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Research and feasibility study to explore menstrual practices and investigate the suitability of menstrual cups for adolescent girls and women in Kenya, Menstrual Cup

KENYA, 2010
Health and Well-Being (HaW)
African Population and Health Research Center
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Identification

IDNO
APHRC-MENSTRUALCUP-2010-1.1
Title
Research and feasibility study to explore menstrual practices and investigate the suitability of menstrual cups for adolescent girls and women in Kenya, Menstrual Cup
Subtitle
Menstrual Cup
Translated Title
ENGLISH
Country
Name Country code
KENYA KEN
Abstract
Limited access to safe, affordable, convenient and culturally-appropriate methods for dealing with menstruation has far-reaching implications for the rights and physical, social and mental wellbeing of many women and adolescent girls in Kenya. It undermines sexual and reproductive health and wellbeing and has been shown to restrict girls' access to education. Menstrual cups, which are used successfully in Europe and North America may be an appropriate technology for many women and girls in Kenya but have not yet been piloted in an African setting. This scoping study on menstruation with adolescent girls and women in Kenya involves: 1) qualitative research to explore beliefs, attitudes, practices and problems associated with menstruation among women and girls in informal settlements and other urban areas of Nairobi; and 2) a pilot to assess the cultural, practical and health-related appropriateness and feasibility of menstrual cups in urban settings within Kenya and participants' opinions of menstrual cups and their comfort and convenience as a method of managing menstrual flow. The four-month pilot targeted 30 menstruating women aged 18 or over living in Korogocho informal settlement, Nairobi, 35 adolescent girls aged 15-17 who were attending a secondary school, and 10 students at a university in Nairobi. The study has increased knowledge on the under-recognised and under-researched area of menstrual beliefs, practices and problems in Kenya and provided data on the feasibility of an under-used technology.

Version

Version Notes
Version 1.1, November 2014. Anonymized with DOI and Recommended Citation added.

Scope

Keywords
Keyword
Sexual and Reproductive health

Coverage

Geographic Coverage
Site 1: Korogocho, an urban informal settlement in Nairobi

Site 2: A university/college in Nairobi

Site 3: A secondary school for adolescent girls in Nairobi
Unit of Analysis
Individuals
Universe
The study populations was as follows:

Adolescent girls and women aged between 12 and 24 in Site 1,

Women aged over 18 for Site 2 and

Adolescent girls aged 15-17 in Site 3.

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
African Population and Health Research Center APHRC
Producers
Name Affiliation Role
Dr Caroline Kabiru African Population and Health Research Center Co-investigator
Dr. Chi-Chi Undie African Population and Health Research Center Co-investigator
Dr. Eliya Zulu African Population and Health Research Center Co-investigator
Dr. Lucy Musyoka Division of Reproductive Health, Ministry of Public Health and Sanitation - Government of Kenya Co-investigator
Dr Josephine Kibaru Division of Reproductive Health, Ministry of Public Health and Sanitation - Government of Kenya Co-investigator
Joanna Crichton African Population and Health Research Center Co-investigator
Funding Agency/Sponsor
Name Abbreviation Role
Department of International Development, UK DFID Funder
Other Identifications/Acknowledgments
Name Affiliation Role
Participants to the study Korogocho, University and College in Nairobi Respondents
Government of Kenya GOK Partners

Sampling

Sampling Procedure
Individuals were identified using purposive quota sampling in phases. In phase 1 Adolescent girls and women aged between 12 and 24 in Site 1, women aged over 18 for Site 2 and adolescent girls aged 15-17 in Site 3. In phase 2 Women aged 18 and over in Sites 1 and 2, and girls aged 15-17 in Site 3. These participants were identified as volunteers from among the informants in the background research. In Site 2, 10 female students aged 18 and over attending college or university in Nairobi took part in the pilot.



As for qualitative a total of 20 In-depth interviews (IDIs) were done with adolescent girls and women aged 12 and over. Purposive quota sampling will be used to ensure that participants of a range of ages and educational status were selected for IDIs. In Site One (the informal settlement in Nairobi), 14 IDIs were done: 4 with in-school girls aged 12-14, 4 with out of school girls aged 12-14, 2 with out of school girls aged 15-17, 2 with women aged 18-29 and 2 with women aged 30 and over. In Site Two, 2 IDIs were held with students aged 18 and over. In Site Three (the secondary school), 4 IDIs were held with girls aged 15-17.
Response Rate
In total, 96 women were interviewed at baseline and 90 at endline for quantitative.

82 women interviewed at baseline and 39 at endline for qualitative
Weighting
No weights were used.

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date Cycle
2010-03-02 2010-09-16 Baseline
2010-08-02 2010-10-25 Endline
Mode of data collection
Face-to-face [f2f]; Indepth interview; FGD; KII
Type of Research Instrument
A structured interview :

This questionnaire was about background information on socio-economic, health and demographic status, access to clean water and sanitation facilities, the participant's menstrual beliefs and practices and their level of comfort and wellbeing relating to menstrual management practices. The questionnaire also included questions on reported symptoms of RTIs and STIs, and on the menstrual irregularities dysmenorrhoea, hypermenorrhoea (also known as menorrhagia), and hypomenorrhoea



In-depth interviews :

This questionnaire collected qualitative data on menstrual wellbeing and participant's experiences with and assessments of menstrual cups. The interview schedule also included a structured module to collect menstrual cup evaluation data, including i) consistency of use and discontinuation rates; ii) participant's rating of the comfort, convenience and acceptability of the product and its viability for the participant's living arrangements and level of access to facilities; and iii) perceptions of social acceptability.

Data Processing

Cleaning Operations
Data editing took place at a number of stages throughout the processing, including:

a) Office editing and coding

b) During data entry

c) Structure checking and completeness

d) Secondary editing
Other Processing
Quantitative Data entered from hard copies questionnaires

Qualitative data transcribed from dictaphones

Data access

Contact
Name Affiliation Email URI
African Population and Research Center APHRC info@aphrc.org www.aphrc.org
Conditions
All non-APHRC staff seeking to use data generated at the Center must obtain written approval to use the data from the Director of Research. This form is developed to assess applications for data use and facilitate responsible sharing of data with external partners/collaborators/researchers. By entering into this agreement, the undersigned agrees to use these data only for the purpose for which they were obtained (as outlined on this form) and to abide by the conditions outlined below:

1. Data Ownership: The data remain the property of APHRC; any unauthorized reproduction and sharing of the data is strictly prohibited. The user will, therefore, not release nor permit others to use or release the data to any other person without the written authorization from the Center.

2. Purpose: The provided data must be used for the purpose specified in the Data Request Form; any other use not specified in the form must receive additional or separate authorization.

3. Respondent Identifiers: The Center is committed to protecting the identity of the respondents who provide information in its research. All analytical data sets (both qualitative and quantitative) released by the Data Unit MUST are stripped of respondent identifiers to protect the identity of the respondents. By accepting to use APHRC data, the user is pledging that he/she will not, under any circumstance, regenerate the identifiers or permit others to use the data to learn the identity of any individual, household or community included in any data set.

4. Confidentiality pledge: The user will not use nor permit others to use the data to report any information in the data sets that could identify, directly or by inference, individuals or households.

5. Reporting of errors or inconsistencies: The user will promptly notify the Head of the Statistics and Survey Unit any errors discovered in the data as soon as the errors are discovered.

6. Publications resulting from APHRC data: The Center requires external collaborators to work with APHRC staff on all publications resulting from its data. In order to facilitate this, lead authors should send a detailed concept note of the paper (including the background, rationale, data, analytical methods, and preliminary findings) to the Principle Investigator (or Theme Leader) for the project (with a copy to the Director of Research), who will circulate the abstract to concerned researchers for possible expression of interest in participating in the publication as co-authors. Any exception to the involvement of APHRC staff should be approved by the Director of Research, APHRC.

7. Security: The user will take responsibility for the security of the data by ensuring that the data are used and stored in a secure environment where access is password protected. This will ensure that non-authorized people should not have access to the data.

8. Loss of privilege to use data: In the event that APHRC determines that the data user is in violation of the conditions for using the data, or if the user wishes to cancel this agreement, the user will destroy the data files provided to him/her. APHRC retains the right to revoke this agreement or informs publishers to withhold publication of any work based wholly or in part on its data if the conditions for using the data are violated.

9. Acknowledgement: Any work/reports from this data must acknowledge APHRC as the source of these data. For example, the suggested acknowledgement for NUHDSS data is:

“This research uses livelihoods data collected under the longitudinal Nairobi Urban Health and Demographic Surveillance System (NUHDSS) since 2006. The NUHDSS is carried out by the African Population and Health Research Center in two slums settlements (Korogocho and Viwandani) in Nairobi City.”

Additionally all funders, the study communities that provided the data, and staff who collected and analyzed or processed the data should be acknowledged.

10. Deposit of Reports/Papers: The user should submit electronic and paper copies of all publications generated using APHRC data to the Policy Engagement and Communications Department, with copies to the Director of Research.

11. Change of contact details: The user will promptly inform the Director of Research of any change in your personal details as contained on this data request form.
Citation requirement
African Population and Health Research Center, Research and feasibility study to explore menstrual practices and investigate the suitability of menstrual cups for adolescent girls and women in Kenya, October 2013. APHRC, Nairobi - Kenya. doi:11239/176-2010-004-1.1

Contacts

Contact
Name Affiliation Email
Head Statistics and Survey Unit APHRC datarequests@aphrc.org

Metadata production

Document ID
APHRC-MENSTRUALCUP-2010-1.1
Producers
Name Abbreviation Role
African Population and Health Research Center APHRC Meta data Producer
Date of Production
2013-10-08
Document version
Version 1.1