The Impact of Menstrual Hygiene Management and Gender on Psychosocial Outcomes for Adolescent Girls in Kenya
This research measures the psychosocial impact of a Menstrual Hygiene Management (MHM) program in Kenya by assessing change in self-efficacy, authenticity, and hope in adolescent girls. Trained researchers administered baseline and end-line assessments, 16 weeks apart, to 311 participants in the Always Keeping Girls in School Program. The schools were assigned to one of three program versions: only period products, only menstrual health education, or both menstrual health education and period products; in all-girls or coed classes. When girls received MHM education and pads in coed classes, there was no change in their self-efficacy or hope scores, but in all-girls classes, self-efficacy and hope scores significantly increased. Authenticity in girls decreased in coed classes unless period products were distributed, and then girl’s authenticity scores increased. The role of gender in assessing change in self-efficacy, authenticity and hope has provided a useful frame for evaluating MHM programming. The data set includes Time 1 and Time 2 data on all key variables.
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Participants This study had a pre and post-test design that compared 6 cohort groups of girls from Nairobi and Kiambu Counties, Kenya. Across the schools there was a total of 6,442 pupils, of whom 3,284 (51%) were boys and 3,158 (49%) were girls. There were 311 girls in the final participant pool. Some classes were co-ed and others were girls only. Participants were 13-14 years of age, and given baseline self-efficacy, authenticity, and hope assessments and post program assessments following the completion of the Always Keeping Girls in School program after a 4-month period. The no intervention group received neither products nor education. The schools were similar in socioeconomic status, general geographic location, and curricula. All schools were public, mixed-gender day schools, but some schools segregated girls for the educational component of the AKGIS curriculum. All participants were Kenyan whose primary language was Kiswahili or Swahili and secondary language was English. The study was conducted in English. Trained researchers who knew both languages were present to assist with any translation issues, which were minimal. The research protocol went through rigorous IRB review at William James College (protocol # 20180117). The Ministry of Education in Kenya as well as the school districts also reviewed and approved the program. Precautions were taken to protect participants by removing identifying data and protecting confidentiality. Parents were informed about the curriculum and routine measures at the beginning of the school year as part of the enrollment process, and they agreed to have their children participate. Children were given the opportunity to give their assent and were free to decline without consequence. The study protocol was reviewed by the local school sub-county. All data gatherers were certified by the Collaborative Institutional Training Initiative (CITI). The design for this research was a pre and post-test study that compared 6 cohort groups of girls from Nairobi and Kiambu Counties, Kenya. There were 311 girls in the participant pool assigned to one of six cohort conditions (see Figure 1). All participants were between 13-14 years of age and given baseline and post intervention assessments on measures of self-efficacy, authenticity, and hope. Study participants came from schools previously identified by the AKGIS program and a local NGO partner, in collaboration with the Kenyan Ministry of Education, Science and Technology. Measures The Generalized Self-Efficacy Scale (Schwarzer & Jerusalem, 1995) is a self-report unidimensional measure of self-efficacy with a Cronbach’s alpha internal reliability between .76 and .90. The Authenticity Scale (Wood et al., 2008) was chosen to measure authenticity in girls. The Child Hope Scale (Snyder et al., 1997) provides a culturally sensitive and validated scale from which to assess hope in girls.