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<p>This mixed-method cross-sectional study evaluated the effect of commercial sanitary
pads on school attendance and symptoms of vaginal infections in rural Kenyan adolescents
aged 11-18. It also provides contextual information that situates the data gathered
on school attendance and vaginal infections in the broader experience of girls managing
their menstruation. A sequential design was used for this study with a total of 8
qualitative focus groups and a quantitative survey. A total of 482 girls were surveyed,
with 321 who were currently attending school and 151 who had dropped out of school.
Qualitative data from focus groups was analyzed using applied thematic analysis, while
the effect of commercial sanitary pads as well as the effect of using other items
on school attendance and symptoms of vaginal infections was estimated using logistic
regression analysis. Overall, girls reported that menstruation negatively affects
their experience at school and in the classroom and causes an array of negative emotions.
Girls also conveyed having to often leave school to change or bathe due to menstrual
leaks and missing class lessons as a result. Poor concentration in class attributed
to menstrual pain and worry over potential leaks was also mentioned. Lastly, the practice
of transactional sex to obtain money to purchase pads was a theme within the data.
It was found through the quantitative data that the prevalence odds of missing one
or more days of school over a two-month period when using commercial sanitary pads
is 1.6 times as high as the odds of missing one or more days of school over a two-month
period when using other items (p = 0.02, 95% C.I. = 1.03-2.07). There was no statistically
significant difference found in the number of school days missed when comparing those
who used reusable pads, many underwear, homemade items, and nothing each to those
using commercial sanitary pads. The overall prevalence of symptoms of vaginal infections
among all girls in this study was found to be 9.4%. There is no statistically significant
difference between the odds of having symptoms of a vaginal infection when using commercial
sanitary pads as compared to using any other item to control menstruation.</p>
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