH education can be positioned in broader RH programming for girls. Trial Registration: ISRCTN, ISRCTN10894523. Registered 22 August 2017 - Retrospectively registered, http://www.isrctn.com/ISRCTN10894523

scholarly journals School-Based Sexual and Reproductive Health Services for Prevention of Adolescent Pregnancy in the Hoima District, Uganda: Cluster Randomized Controlled Trial

2019 ◽  
Vol 2 (1) ◽  
pp. 21
Author(s):  
Gloria Kirungi Kasozi ◽  
Julius Kasozi ◽  
Frank Pio Kiyingi ◽  
Miph Musoke
Keyword(s):  
Randomized Controlled Trial ◽  
Reproductive Health ◽  
Adolescent Pregnancy ◽  
Sexual And Reproductive Health ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cluster Randomized Controlled Trial ◽  
Randomized Controlled ◽  
School Based ◽  
Cluster Randomized

Uganda has persistently had high adolescent pregnancy prevalence; 25% for the last 10 years. This protocol presents the design of a Cluster Randomized Controlled Trial (CRCT) to investigate the effectiveness of School-Based Sexual and Reproductive Health (SBSRH) interventions on prevention of pregnancy among school girls aged 15–19 years in the Hoima District, Uganda. 18 secondary schools (clusters) will be selected using cluster sampling and allocated 1:1 into control or intervention group stratified by geographical location. 1080 (60 each cluster) participants/girls aged 15–19 years will be selected using simple random sampling. The intervention group will receive tailored SRH information, in-school medical care and referral over 12 months. The control group will receive no intervention from the research team; however, they can access alternative services elsewhere if they wish. Data will be obtained at baseline, 6 months and 12 months. The outcomes are reduction in occurrence of pregnancy, utilization of SRH services and sexual behavioral change. To our knowledge, this is the first CRCT providing combined SRH interventions for prevention of adolescent pregnancy in Uganda. If effective, it could have great potential in preventing adolescent pregnancy. Trial Registration: Pan African Clinical Trial Registry (PACTR201810882140200) Registered on 16 October 2018.

scholarly journals Effects of Sanitary Pad Distribution and Reproductive Health Education on Primary School Attendance and Reproductive Health Knowledge and Attitudes in Kenya: A Cluster Randomized Controlled Trial

2020 ◽  
Author(s):  
Karen Austrian ◽  
Beth Kangwana ◽  
Eunice Muthengi ◽  
Erica Soler-Hampejsek
Keyword(s):  
Reproductive Health ◽  
Primary School ◽  
Self Efficacy ◽  
School Engagement ◽  
Primary Schools ◽  
Health Knowledge ◽  
School Attendance ◽  
Gender Norms ◽  
Analysis Of Covariance ◽  
Knowledge And Attitudes

Abstract Background: Adolescent girls’ risk of school dropout and reproductive health (RH) challenges may be exacerbated by girls’ attitudes toward their bodies and inability to manage their menstruation. We assessed effects of sanitary pad distribution and RH education on girls in primary grade 7 in Kilifi, Kenya.Methods: 140 primary schools were randomly assigned to one of four study arms: 1) control; 2) sanitary pad distribution; 3) RH education; or 4) both sanitary pad distribution and RH education. Outcomes were school attendance, school engagement, RH knowledge and attitudes, gender norms, and self-efficacy. For outcomes measured both at baseline and endline, difference-in-differences (DID) models were estimated and for outcomes without baseline data available, analysis of covariance models were used. Results: There was no evidence of an effect on primary school attendance on arm 2 (coefficient [coef] 0.37, 95% CI -0.73, 1.46), arm 3 (coef 0.14, 95% CI -0.99, 1.26) or arm 4 (coef 0.58, 95% CI -.37, 1.52). There was increased positive RH attitudes for girls in arm 3 (DID coef. 0.63, 95% CI 0.40-0.86) and arm 4 (DID coef. 0.85, 95% CI 0.64, -1.07). There was also an increase in RH knowledge, gender norms and self-efficacy in arms 3 and 4.Conclusions: The findings suggest that neither sanitary pad distribution nor RH education, on their own or together, were sufficient to improve primary school attendance. However, as the RH education intervention improved RH outcomes, the evidence suggests that sanitary pad distribution and RH education can be positioned in broader RH programming for girls. Trial Registration: ISRCTN, ISRCTN10894523. Registered 22 August 2017 - Retrospectively registered, http://www.isrctn.com/ISRCTN10894523

scholarly journals Expression of Concern to: A protocol for a cluster-randomized controlled trial testing an empowerment intervention to prevent sexual assault in upper primary school adolescents in the informal settlements of Nairobi, Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Clea Sarnquist ◽  
Jennifer Lee Kang ◽  
Mary Amuyunzu-Nyamongo ◽  
Gabriel Oguda ◽  
Dorothy Otieno ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Sexual Assault ◽  
Primary School ◽  
Controlled Trial ◽  
Informal Settlements ◽  
Cluster Randomized Controlled Trial ◽  
Randomized Controlled ◽  
Trial Testing ◽  
Cluster Randomized

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