Background
Intervention Overview
Methods
Theoretical Approach
Study Design & Setting
Sampling Frame and Participants
Data Collection
Variables
Independent variables # of sub-measures | Sub-Scales | # of questions in Sub-scale | Range of Sub-Scale | Final labels |
---|---|---|---|---|
Knowledge [3] | Knowledge about puberty | 2 | 0-13 | Low: 0-4 |
Medium: 5 - 8 | ||||
High: 9 - 13 | ||||
Knowledge about reproductive organs | 6 | 0-12 | Low: 0 | |
Medium: 1- 11 | ||||
High: 12 | ||||
Knowledge about absorbent use | 10 | 4-18 | Low: 0 - 8 | |
Medium: 9 - 13 | ||||
High: 14 - 18 | ||||
Attitudes [4] | Attitudes towards menstruation | 6 | 0-24 | Negative: 0 – 12 |
Neutral: 13 – 15 | ||||
Positive: 16 - 24 | ||||
Attitudes towards absorbent use | 10 | 0-40 | Negative: 0 – 21 | |
Neutral: 22 – 28 | ||||
Positive: 29 - 40 | ||||
Attitudes towards restrictions | 4 | 0-20 | Negative: 0 – 7 | |
Neutral: 8 – 11 | ||||
Positive: 12 - 20 | ||||
Attitudes towards gender | 5 | 0-20 | Negative: 0 – 11 | |
Neutral: 12 – 15 | ||||
Positive: 16 - 20 | ||||
Interpersonal Communication [1] | 9 | 1-18 | 0: No discussion | |
1 – 17: Some discussion/ dialogue | ||||
18: All discussion | ||||
Restrictions [7] | Clothing | 6 | 0-6 | 0: Present |
1: Not present | ||||
Food | 6 | 0-6 | 0 : Present | |
1: Not present | ||||
Mobility | 5 | 0-5 | 0:Present | |
1: Not present | ||||
Social/Religious | 4 | 0-4 | 0: Present | |
1: Not present | ||||
Personal | 21 | 0-12 | 0: Present | |
1: Not present | ||||
Social | 21 | 0-11 | 0: Present | |
1: Not present | ||||
Structural | 21 | 0-7 | 0: Present | |
1: Not present |
Sample Size Calculation
Analysis
Results
N | Encoded Exposure | ||||||
---|---|---|---|---|---|---|---|
Overall | None | Low | Medium | High |
p-value
| ||
2206 | 1074 | 352 | 477 | 303 | |||
District |
Jaunpur
| 36.76% | 35.75% | 36.93% | 37.53% | 38.94% | 0.002 |
Sonebhadra
| 29.74% | 30.82% | 34.09% | 30.40% | 19.80% | ||
Mirzapur
| 33.50% | 33.43% | 28.98% | 32.08% | 41.25% | ||
Religion |
Non-Hindu
| 2.95% | 2.61% | 2.27% | 2.31% | 5.94% | 0.01 |
Hindu
| 97.05% | 97.39% | 97.73% | 97.69% | 94.06% | ||
Caste |
General Caste
| 9.38% | 8.66% | 9.66% | 8.81% | 12.54% | 0.02 |
Scheduled Caste
| 50.54% | 47.77% | 53.98% | 54.93% | 49.50% | ||
Other Backward Caste
| 40.07% | 43.58% | 36.36% | 36.27% | 37.95% | ||
Age (years) | 16.24 | 16.25 | 16.15 | 16.22 | 16.34 | 0.58 | |
Education (grade) | 9.13 | 9.42 | 9.25 | 10.0 | 9.85 | 0.25 | |
Type of house |
Kutcha
| 47.05% | 42.74% | 54.26% | 53.25% | 44.22% | <0.01 |
Semi-pucca
| 24.52% | 25.70% | 21.02% | 23.06% | 26.73% | ||
Pucca
| 28.42% | 31.56% | 24.72% | 23.69% | 29.04% | ||
Marital Status |
Married
| 0.86% | 0.74% | 1.14% | 1.05% | 0.66% | 0.86 |
Unmarried
| 98.87% | 98.88% | 98.58% | 98.95% | 99.01% | ||
Other
| 0.27% | 0.37% | 0.28% | 0% | 0.33% | ||
Duration since menarche |
< 1 year
| 13.65% | 13.57% | 14.45% | 12.34% | 15.10% | 0.70 |
≥1 year | 86.35% | 86.43% | 85.55% | 87.66% | 84.90% | ||
Preparation of clean absorbent |
Inadequate (inad)
| 52.18% | 59.12% | 51.42% | 43.82% | 41.58% | < 0.01 |
Semi-adequate (semiad)
| 24.43% | 18.99% | 23.86% | 32.49% | 31.68% | ||
Adequate (ad)
| 23.39% | 21.88% | 24.72% | 23.69% | 26.73% | ||
Storage of clean absorbent |
inad
| 22.71% | 30.54% | 14.77% | 16.77% | 13.53% | <0.01 |
semiad
| 16.77% | 19.37% | 15.06% | 14.05% | 13.86% | ||
ad
| 60.52% | 50.09% | 70.17% | 69.18% | 72.61% | ||
Frequency of changing |
inad
| 36.17% | 52.42% | 26.70% | 15.30% | 22.44% | <0.01 |
ad
| 63.83% | 47.58% | 73.30% | 84.70% | 77.56% | ||
Disposal |
inad
| 34.72% | 44.23% | 28.41% | 24.74% | 24.09% | <0.01 |
semiad
| 24.75% | 24.12% | 24.43% | 25.58% | 26.07% | ||
ad
| 40.53% | 31.66% | 47.16% | 49.69% | 49.83% | ||
Hygiene |
inad
| 36.40% | 42.55% | 31.25% | 28.51% | 33.0% | <0.01 |
semiad
| 15.87% | 15.08% | 19.32% | 17.40% | 12.21% | ||
ad
| 47.74% | 42.36% | 49.43% | 54.09% | 54.79% |
Relationship between Encoded Exposure and Mediators
Characteristics | High encoded exposure AOR (95% CI) |
---|---|
Knowledge about puberty | |
Low | 1.0 |
Medium | 1.49 (1.12 – 1.99)** |
High | 2.97 (1.89 – 4.65)*** |
Knowledge about reproductive parts | |
Low | 1.0 |
Medium | 1.87 (1.36 – 2.57)*** |
High | 2.04 (1.32 – 3.17)** |
Attitudes towards gender | |
Negative | 1.0 |
Neutral | 1.10 (0.77 – 1.58) |
Positive | 1.47 (1.01 – 2.14)* |
Interpersonal communication | |
No discussion | 1.0 |
Some discussion and dialogue | 1.40 (1.03 – 1.90)* |
All dialogue | 0.93 (0.55 – 1.57) |
Random effects | |
District (var) | 1.75 e-33 |
District>Block (var) | 32.10 (14.17 – 72.66) |
District>Block>Village (var) | 0.87 (0.54 – 1.42)*** |
Relationship between Encoded Exposure, Mediators and MHHM Behaviors
Characteristics | Adequate preparation of clean absorbent AOR (95% CI) | Adequate storage of clean absorbent AOR (95% CI) | Adequate frequency of changing AOR (95% CI) | Adequate disposal AOR (95% CI) | Adequate hygiene AOR (95% CI) |
---|---|---|---|---|---|
Encoded Exposure | |||||
None | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Low | 1.23 (0.92 – 1.66) | 2.14 (1.50 – 3.05)*** | 2.64 (1.71 – 4.07)*** | 1.73 (1.22 – 2.43)** | 1.67 (1.16 – 2.39)** |
Medium | 1.38 (1.04 – 1.84)* | 1.91 (1.35 – 2.70)*** | 4.87 (3.10 – 7.63)*** | 1.79 (1.28 – 2.50)** | 1.78 (1.25 – 2.55)** |
High | 1.36 (0.98 – 1.88) | 2.10 (1.42 – 3.12)*** | 2.52 (1.57 – 4.04)*** | 1.93 (1.33 – 2.80)** | 1.41 (0.95 – 2.10) |
Knowledge about puberty | |||||
Low | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Medium | 1.14 (0.92 – 1.42) | 0.78 (0.62 – 0.98)* | 1.25 (0.96 – 1.61) | 0.88 (0.71 – 1.09) | 1.14 (0.91 – 1.43) |
High | 1.17 (0.81 – 1.70) | 1.08 (0.70 – 1.66) | 2.21 (1.30 – 3.76)** | 0.78 (0.54 – 1.13) | 1.31 (0.87 – 1.96) |
Knowledge about reproductive parts | |||||
Low | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Medium | 0.89 (0.71 – 1.10) | 1.25 (1.0004 – 1.56)* | 1.18 (0.92 – 1.51) | 1.50 (1.21 – 1.85)*** | 1.02 (0.82 – 1.27) |
High | 0.92 (0.66 – 1.28) | 1.87 (1.29 – 2.71)** | 0.95 (0.61 – 1.47) | 1.56 (1.12 – 2.18)* | 1.46 (1.01 – 2.12)* |
Attitudes towards gender | |||||
Negative | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Neutral | 1.40 (1.08 – 1.80)** | 1.17 (0.91 – 1.51) | 0.85 (0.64 – 1.14) | 1.12 (0.88 – 1.43) | 0.88 (0.69 – 1.14) |
Positive | 1.57 (1.21 – 2.05)*** | 1.61 (1.22 – 2.12)*** | 0.94 (0.69 – 1.28) | 1.00 (0.78 – 1.29) | 1.02 (0.78 – 1.33) |
Interpersonal communication | |||||
No discussion | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Some discussion and dialogue | 1.09 (0.88 – 1.35) | 1.42 (1.14 – 1.77)** | 1.31 (1.03 – 1.67)* | 1.38 (1.12 – 1.70)** | 1.39 (1.12 – 1.72)** |
All dialogue | 1.28 (0.89 – 1.84) | 0.95 (0.67 – 1.35) | 0.91 (0.59 – 1.40) | 0.89 (0.63 – 1.26) | 1.87 (1.26 – 2.77)** |
Random Effects | |||||
District (var) | 0.0072 (0.00016 – 0.32) | 1.02 e -36 | 0.23 (0.06 – 0.84) | 0.05 (0.005 – 0.40) | 3.36 e -34 |
District>Block (var) | 8.38 e -33 | 0.038 (0.007 – 0.21) | 0.28 (0.14 – 0.56) | 0.04 (0.005 – 0.29) | 0.04 (0.0027 – 0.55) |
District>Block>Village (var) | 0.26 (0.15 – 0.44)*** | 0.20 (0.10 – 0.42)*** | 0.56 (0.40 – 0.79)*** | 0.24 (0.13 – 0.43)*** | 0.38 (0.23 – 0.62)*** |